Background: Digital health is well-positioned in low and middle-income countries (LMICs) to revolutionize health care due, in part, to increasing mobile phone access and internet connectivity. This paper evaluates the underlying factors that can potentially facilitate or hinder the progress of digital health in Pakistan. Objective: The objective of this study is to identify the current digital health projects and studies being carried out in Pakistan, as well as the key stakeholders involved in these initiatives. We aim to follow a mixed-methods strategy and to evaluate these projects and studies through a strengths, weaknesses, opportunities, and threats (SWOT) analysis to identify the internal and external factors that can potentially facilitate or hinder the progress of digital health in Pakistan. Methods: This study aims to evaluate digital health projects carried out in the last 5 years in Pakistan with mixed methods. The qualitative and quantitative data obtained from field surveys were categorized according to the World Health Organization’s (WHO) recommended building blocks for health systems research, and the data were analyzed using a SWOT analysis strategy. Results: Of the digital health projects carried out in the last 5 years in Pakistan, 51 are studied. Of these projects, 46% (23/51) used technology for conducting research, 30% (15/51) used technology for implementation, and 12% (6/51) used technology for app development. The health domains targeted were general health (23/51, 46%), immunization (13/51, 26%), and diagnostics (5/51, 10%). Smartphones and devices were used in 55% (28/51) of the interventions, and 59% (30/51) of projects included plans for scaling up. Artificial intelligence (AI) or machine learning (ML) was used in 31% (16/51) of projects, and 74% (38/51) of interventions were being evaluated. The barriers faced by developers during the implementation phase included the populations’ inability to use the technology or mobile phones in 21% (11/51) of projects, costs in 16% (8/51) of projects, and privacy concerns in 12% (6/51) of projects. Conclusions: We conclude that while digital health has a promising future in Pakistan, it is still in its infancy at the time of this study. However, due to the coronavirus disease 2019 (COVID-19) pandemic, there is an increase in demand for digital health and implementation of health outcomes following global social distancing protocols, especially in LMICs. Hence, there is a need for active involvement by public and private organizations to regulate, mobilize, and expand the digital health sector for the improvement of health care systems in countries.

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中文翻译：

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巴基斯坦数字健康干预的当前挑战：混合方法分析。

背景：数字医疗在中低收入国家（LMIC）中处于有利位置，从而在一定程度上改变了医疗保健方式，从而彻底改变了医疗保健，这归因于手机访问和互联网连接的增加。本文评估了可能促进或阻碍巴基斯坦数字健康发展的潜在因素。目标：这项研究的目的是确定巴基斯坦当前正在进行的数字卫生项目和研究，以及参与这些计划的主要利益相关者。我们旨在遵循混合方法策略，并通过优势，劣势，机会和威胁（SWOT）分析评估这些项目和研究，以识别可能促进或阻碍巴基斯坦数字健康发展的内部和外部因素。方法：这项研究旨在评估过去五年中在巴基斯坦使用混合方法进行的数字医疗项目。根据世界卫生组织（WHO）建议的卫生系统研究构建基块，对从野外调查获得的定性和定量数据进行了分类，并使用SWOT分析策略对数据进行了分析。结果：在过去五年中，巴基斯坦开展了数字卫生项目，其中51个项目得到了研究。在这些项目中，46％（23/51）的技术用于进行研究，30％（15/51）的技术用于实施，12％（6/51）的技术用于应用程序开发。目标健康领域为一般健康（23/51，46％），免疫（13/51，26％）和诊断（5/51，10％）。55％（28/51）的干预措施中使用了智能手机和设备，59％（30/51）的项目包括扩大规模的计划。31％（16/51）的项目使用了人工智能（AI）或机器学习（ML），并且正在评估74％（38/51）的干预措施。开发人员在实施阶段面临的障碍包括：21％（11/51）的项目中无法使用技术或手机，16％（8/51）的项目中的成本以及12％的隐私问题（6/51）个项目。结论：我们得出的结论是，尽管数字健康在巴基斯坦具有广阔的发展前景，但在进行本研究时仍处于起步阶段。但是，由于2019年冠状病毒病（COVID-19）大流行，在全球社会疏远协议之后，尤其是在LMIC中，对数字健康和健康成果实施的需求增加。因此，

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