Dr. Smisha Agarwal (Johns Hopkins University Global Center for Digital Health Innovation) joins me to unpack some hard truths on the Global Perspectives on Digital Health podcast.

🛑 Why global health systems remain fragile

📉 How digital tools often scale without legitimacy

📊 What’s wrong with our fixation on "did it work?" and significance values

🔁 And how global health is stuck in systems that haven’t evolved

💬 “We’re brought into a system of aid and global development that has stopped questioning how things were done. And the world has progressed, but our field hasn’t.”

🔑 But Smisha also offers a way through:

- Thinking differently about evaluating system level impact

- The work of the Oxford Open Health Journal to increase visibility and representation of people's research in LMICs

👉 If you work in digital health, research, policy, or global development this is for you.

About Smisha:

Dr.Smisha Agarwal, PhD, MPH, MBA, BDS is the Director of the Center for Global Digital Health Innovation and Associate Professor in the Department of International Health at the Johns Hopkins Bloomberg School of Public Health. She brings expertise in advancing primary health

care through strengthening community health systems and leveraging innovative technological solutions including digital devices. A part of her research has focused on using predictive analytics and machine learning algorithms based on routine monitoring data to enhance our understanding of quality of care, create safety nets to care for high-risk populations and improve effectiveness of reproductive health services.

Over the last two decades, her research has been leveraged by normative agencies like WHO to develop guidelines on national digital

transformation, donors to guide investments in primary health care, and governments to develop their national digital health strategies. She is the Editor-in-Chief of the Oxford Open Digital Health Journal.

• (00:00) - Introduction, Smisha's background
• (05:01) - Impact of Global Health Aid Cuts
• (10:03) - Challenges in Monitoring and Evaluation
• (15:35) - Health First: How to think about outcomes, measuring the right things
• (20:54) - Supporting healthcare workers as a goal
• (26:37) - Impact: Measuring what matters
• (28:39) - Donor decision making dynamics
• (30:09) - Rethinking system level success: from yes/no to more nuance
• (33:50) - Innovations in Academic Publishing
• (37:37) - Challenging the Status Quo in Global Health
• (42:20) - Upcoming events in Global Digital Health