Digital health at the forefront of the community response in Mozambique amidst COVID-19 pandemic

Malaria Consortium is rapidly adapting its existing digital platform, upSCALE, to better support health workers’ ability to respond to the COVID-19 pandemic in Mozambique. The changes include a dedicated education module, targeted SMS messaging, stock management of PPE materials, improved surveillance and reporting on COVID-19 and symptom tracking capabilities.

In Mozambique, limited access to primary healthcare for rural populations and poor linkages between community health workers and the national health information system were challenges that exacerbated the high-burden of infectious diseases.

The original upSCALE platform, created to overcome these challenges, supports a smartphone and tablet app that assists community health workers, known locally as agentes polivalentes elementares (APEs), with patient registration, diagnosis and advice on treatment and referrals. It also allows supervisors to monitor APE performance and stock levels of drugs and equipment. Data entered through the app is captured in the District Health Information System at district, provincial and national level and the ability to analyse local disease-specific trends in near real-time improves resource allocation. Mozambique’s Ministry of Health began a country-wide rollout of the app in 2019 – the first of its kind on this scale.

In the context of COVID-19, APEs are now facing additional challenges. Misinformation arising from a lack of accurate and up-to-date evidence on the virus and confusion over diagnoses due to similarities of some COVID-19 symptoms to those of malaria and pneumonia has made it more difficult for APEs’ to do their job effectively and support the COVID-19 response. Incorporating COVID-19 surveillance into existing surveillance networks, including the likely spread of COVID-19 in the community and signs the health systems is becoming overburdened, are all essential to tackling the new threat.

In response, Malaria Consortium is adapting the existing upSCALE digital platform to support APEs to respond to the pandemic. New COVID-19 modules have been developed that cover: awareness, education, disease surveillance and stock control. Changes in government advice and new symptoms as they are identified will be communicated via the app – including SMS, audio and video message. Knowledge and awareness mapping surveys will be added as well as a stock management system to track levels of equipment – such as PPE – provided by Mozambique’s Ministry of Health.

Since activities began four weeks ago 30,000 SMS messages have been sent to APEs in relation to COVID-19, with 15% of APEs saying they have learned about COVID-19 from UpSCALE. It is anticipated that this research will further highlight how important digital platforms are in supporting frontline health workers in their lifesaving work.

Malaria Consortium is committed to fighting the COVID-19 pandemic. It is our mission to protect the most vulnerable, and COVID-19 is a new addition to a list of communicable diseases that still includes malaria, pneumonia, diarrhoea and dengue.  Any diversion from tackling these diseases would be devastating for millions of people across Africa and Asia at a time when health systems are fragile and likely to be stretched to breaking point by the added burden of COVID-19. For more information about how we’re adapting our work, visit our COVID-19 hub.