DPI-HDigital Public Infrastructure for Health
In short
DPI-H is an approach that proposes investing in a set of shared digital health services (patient and facility registries, terminologies, an interoperability layer, a shared record) on which many applications can be built, instead of funding isolated systems for each programme or disease. The concept is developed in a 2023 report by Vital Wave with Digital Square (PATH), aimed at low- and middle-income countries.
- Type
- Concept
- Steward
- No single steward: general concept or generic technology
- Reviewed
- October 25, 2026
Explanation
What it is
The concept is developed in the report Digital Public Infrastructure for Health: Charting a path to implementation in LMIC health systems (2023), produced by Vital Wave with thought-partnership from PATH and Digital Square, support from Co-Develop and funding from Wellcome. According to its foreword, the report is an early step in conceptualizing digital public infrastructure applied to health.
It builds on the discourse on digital public infrastructure (DPI): inclusive, foundational, open and transparently governed platforms that perform a basic function at scale for others to build on, such as digital identity or payments. DPI-H groups the health-specific digital functions that enable many digital health interventions. It does not replace foundational DPI: it complements it.
The framework
| Layer | Components |
|---|---|
| Cross-domain base | Foundational DPI (payments, identity, exchange with other sectors) and technology infrastructure (connectivity, mobile networks, cloud), through a digital services gateway |
| Canonical registries and terminologies | Client, facility, product, health worker and provider registries; terminology services |
| Interoperability platforms and standards | Messaging standards, such as HL7 FHIR, and interoperability layers |
| Scaled digital health services | Shared health record, immunization, logistics, HMIS, health financing, surveillance |
| Central data repositories | Data warehouses for analytics and reporting |
| Health data security frameworks | Consent management, auditing, linking and de-identification of records |
| Supporting goods | Curated open data, curated content (such as WHO guidelines and SMART guidelines) and open AI models |
The report clarifies that an individual product, by itself, is generally not infrastructure: it is an example of a product that can perform an infrastructural function.
Relationship with HIE and OpenHIE
According to the report, its components strongly overlap with those of OpenHIE, and a functioning health information exchange would be a good example of DPI-H.
What the report found
- Existing digital public goods and global goods, according to the report, are not ready to function as DPI-H: they often do not operate at scale or let other applications leverage their functions.
- Leadership and governance capacity remains insufficient.
- Donor investments have followed disease silos rather than an ecosystem approach.
- Current systems were designed for data collection rather than data exchange and use.
Common misconceptions
- Confusing it with software. It is an investment approach and a conceptual framework, not a product or a standard.
- Believing open-source software is enough. The report warns that having digital public goods is not the same as having infrastructure ready to operate at scale.
Usage examples
In Nigeria, according to the report, NigeriaMRS is used in over 98% of CDC-supported facilities for their HIV programmes, but 99% of the country's electronic health records are used exclusively for HIV and operate in isolation from other systems.
In Kenya, the KeHMIS project implemented over 1,200 instances of KenyaEMR and a data exchange layer for eight systems, with strong governance by the national task team, according to the report.
In Rwanda, the report describes the pilot of an interoperability layer and 65 instances connected to the shared health record as of July 2023.
The report cites the Zambia National Data Warehouse and South Africa's Western Cape Provincial Health Data Centre as examples of central data repositories.
Among supporting goods, the report mentions WHO clinical guidelines and SMART guidelines as curated content reusable by many applications.
Relation to other terms
Relies on6
- MPI / EMPIStrong
The client registry is one of the canonical registries the framework includes among its core components.
- Consent managementMedium
The model's health data security frameworks include services for managing consent.
- FHIRMedium
The report cites HL7 FHIR as an example of a messaging standard for the interoperability layer.
- HIEMedium
The report presents a functioning health information exchange as a good example of DPI-H, and aligns the components of both (registries, interoperability layer).
- OpenHIEMedium
The report shows a strong overlap between its components and those of OpenHIE, and aligns them in a table.
- Terminology serverMedium
The framework groups terminology services with the canonical registries, to map codes during exchange.
Depend on this one0
No glossary term depends on this one.