Strengthening Digital Health Local Capacity: Driving Forces and Milestones in Ethiopia

Background Strengthening local capacity is central to building sustainable digital health systems in low- and middle-income countries (LMICs). Ethiopia’s experience illustrates how nationally led strategies can drive digital transformation. Methods This study uses a qualitative descriptive case study approach, drawing on government policies, program reports, peer-reviewed literature, and the authors’ direct implementation experience. Data were reviewed and analyzed thematically to trace the driving forces, milestones, achievements, and challenges of Ethiopia’s digital health journey between 2016 and 2025. Findings Ethiopia’s transformation was enabled by strong national governance and institutional leadership, the adoption of interoperable standards and a unified health data platform, investments in workforce capacity through mentorship and university partnerships, and the introduction of innovative digital services such as eCHIS and electronic logistics systems. These initiatives improved data quality, expanded digital service delivery, and supported evidence-based decision-making. However, persistent challenges include resource constraints, limited digital literacy among frontline workers, and heavy reliance on donor financing. Conclusions & Significance Ethiopia’s nationally led and capacity-focused approach demonstrates that sustainable digital health transformation in LMICs requires more than technology; it demands governance reform, local ownership, and long-term financing strategies. The lessons from Ethiopia provide transferable insights for other countries seeking to build resilient, self-reliant digital health ecosystems.