Transforming Healthcare through Research, Innovation, and Value Engineering (THRIVE): A Framework for Sustainable Health Solutions in LMICs

Congratulations to UCD School of Medicine’s Visiting Associate Professors John O’Donohue and Balwani Mbakaya, as well as Sunali Bandara and Dr Joe Gallagher, and all those involved, on their open letter preprint. This letter introduces the THRIVE framework - a structured, holistic approach to designing and deploying digital health and ICT infrastructure in low- and middle-income countries (LMICs).

In this open letter, the team dive into the essential building blocks (governance models, integration pathways, interoperable standards, value engineering, feedback loops, AI governance) needed to ensure that digital health systems aren’t just innovative, but sustainable, equitable, and resilient.

Lessons have been learned from both successes and failures in ICT rollouts, including challenges around adoption, scalability, maintenance, and alignment with host national and International policies. THRIVE has the potential to become a reference point for governments, NGOs, development agencies, and academia as they co-create solutions that last, not just quick pilot wins, but durable transformation in health systems.

Abstract

Despite significant investments by governments in low- and middle-income countries (LMICs), achieving long-term, sustainable digital health solutions remains a persistent challenge. Ministries of health allocate considerable resources to research, digital technologies, and health information systems, yet many initiatives are short-lived or fragmented, lacking the systemic integration needed for enduring impact. Sustainable digital health solutions require more than financial investment; they demand a strategic combination of research initiatives, policy development, and effective use of technology. Initiatives such as the WHO Strategic Partners Initiative for Data and Digital Health (SPI-DDH) demonstrate how coordinated global efforts can enhance data interoperability, stimulate innovation, and guide policy formation. However, these benefits can only be realised through a dedicated infrastructure that supports the continuous cycle (feedback loop) of innovation, evaluation, and implementation. This article introduces the Transforming Healthcare through Research, Innovation, and Value Engineering (THRIVE) Framework, a comprehensive, research-driven approach designed to build a sustainable health system infrastructure.

Read online (opens in a new window)here.