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.
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.