The aim of this toolkit is to provide a systematic and structured approach to assessing the enabling environment for digital health.
To build on the growing momentum of scaled implementation of digital health tools, governments in LMICs require support to transition from an environment of isolated pilots and large-scale programs, to establishing national integrated digital health systems. This support includes assessing current environments, and using that context to develop pragmatic, evidence-based national strategies and frameworks that provide an overarching vision and rationale for digital health, in addition to establishing policies that enable investments in key foundational elements. The World Health Organization (WHO) and the International Telecommunications Union (ITU) have developed a toolkit to guide countries through the process of establishing a national digital health vision, action plan and monitoring framework. The seven core components of the framework are leadership and governance; strategy and investment; legislation, policy and compliance; standards and interoperability; workforce; infrastructure, and services and applications (See Table 1). Between 2012 and 2015, the Federal Ministry of Health (FMOH) and the Federal Ministry of Communication Technology (FMCT) in the Government of Nigeria (GoN), in collaboration with the United Nations Foundation (UN Foundation), with support from the Norwegian Agency for Development Cooperation (NORAD), used the WHO/ITU eHealth strategy toolkit to guide a three-phase assessment of the digital health environment. This process was designed to evaluate the current state of digital health in Nigeria, to ensure that the national digital health strategy built on existing efforts and was informed and grounded in sector realities.1 As part of this process, a set of assessment tools were developed and used to implement the various research phases. As more countries engage in the process of establishing, revising or revitalizing their national digital health strategies, these tools can be used and adapted to conduct baseline digital health assessments.