The COVID-19 pandemic fast-tracked innovations in digital health in high-resource settings. However, the application of these technologies in low- and middle-income countries and humanitarian contexts is lagging — despite growing unmet health needs in these settings.

The MSF Sweden Innovation Unit (SIU) team believes that MSF has both an immense opportunity to improve health access and quality of care through patient centered digital health interventions and a responsibility to support the development of integrated, evidence-based digital health solutions in humanitarian settings.

Before we dive deeper, let’s go back to the basics — what is digital health?

Digital health is a broad multidisciplinary field which includes new ways of working at the intersection of technology and healthcare. Under its umbrella, digital health includes an ecosystem of telemedicine tools, health information technologies, and patient support apps for behavior change/digital therapeutics (DTx).

Digital health interventions are not a replacement of existing health systems, but they can enhance healthcare services and be one component in a multipronged approach to address issues related to lack of access to essential healthcare.

In this article, we take a closer look at five digital health interventions deployed across MSF.

5 Digital Health Interventions Deployed Across MSF

1. Digital Therapeutics for MDR-TB

One digital health solution by the MSF Sweden Innovation Unit (SIU) is the Digital Therapeutic for multi-drug resistant tuberculosis (MDR-TB) application DOST (short for Digitally Supported Treatment). Launched in 2019, this tuberculosis Digital Therapeutic (DTx) is a result of a collaboration between the MSF Sweden Innovation Unit, MSF India and MSF Operational Center Brussels (OCB).

The DOST app supports patients being treated for MDR-TB to improve treatment literacy, medication adherence and access to counselling, and is currently piloted in Mumbai, India’s most populous city, where MDR-TB is a significant problem. The app is purposefully designed to aid recently-diagnosed MDR-TB patients during the initial phase of their treatment.

From November 2021 to January 2022 the DOST app was provided to 28 TB patients in Mumbai, as a part of the project team’s initial feasibility assessment. This assessment is now being used to inform the upcoming expansion of the platform through delivery to a larger number of patients.

2. Digital Therapeutics for Diabetes

It is currently estimated that 80 per cent of annual mortality related to non-communicable diseases (NCDs) occurs in low- and middle-income countries, according to the WHO. One of the determinants of poor outcomes for patients with diabetes (Type 1 and Type 2) is low adherence to medication, hence there is a clear need in many settings where MSF works for scalable solutions that can support NCD patients through their treatment journey.

The Digital Therapeutic (DTx) for Diabetes case, initially launched by the SIU in 2021, aims to both deliver a patient support intervention and improve MSF’s understanding of how DTx may supplement our current practices. The smartphone app is currently being developed and will be piloted for patients undergoing treatment in MSF clinics in the Bekka Region, Lebanon, in 2023. The application will offer patient education videos, medication adherence support, and counselling services.

Learn more about the DTx for Diabetes case here.

3. Antibiogo

Antimicrobial resistance (AMR) is a major threat to public health, with an estimated 1,27 million deaths directly caused by AMR in 2019. Antibiogo is an open-source diagnostic application to counter AMR. In May this year, the Antibiogo smartphone app became the first CE-marked medical product developed by MSF.

Antibiogo enables non-expert laboratory technicians to measure and interpret antibiograms, the tests used to determine if bacteria will respond to particular antibiotics. Antibiogram tests are essential as they help doctors prescribe the most effective antibiotics. These tests are usually interpreted by highly trained microbiologists. However, in low- and middle-income countries that do not have the equipment necessary to carry out antibiograms or enough clinical microbiologists to interpret them, the identification of antibiotic resistance is much more complicated or even impossible, creating more opportunities for individual and community resistance to form.

Antibiogo is based on image processing, artificial intelligence (AI) technology and an existing expert system. This innovative diagnostic tool, developed and tested by the MSF Foundation, will eventually be available in the form of a free, offline and downloadable application, and offers considerable hope for slowing down antibiotic resistance.

For more information about Antibiogo, check out the Antibiogo case page on the MSF Foundation’s website.

4. COVID Challenge App

Gamification is all about using game elements in non-game contexts. It can be applied in digital health solutions to improve user engagement and motivation – one example of this is the MSF COVID Challenge app, an interactive quiz app, developed by MSF Operational Center Geneva (OCG) in collaboration with Pixel Impact.

The COVID Challenge app was first launched in September 2020 to counteract misinformation around COVID-19 and teach users how to protect themselves from the disease. Users of the app are presented with questions related to the novel coronavirus and response alternatives accompanied by colorful illustrations.

Since the launce, the app has been translated into several languages and it is now available in English, Spanish, French, Arabic and Ukrainian. Staying close to the users and responding to a very real need to debunk harmful myths, a series of questions about COVID-19 vaccinations was added to the app in 2021.

The COVID Challenge app is available on both Android and iOS. Its concept comes from the Champions against Ebola app, a quiz challenge game developed by MSF in 2019 during the Ebola outbreak in the Democratic Republic of Congo.

5. The Telehealth Toolkit

Telehealth encapsulates a broad range of technology-enabled health interactions, both clinical and non-clinical, and is being increasingly recognized as an effective support method to help expand access to healthcare and dissemination of health information.

The Telehealth Toolkit aims to support MSF field teams in better implementing and evaluating telehealth interventions, such as Telehealth Hotlines and Call Centers, with a special focus on MSF operations in response to the primary and secondary implications of COVID-19. The main body of the MSF Telehealth Toolkit is based around three main components: pre-launch planning, implementation, and evaluation.

The toolkit was launched in 2020 as a collaborative effort between the MSF Sweden Innovation Unit (SIU), MSF Operational Center Geneva (OCG) and MSF Telemedicine Unit Canada. The Toolkit is currently being adapted to a digital platform to allow teams across the movement to streamline their coordination and planning when approaching a telehealth implementation and share learnings across the MSF movement.

Learn more about the Telehealth Toolkit in this blog post on our site.

5 Digital Health Interventions by MSF