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Rethinking Public Health Investment in Low-Resource Settings: A Policy Framework for Optimizing Digital Health Portfolios Using Risk Diversification Principles

Chris Nnamdi Anazia

Abstract

In the face of constrained resources, low- and middle-income countries (LMICs) are increasingly adopting digital health technologies to strengthen healthcare delivery. However, the lack of strategic frameworks for prioritizing digital health investments can lead to inefficiencies and fragmented systems. This study develops a policy-oriented framework grounded in portfolio optimization principles to guide the allocation of public funds in digital health. Drawing from financial portfolio theory—specifically, risk diversification, asset allocation, and expected return—this study qualitatively adapts these principles to the health policy landscape. Through document reviews and key informant interviews conducted across selected LMICs (including Ghana, Kenya, Nigeria, and India), this research identifies core patterns in digital health investment strategies, perceived risks, and health outcomes. A practical tool is proposed to assist policymakers in evaluating and diversifying digital health investments, with the aim of enhancing efficiency, sustainability, and equity. The framework also considers contextual factors such as governance, digital infrastructure, and system maturity, offering a comprehensive and replicable approach to health investment planning. It advances the literature on strategic health financing while offering actionable insights for LMIC policy leaders (Labrique et al., 2018; WHO, 2020; Drummond et al., 2015). This study also addresses the absence of systematic frameworks that allow governments to evaluate competing digital health interventions based on context-specific priorities. By framing digital tools as strategic assets, the paper advocates for a shift from ad hoc budgeting to evidence- driven investment planning. Furthermore, it highlights how donor alignment, public-private collaboration, and equity weighting can enhance impact and reduce redundancy in national digital health portfolios. The proposed fra

References

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