Constructing and validating a health informatics readiness index for Gulf Cooperation Council countries: a multi-indicator WHO-GHO ecological analysis

Background. Country-level measures of digital health capture single dimensions: the Global Digital Health Monitor (GDHM) measures digital health maturity, the UHC Service Coverage Index measures service outputs, and the ITU ICT Development Index (IDI) measures connectivity. No composite measure of health informatics readiness exists for the six Gulf Cooperation Council (GCC) states. Objective. To construct a Health Informatics Readiness Index (HIRI) for the GCC entirely from openly available international data, and to assess its construct validity against held-out health-system outcomes. Methods. Ecological analysis of Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and the United Arab Emirates. Following the OECD/JRC composite-indicator handbook, eight indicators from the ITU, WHO Global Health Observatory (GHO), GDHM and World Bank were grouped into three domains (digital infrastructure; workforce and governance; financing), normalised to 0-100 against fixed goalposts, and combined with equal weights. Only indicators reported for all six countries were used and no values were imputed. UHC service coverage and neonatal, under-5 and maternal mortality were held out of construction and used for validation against pre-specified Spearman correlation thresholds. Robustness was assessed across 19 alternative specifications. Results. The HIRI ranking was the United Arab Emirates (81.8), Saudi Arabia (81.3), Qatar (73.7), Kuwait (71.9), Oman (64.3) and Bahrain (60.3). Digital infrastructure was uniformly high (domain mean 86.8), whereas workforce and governance (mean 67.9) and financing (mean 62.0) were lower; workforce and governance accounted for most between-country separation (coefficient of variation 24.9%). HIRI correlated with UHC service coverage (rho = +0.72), under-5 mortality (rho = -0.77) and neonatal mortality (rho = -0.83), meeting three of four pre-specified hypotheses; the correlation with maternal mortality (rho = -0.23) did not meet its threshold. HIRI correlated with GDHM maturity phase (rho = +0.83) but not with the ITU IDI (rho = +0.06), whose GCC values are near the ceiling. The ranking was unchanged in 11 of 19 alternative specifications and correlated at rho >= 0.89 with the base ranking in all of them. Conclusions. A transparent, fully reproducible readiness index can be built for the GCC from open international data. Connectivity does not distinguish the six states; workforce and governance capacity does. With six countries the validation is descriptive, and the index should be tested in a larger regional sample. The index was first developed in June–July 2026; this version (v1, September 2026) was rebuilt from source data for public release.