Contents lists available at ScienceDirect International Journal of Medical Informatics journal homepage: www.elsevier.com/locate/ijmedinf The role of digital health in making progress toward Sustainable Development Goal (SDG) 3 in conflict-affected populations ☆ Yara M. Asi a, ⁎ , Cynthia Williams b a Department of Health Management and Informatics, College of Health and Public Affairs, University of Central Florida, Orlando, FL, United States b Department of Public Health, Brooks College of Health, University of North Florida, Jacksonville, FL, United States ARTICLE INFO Keywords: Digital health Conflict Fragile states SDGs Health Development ABSTRACT Purpose: The progress of the Millennium Development Goals (MDGs) shows that sustained global action can achieve success. Despite the unprecedented achievements in health and education, more than one billion people, many of them in conflict-affected areas, were unable to reap the benefits of the MDG gains. The recently de- veloped Sustainable Development Goals (SDGs) are even more ambitious then their predecessor. SDG 3 prior- itizes health and well-being for all ages in specific areas such as maternal mortality, communicable diseases, mental health, and healthcare workforce. However, without a shift in the approach used for conflict-affected areas, the world’s most vulnerable people risk being left behind in global development yet again. We must engage in meaningful discussions about employing innovative strategies to address health challenges fragile, low-resource, and often remote settings. In this paper, we will argue that to meet the ambitious health goals of SDG 3, digital health can help to bridge healthcare gaps in conflict-affected areas. Methods: First, we describe the health needs of populations in conflict-affected environments, and how they overlap with the SDG 3 targets. Secondly, we discuss how digital health can address the unique needs of conflict- affected areas. Finally, we evaluate the various challenges in deploying digital technologies in fragile environ- ments, and discuss potential policy solutions. Discussion: Persons in conflict-affected areas may benefit from the diffusive nature of digital health tools. Innovations using cellular technology or cloud-based solutions overcome physical barriers. Additionally, many of the targets of SDG 3 could see significant progress if efficacious education and outreach efforts were sup- ported, and digital health in the form of mHealth and telehealth offers a relatively low-resource platform for these initiatives. Lastly, lack of data collection, especially in conflict-affected or otherwise fragile states, was one of the primary limitations of the MDGs. Greater investment in data collection efforts, supported by digital health technologies, is necessary if SDG 3 targets are to be measured and progress assessed. Standardized EMR systems as well as context-specific data warehousing efforts will assist in collecting and managing accurate data. Stakeholders such as patients, providers, and NGOs, must be proactive and collaborative in their efforts for continuous progress toward SDG 3. Digital health can assist in these inter-organizational communication efforts. Conclusion: The SDGS are complex, ambitious, and comprehensive; even in the most stable environments, achieving full completion towards every goal will be difficult, and in conflict-affected environments, this challenge is much greater. By engaging in a collaborative framework and using the appropriate digital health tools, we can support humanitarian efforts to realize sustained progress in SDG 3 outcomes. 1. Introduction To bring progress to the world’s development targets, the United Nations (UN) has twice agreed to a specific agenda to be achieved by all 189-member states. The first agreement was the Millennium Development Goals (MDGs) which were set for 2000–2015; the second agreement was the Sustainable Development Goals (SDGs), the current framework which is for 2015–2030. The MDGs were successful in achieving many of their targets. Estimates suggest that more than 21 million additional lives were saved during this period [50]. However, even early in the MDG period, reports warned that ‘the MDGs cannot be achieved without more progress in fragile states’. Early data suggested that when compared to other low- and middle-income countries (LMIC), fragile states had significantly worse outcomes [28]. At the http://dx.doi.org/10.1016/j.ijmedinf.2017.11.003 Received 15 April 2017; Received in revised form 30 October 2017; Accepted 4 November 2017 ☆ This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. ⁎ Corresponding author. E-mail addresses: Yara.asi@knights.ucf.edu (Y.M. Asi), cynthia.white-williams@unf.edu (C. Williams). International Journal of Medical Informatics xxx (xxxx) xxx–xxx 1386-5056/ © 2017 Elsevier B.V. All rights reserved. Please cite this article as: Asi, Y.M., International Journal of Medical Informatics (2017), http://dx.doi.org/10.1016/j.ijmedinf.2017.11.003