Assessing the Nexus between Digital Maturity and Institutional Accountability in Bangladesh’s Public Health System: A 2022 Cross-Sectional Analysis

Abstract

In the 2022 post-pandemic landscape, the digitalization of health services in the Global South has transitioned toward increased institutionalization. This research investigates the statistical association between perceived facility-level digital governance maturity and institutional accountability across a stratified sample of 450 public healthcare facilities in Bangladesh. Employing a cross-sectional quantitative design, the study sampled health administrators across eight divisions to evaluate digital literacy, infrastructure maturity, and policy knowledge as observed correlates of accountability performance. Data were analyzed using Ordinal Logistic Regression (OLR). Results indicate that higher levels of digital literacy (OR=3.64, 95% CI [2.89, 4.60]) and infrastructure maturity (OR=2.81, 95% CI [2.21, 3.58]) are positively associated with achievement of higher accountability tiers. These association patterns suggest a "policy dissemination gap," in which technical adoption has outpaced administrative understanding of data governance standards. While these findings suggest that digital maturity correlates with transparency, the study is limited by its cross-sectional design, reliance on self-reported administrative perceptions, and lack of external validation against objective system audit logs. The associations provide an empirical basis for refining the 2023-2027 Digital Health Strategy by prioritizing human capital and policy clarity alongside hardware expansion.