SMART Guidelines -- Digital Adaptation Kits: Implementation research and technical support

Overview

Evidence-based guidelines, such as those published by WHO, offer a validated starting point for informing the content of digital systems, but they are often in narrative format and not readily able to be digitized (1,2). Digital adaptation kits (DAKs) are software-neutral, operational, and structured documentation based on WHO clinical, health system and data use recommendations to systematically inform the design of digital systems. DAKs include the package of business process workflows, core data needs, decision support algorithms, linkages to indicators, and functional requirements for a health domain area, which can then be incorporated more easily in a digital system. In creating these operational tools derived from WHO guidelines, the DAKs provide a unique way to reinforce recommendations and ensure adherence to clinical guidelines and standards within digital systems for improved service delivery. WHO HRP has published DAKS for antenatal care, family planning, and incorporated considerations related to self-care interventions, intimate partner violence, and adolescent SRH; following these initial examples, DAKs are being expanded to additional health domains such as STI,HIV, child health, immunization, and self-care interventions.

As a next step, HRP is conducting a multi-country (Ethiopia, Namibia, and Ghana) implementation research aimed at validating processes for adapting and incorporating the DAKs into countries’ existing digital systems for strengthening primary care and routine health information systems. In addition to the implementation research, WHO HRP will continue to provide technical support for the mainstreaming and effective use of the DAKs to countries outside the scope of the implementation research. 

(1) Tamrat T, Ratanaprayul N, Barreix M, Tunçalp Ö, Lowrance D, Thompson J, Rosenblum L, Kidula N, Chahar R, Gaffield ME, Festin M. Transitioning to Digital Systems: The Role of World Health Organization’s Digital Adaptation Kits in Operationalizing Recommendations and Interoperability Standards. Global Health: Science and Practice. 2022 Feb 11.

(2)Mehl G, Tunçalp Ö, Ratanaprayul N, Tamrat T, Barreix M, Lowrance D, Bartolomeos K, Say L, Kostanjsek N, Jakob R, Grove J. WHO SMART guidelines: optimising country-level use of guideline recommendations in the digital age. The Lancet Digital Health. 2021 Apr 1;3(4):e213-6.