{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T13:00:04Z","timestamp":1790600404521,"version":"4.1.0"},"reference-count":17,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T00:00:00Z","timestamp":1788566400000},"content-version":"vor","delay-in-days":247,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Open-source digital public goods play a growing role in point-of-care health service delivery in low- and middle-income countries. Many of these systems are developed and maintained by organizations that rely heavily on donor funding, making their long-term sustainability vulnerable to funding instability. The January 2025\u00a0U.S. Agency for International Development funding freeze created a rare natural experiment to observe how different organizations maintaining these systems respond under external funding shocks. Using 7922 issues from eight repositories created between June 2023 and June 2025, a DistilBERT model was fine-tuned to classify bug severity. Organizations were categorized into three funding-based models: donor-driven (primarily grant-funded), revenue-driven (sustained through commercial or internal investment), and hybrid (combining grants and revenue). Interrupted time series and Cox proportional hazards models were then applied to evaluate changes in bug-resolution efficiency. Revenue-driven organizations did not exhibit a statistically significant immediate level change but experienced significant deterioration in the post-intervention period. Donor-driven organizations exhibited no substantial changes following the intervention, maintaining stable baseline levels. Hybrid organizations showed resilience to the immediate funding shock, with a gradual decline in bug resolution as time went on after the shock. These findings suggest that the funding shocks function as a stress test for digital public goods and highlight the resilience advantages of various governance models.<\/jats:p>","DOI":"10.1093\/oodh\/oqag035","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T11:40:16Z","timestamp":1788522016000},"source":"Crossref","is-referenced-by-count":0,"title":["Maintenance dynamics in digital health public goods: a quasi-experimental study of issue resolution during the 2025\u00a0USAID funding disruption"],"prefix":"10.1093","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-9207-6971","authenticated-orcid":false,"given":"Jinyou","family":"Sheng","sequence":"first","affiliation":[{"name":"Duke Global Health Institute, Duke University , Trent Hall, 310 Trent Drive, Durham, NC, 27710 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4940-6581","authenticated-orcid":false,"given":"Amy","family":"Finnegan","sequence":"additional","affiliation":[{"name":"Duke Global Health Institute, Duke University , Trent Hall, 310 Trent Drive, Durham, NC, 27710 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,5]]},"reference":[{"key":"2026092808253198400_ref1","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1007\/s41469-023-00156-8","article-title":"Purpose-driven transformation: a holistic organization design framework for integrating societal goals into companies","volume":"12","author":"Carballo","year":"2023","journal-title":"J Organ Des"},{"key":"2026092808253198400_ref2","doi-asserted-by":"publisher","first-page":"388","DOI":"10.1109\/SANER50967.2021.00043","volume-title":"2021 IEEE Int Conf Softw Anal Evol Reengineering SANER","author":"Champion","year":". 2021"},{"key":"2026092808253198400_ref3","volume-title":"5 Things Digital Public Good Software Projects Need to Scale, Uncategorized","author":"DIAL","year":"7 . 2020"},{"key":"2026092808253198400_ref4","doi-asserted-by":"publisher","first-page":"106406","DOI":"10.1016\/j.jbusvent.2024.106406","article-title":"Exploring the microfoundations of hybridity: a judgment-based approach","volume":"39","author":"Dorobat","year":"2024","journal-title":"J Bus Ventur"},{"key":"2026092808253198400_ref5","doi-asserted-by":"publisher","first-page":"102800","DOI":"10.1016\/j.labeco.2025.102800","article-title":"Career concerns as public good the role of signaling for open source software development","volume":"97","author":"El-Komboz","year":"2025","journal-title":"Labour Econ"},{"key":"2026092808253198400_ref6","volume-title":"Opinionated summary of the 2024 Open Source Software Funding Report - 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