Potential of Digital Health Solutions in Facing Shifting Disease Burden and Double Burden in Low- and Middle-Income Countries
Authors: Vu Hanh , François Kishore Kumar , Hung Nguyen Xuan , Trung Nguyen Vu , Hieu Nguyen Lan 
Published: August 2024

The changes in global health have fueled the concept of disease burden, and the process of how a shifting disease burden leads to a double burden has been observed in low-income countries (LIC) and lower-middle-income countries (LMIC) for the last few decades, replicating a trend experienced by high-income countries (HIC) in the previous century. Adding to the burden of communicable, maternal, neonatal, and nutritional diseases, non-communicable diseases (NCD) are becoming more prevalent due to socio-economic development that changes lifestyles in an aging population resulting in significant increases in life expectancy. The shifting disease burden drives healthcare systems to change accordingly to provide an adequate response. In the meantime, unsolved problems of inequality, shortage of medical personnel, and high prevalence of infectious diseases remain significant, putting massive pressure on the limited resources of healthcare systems in LICs and LMICs.

This is where digital health brings its promising potential, firstly to better understand the disease burden itself for an accurate conception of the health risks for the population, secondly to develop new solutions that will improve the efficiency of the current healthcare ecosystem, alleviating constraints and overcoming the lack of resources, and finally to provide better health outcomes for individuals as a customer-centric solution. Applications like health information technology (health IT) with electronic health records (EHR) offer an inclusive perspective on a patient’s total health and access to all healthcare providers, insurers, and other healthcare stakeholders. Mobile applications and wearables empower and engage patients in self-care management while real-time monitoring, collection, and exchange of their health status provide a continuous image of their health. Such solutions used together can build a strong history of a patient’s health status, and the data can then be used in conjunction with other data, such as genomics, etc., for early detection of many kinds of diseases, providing space and time for rapid treatment through personalized and precise medicine that works better for each individual, going towards more preventive care and wellbeing, which is particularly effective in managing NCDs. On the other hand, telehealth, using digital information and communication technologies, has already proven its usefulness in dealing with communicable diseases, as recently seen during the COVID-19 pandemic, while improving healthcare access and cost for rural, remote, and marginalized communities. The applications vary and are constantly updated as new technologies emerge, with numerous interrelated factors driving the changes.

This chapter studies LMICs in particular as they are the most strained and impacted by the double burden and provide us with insights into the challenges and the opportunities that emerge with digital health solutions as contenders. Amongst LMICs, Vietnam is an interesting case due to its rapid socio-economic growth that brings homegrown solutions to the local and foreign markets, while facing important health and inequality issues. As such, in dealing with the double burden and particularly for LMICs, digital health promises to be the answer for gaining equitable and universal access to high-quality healthcare that is both cost-effective and affordable. In highlighting this, indicative examples will be presented to illustrate the point.