Knowledge is power and the future will belong to those who collect and use data wisely to drive decision-making.

The advances in technology and proliferation of smart devices in healthcare mean that the volumes of data being collected have grown in magnitude. The challenge is to collate all this data from the field, analyse it sensibly and take decisions based on the story being told.

Health systems now have the opportunity to be learning systems if they act on local data and adapt based on locally-identified needs and challenges. For instance, the State-level disease burden estimates produced by the Indian Council of Medical Research, the Institute for Health Metrics and the Public Health Foundation of India (2017) demonstrated the wide variability in causes of death and disability between States.

While southern States like Kerala and Tamil Nadu experienced an epidemiological transition (from more of communicable to non-communicable diseases) in the late 1980s, the central and northern States took another 20 years. Today, while some districts in India enjoy health parameters similar to Western Europe, others are more like sub-Saharan Africa.

Real-time data from health facilities, including complete and high-quality records on the causes of death, is critical for health policy planning and allocation of resources. A special drive is needed to ensure complete birth and death registration. In the absence of real data, one is forced to use modeling and other methods of estimation, which have their own limitations.

The national family health survey done once every five years is a useful source of information on many health parameters, but such a massive exercise cannot be repeated too often.

Data from other sectors is also critical for health. The percentage of land under green cover, levels of air pollution, water quality and the diversity of diets — all have important effects on individual and community health. As India urbanises, it will be important to ensure the availability of open spaces, as well as bicycle lanes and pedestrian zones in order to encourage walking and cycling. This will have benefits for individual health by reducing obesity and non-communicable diseases, as well as population health by minimising vehicular pollution and fossil fuel use, which contribute to climate change.

How data drives action

The reason for recent public awareness and demand for action on air pollution is a consequence of the wider availability of air quality data, proving, again, that data can drive action. It can also inform health literacy campaigns, as one can focus on reducing the risk factors that are most common in that population.

India has demonstrated strong leadership in health information systems and digital health. At the World Health Assembly in May 2018, India introduced the digital health resolution, which was unanimously adopted by Member States. The need for countries to have a clearly articulated digital health strategy is because the field is growing rapidly, and while technological solutions are plenty, their applications for public health are limited.

Proprietary software use results in systems that lack interoperability and results in complexity of data pooling for analyses, apart from being expensive to procure and maintain. Issues of data privacy and access, interoperability, cyber security, standards, cost-effectiveness and impact on health outcomes — all need attention.

The potential applications of artificial intelligence in health are expanding rapidly, but a global system for validation and benchmarking is missing. AI can, if used appropriately, reduce the workload of doctors and other healthcare personnel, improve accuracy of diagnosis, screen for diseases in the community and help choose treatment options for complex conditions.

The World Health Organization and the Health Ministry have been jointly working on designing the Integrated Health Information Platform, a comprehensive information system to monitor data being collected at health facilities and laboratories across the country. It will help in the early detection of emerging public health threats (currently being deployed at the Kumbh Mela), and can be used to monitor health events during disasters and mass gatherings.

This platform will allow public health officials to describe and analyse geographic variations in diseases and conduct public health surveillance in the context of One Health.

Bridging the digital divide will also help in reducing gender disparities and ensuring equitable distribution of resources. Sustainable development goals call for “leaving no one behind” and this can only be ensured when all data is examined through a gender and equity lens.

The writer is Deputy Director-General (Programmes) with the World Health Organization, Geneva. Views expressed are personal

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