## 2.3 Usefulness to Whom? The Intended Audience

A fundamental aim of the framework is that it should be “useful” to those planning, conducting, and using economic evaluations of DHIs. There would be limited merit in attempting to develop methodology for only some stakeholders related to economic evaluation of DHIs as there needs to be a consistent understanding and representation through the chain of evidence generation and use.

As a World Bank product, the framework has an immediate intended use for country governments supported by World Bank country and global teams. The broader target audience however can be defined into three major groupings:

- Investor: aiming to invest in the highest value interventions

- Product developer: aiming to develop high-value interventions

- Researcher: aiming to analytically assess and represent value.

Investors are those who are determining whether to fund or reimburse a digital health intervention in a health system. This includes country governments, development partners, and private providers. This category also includes those supporting purchasing decisions in digital health, such as development partners providing technical assistance.

Product developers are those who are producing or creating DHIs. This includes developers in private and public research institutions and start-ups, reflecting the multiple different DHI types and use cases. This also incorporates those who are directly funding development of DHIs, noting that it is particularly important that the representation of value at the product development stage should align closely to the representation of value at implementation.

Researchers and analysts are those who conduct economic evaluations of DHIs within research institutes or other public and private organizations including consultancies. This category also includes research funding organizations that may be providing funding for economic evaluations of DHIs, and researchers who may be using economic evaluations in associated research in digital health such as policy analysis or systematic reviews of the literature. This is a particularly important group as it will undertake the application and production of economic evidence and develop methodological improvements and innovation, building on the research agenda promoted by the framework.

# 3. A Review of the Literature: Evaluating Digital Health Interventions

To determine the utility of an Economic Evaluation framework for DHIs, it is necessary to have a good understanding of the existing evidence base. The World Bank and 3ie developed an evidence gap map (EGM) to investigate the available published literature on impact evaluations of DHIs [15]. The broad goal of this EGM was to facilitate decision-making regarding investment in research to assess the effects and costs of DHIs and AI globally. A more specific objective of the EGM was to support the development of the economic evaluation framework for DHIs, and key findings are summarized below.

## 3.1 Main Findings and Gaps

For the EGM, 63,014 records were retrieved, and 17,142 duplicates were excluded. Most of the records (n=40,374) were excluded during the title and abstract screening. After the fulltext screening, the EGM included 632 Impact Evaluations (IEs) (436 completed and 196 ongoing) and 97 Systematic Reviews (SRs) (89 completed and 8 ongoing).