DHIRT: How Donors Will Evaluate Your Digital Health Proposal

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It’s no secret that donors like USAID, DFID, and the Gates Foundation, and national governments struggle to evaluate digital health solutions embedded in program proposals and project workplans.
Technology innovations are often creative, complex, and cutting-edge, and don’t fit neatly into grant funding solicitations or requests for proposals (RFP) contract language. This results in two very important questions:

  • How can implementing partners show that their solutions will be effective, sustainable, and context-appropriate?
  • How can donors and governments properly evaluate digital health proposals to ensure the best value for money?

Digital Health Investment Review Tool
Introducing the Digital Health Investment Review Tool (DHIRT), which provides high-level guidance, printable and electronic handouts, and a list of resources to evaluate digital health solutions (download all four at once).

  • Donors can use DHIRT when creating requests for solicitations, defining contract language, and evaluating proposals for grant funding and software procurement.
  • Implementers can use DHIRT to respond to RFPs, design their activities, and implement their technology solution with digital health best practices.

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DHIRT evolved from a three-plus year iterative process with USAID, DIAL, and the global digital health community to break down two sets of Principles into a set of scoring criteria for strategic investments in global digital health:

DHIRT requires little to no digital health technical expertise to use, making it accessible to non-techies in national governments, foundations, and humanitarian organizations involved with creating solicitations, writing proposals, evaluating solutions, and making purchasing decisions for digital health systems.
12 Digital Health Proposal Evaluation Criteria
The Digital Health Investment Review Tool explores 12 evaluation criteria for digital health solutions to convey the need for the element and explain the ramifications of its relative maturity on the solution’s potential for success. The 12 evaluation criteria are:

  1. Policy Landscape
  2. Health Information System Ecosystem
  3. Key Stakeholders
  4. System Users
  5. Relevant Groups
  6. Scale
  7. Cost of Ownership
  8. Monitoring, Evaluation, and Learning Plan
  9. Open Source vs. Proprietary License
  10. Privacy and Security
  11. Reuse and Improve
  12. Change Management

Each evaluation criteria is scored on a 1-5 scale to denote the relative maturity of that criteria, and the individual values can be added together to create an overall ranking of a digital health solution.

  • Level 1: None or Nascent – No capability is evident or processes are not systematically followed.
  • Level 2: Emerging – Processes and structures are defined but not systematically documented.
  • Level 3: Established – Processes and systems are documented and functional.
  • Level 4: Institutionalized – Ongoing systems and standard practices are used to monitor activities and measure progress.
  • Level 5: Optimized – Routine monitoring, reviewing, and updating of processes to measure progress is in place.

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