New research highlights the power of digital tools to reach more children and fight malaria in Mozambique

A new paper in Oxford Open Digital Health, published in January 2026, documents the transition from paper-based to digital data collection during the 2023–2024 seasonal malaria chemoprevention (SMC) campaign across 23 districts in Nampula province, Mozambique. The findings of the study reveal how digital innovations, when implemented appropriately, can enhance the effectiveness of malaria prevention campaigns, ultimately leading to more lives saved.  

The paper, authored by Malaria Consortium Mozambique alongside colleagues from the National Malaria Control Programme (NMCP) and eGovernments Foundation (eGov), presents a case study of operational insights, implementation experience and lessons learnt from the digitalisation process.

“Digital health can take our interventions further, but without thoughtful evaluation and contextual adaptation, scale risks outpacing impact,” says Maria Rodrigues, Country Direction of Malaria Consortium Mozambique — especially, she says, in settings like Mozambique with a vast cultural diversity, meaning that the delivery may require tailoring to fit the communities with whom we work. 

Mozambique remains heavily affected by malaria, carrying the fifth largest burden of any country in the world. This underscores the importance rolling out interventions such as insecticide-treated nets (ITNs), indoor residual spraying and chemoprevention as evenly and widely as possible. 

Previously in Mozambique, the rollout of SMC — a community-based, highly effective intervention to prevent malaria infections by regularly administering antimalarial drugs to children during the peak malaria transmission season — relied on paper-based systems. Data inaccuracies and delays in data collection impacted on timely decision-making. However, the introduction of digital health platforms, such as eGOV’sDIGIT Health Campaign Management (HCM) platform, is increasingly transforming the design, implementation and evaluation of health campaigns, streamlining and improving all aspects to ensure health campaigns are delivered smoothly.  

The DIGIT HCM platform, known locally as SALAMA, was used to register households and eligible children, record medication administration, log adverse events or side effects, monitor and manage stock, supervise and monitor campaign staff activities, and to record onward referrals into the health system. Over 14,500 implementers were trained to use the platform to support door-to-door delivery of SMC. SALAMA was initially adopted by the country’s NMCP to support ITN distribution campaigns in Mozambique in 2023 and was rolled out to support SMC implementation in Nampula in 2024. 

The campaign clearly showed that a digitised approach improved operational efficiency, data-driven decision-making, supervision and data quality. The research found that the digital health records were more consistent with independent household survey data than the previous paper-based campaign had been, suggesting that a digital tool approach reduced the over-reporting that paper systems tend to produce. Real-time monitoring enabled quicker real-time responses; the system detected early in the delivery of the antimalarial medicines that some medicine was being wasted, which prompted immediate targeted supervision, and reduced waste in the following days.  

The authors identified certain barriers to uptake, such as poor battery life of mobile devices, inconsistent internet connectivity in remote areas, duplicate household registrations and digital literacy gaps among some staff. The barriers revealed that digital health tools only work when they are adapted to suit the context for which they are being implemented. 

Nick Banks, Digital Health Specialist at Malaria Consortium says, “What we are seeing across countries is that, with the right support from the start, digital tools can improve visibility, strengthen supervision and help teams respond faster. Long-term success still depends on local ownership, practical design and tools that are adapted to the local context and the realities faced by frontline workers.” 

A second study — still in preprint form while it awaits peer review — sets out the protocol for a new implementation research study to evaluate an enhanced module within the upSCALE digital health platform, which has become embedded in the health system in Mozambique, modelling a locally led and government-owned digital health innovation.  

In this instance, the project, called the Zero-dose Identification and Reach (ZIDER) initiative, is a research project that uses the upSCALE digital health platform to find and reach un-immunised (zero-dose) and under-immunised children in remote communities. This study specifically looked at Zambezia province, which is among the provinces with the lowest immunisation coverage in the country, where an estimated 53 percent of children have not received the first dose of the vaccine. 

Community health workers already use upSCALE to deliver integrated care to remote communities. The new module will enable them to systematically identify zero-dose and under-immunised children and link them to vaccination services. This study will compare immunisation outcomes where the enhanced module will be deployed. 

The study exemplifies how upSCALE has matured beyond its original use case to be able to deliver interventions such as immunisation. Although the results are forthcoming, the paper serves to generate evidence to guide the scale-up of immunisation programmes in Mozambique, helping policymakers and health planners to make better decisions about strategy and resource allocation. 

These two pieces of research speak to the same question: how do we use digital tools not just to do things faster, but better? The SALAMA platform shows the potential of something as simple as moving from paper to digital, but also reveals the growing pains that may come with that transition. In the case of upSCALE, the research will reveal how digital innovation can be adapted to go make existing systems go further. 

Together, the two demonstrate that when digital tools are built around the realities of frontline delivery — adapted to local contexts, supported with genuine training and owned by national programmes — they can change how campaigns are managed and how lives are saved.