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Governance and Standards

Open Health Stack alignment with WHO SMART Guidelines, Digital Public Goods standards, and open source stewardship.

Grounded in global health standards​

Open Health Stack is built to uphold international digital health recommendations and open standards. By aligning directly with established global frameworks, the stack ensures that digital health investments remain interoperable, transparent, and sustainable over decades.

Four standards alignments. WHO SMART Guidelines, native support for Level 2, Level 3, and Level 4 clinical adaptation kits. Digital Public Goods, open source and privacy-preserving with transparent governance. HL7 FHIR Foundation, un-forked R4, R4B, R5, and R6 ready with standard data exchange schemas. Open Licensing, Apache 2.0 open source licenses with zero recurring licensing fees.

Alignment with WHO SMART Guidelines​

The World Health Organization established the SMART Guidelines framework to translate public health recommendations systematically from narrative guidelines into executable digital software.

Open Health Stack maps directly to the WHO SMART Guidelines tiers.

  • Level 1 (Narrative recommendations) encompasses public health guidelines authored by clinical expert panels.
  • Level 2 (Digital Adaptation Kits or DAKs) defines operational workflows, data dictionaries, decision logic tables, and indicator definitions.
  • Level 3 (Machine-readable standards) publishes formal FHIR Implementation Guides, Structured Data Capture questionnaires, and Clinical Quality Language logic libraries.
  • Level 4 (Executable software) represents production digital health tools running in frontline clinics and community programmes.

Open Health Stack bridges Level 3 and Level 4. It consumes standard FHIR Questionnaires and Implementation Guides directly to render mobile forms and execute validation rules without custom programming.

Digital Public Goods compliance​

Open Health Stack adheres to the criteria established by the Digital Public Goods Alliance to ensure ethical, sustainable digital transformation.

  • Open source licensing ensures all core libraries, client SDKs, reference implementations, and documentation are published under standard permissive open source licenses, primarily Apache 2.0.
  • Protection of privacy and personal data enforces privacy-by-design principles, role-based access control, secure token exchange, and clear data isolation for sensitive health data.
  • Standards compliance guarantees the stack relies entirely on open standards, avoiding proprietary extensions or closed database formats.
  • Do No Harm principles prioritizes offline resilience, data integrity, and deterministic validation to safeguard patient health outcomes in low-resource settings.

Foundation stewardship and community governance​

Open Health Stack is stewarded by the Open Health Stack Foundation in collaboration with global health organizations, academic partners, technology contributors, and implementing ministries.

  • Community-driven roadmaps shape technical priorities and library enhancements openly in public repositories with regular community working groups.
  • Vendor neutrality maintains strict neutrality, ensuring no commercial entity controls data schemas or architectural decisions.
  • Ecosystem sustainability invests in shared core infrastructure, allowing all members of the digital health ecosystem to benefit from collective engineering improvements.