BARCELONA — Mozambique, which has one of the lowest doctor-to-patient ratios in the world, is rolling out a mobile health platform to strengthen community health delivery in underserved areas — making it one of the first low-income countries to bring an mHealth initiative to the national scale. While digital health strategies have sprung up by the hundreds, most exist only as short-lived pilots or isolated projects.
The upSCALE platform, which is intended to become an integral part of the national community health system, has survived beyond this phase. It builds on evidence from a seven-year pilot and a one-year expansion in two provinces of Mozambique, funded by the Bill & Melinda Gates Foundation and the United Kingdom Department for International Development, respectively. The national rollout is expected to take between three and five years to complete.
Digital health will only succeed if it can embrace four major trends affecting health care provision in developing countries, including the changing roles of patients and health workers, systems thinking, and integration, according to Marc Mitchell, president of D-tree International.
The strategy includes phone- and tablet-based apps designed for community health workers and their supervisors at health facilities. They walk CHWs through the registration, diagnosis, treatment, referral, and follow-up of patients; enhance drug stock management by relaying drug reports in real time; and boost supervision and motivation, two Achilles heels of community-based care.
upSCALE partners Malaria Consortium, UNICEF Mozambique, and the Ministry of Health took Devex behind the scenes of the rollout of the platform, and shared hard-learned advice on bringing mHealth to scale.