SD.20.018 – Digital health support to chronic disease care in low resource settings

Route: Sustainable development goals for inclusive global development

Cluster question: 094 How do we improve the quality of health care as much as possible while keeping it affordable?

Healthcare is worldwide under great pressure. Globally, the burden of non-communicable diseases is largest in low- and middle-income countries undergoing rapid societal, environmental and health transitions fuelled by life-style changes related to urbanisation and globalisation of commodities to the extent where it is challenging communicable diseases as the major cause of death in these countries. Co-existence of chronic diseases, many of which share mutual risk factors, is increasingly common and compounded by inequities intensifying the already existing health disparities between high and low- and middle-income countries (LMIC). Political, societal and donor funding related pressure have directed health care systems in LMIC to deliver HIV care efficiently. HIV programs, with hard international norms in terms of targets, have demonstrated successful case finding, linkage to care and retention on treatment, with excellent adherence due to patient buy-in around treatment processes and resources invested in communication. No other chronic disease has had this success in these countries, with many diagnosed late, once complications have developed, and under-treatment and loss to follow-up commonplace.
Building on the lessons learned from HIV programs in South Africa, the implementation science research will evaluate digital health supported patient management to address co-morbidity of chronic diseases, such as obesity, hypertension, diabetes, mental health and HIV in a LMIC setting, for better health outcomes, quality of life and health care system efficiency. The Exploration, Preparation, Implementation, Sustainment (EPIS) framework will guide the development, application, and integration of digital health support to patients and health care professionals in routine chronic disease care in SA, and the evaluation of cost-efficiency, sustainability and potential for scale-up and applicability to other LMIC settings with the aim to contribute towards achievement of Sustainable Development Goal 3.


diabetes, digital health, health economics, health equity, health systems, HIV, hypertension, integrated chronic care, low- and middle-income countries, mental health, multimorbidity, sustainable development goals

Other organisations

University of the Witwatersrand (South Africa), Utrecht University (UU)


Organisation Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (UMCU)
Name Dr. K. (Kerstin) Klipstein-Grobusch