  With societal challenges, including but not limited to human development,
equity, social justice, and climate change, societal-level digital
transformation (SDT) is of imminent relevance and theoretical interest. While
building on local-level efforts, societal-level transformation is a nonlinear
extension of the local level. Unfortunately, academic discourse on digital
transformation has largely left SDT unaccounted for. Drawing on more than 25
years of intensive, interventionist research engagement with the digital
transformation of public healthcare information management and delivery in more
than 80 countries in the Global South, we contribute to theorizing SDT in the
form of a design theory consisting of six interconnected design principles.
These design principles articulate the interplay and tensions of accommodating
over time increased diversity and flexibility in digital solutions, while
simultaneously connecting local, national, and regional/ global efforts.
