Project overview

In Mozambique, community health workers (CHWs) — known locally as Agentes Polivalentes Elementares — are trained to carry out health promotion and health prevention activities in the remote areas in which they reside. They also diagnose and treat malaria, pneumonia and diarrhoea; refer cases of malnutrition, as well as newborns and pregnant women with danger signs to the nearest health facility for treatment; provide family planning, antenatal and postnatal care services; and counsel tuberculosis and HIV patients on treatment adherence.

Between 2009 and 2016, Malaria Consortium developed and tested an interactive mobile phone application called inSCALE to improve the quality of care provided by CHWs in Inhambane province. Based on the trial’s success, we created the digital health platform upSCALE together with the Ministry of Health (MoH) and Unicef. Ever since, the platform has continued to evolve to respond to the needs of the country’s Community Health Workers’ Programme — known locally as Programa Nacional de Agentes Polivalentes Elementares (PNAPE).

upSCALE consists of a smartphone app that walks CHWs through patient registration, assists with diagnosis and advises on treatment and referrals, and a tablet-based app that allows supervisors to monitor CHW performance and stock levels. Data entered by CHWs through the upSCALE app is visualised in the District Health Information System (DHIS2) at district, provincial and national levels of Mozambique’s health system. The ability to analyse local disease-specific trends in near realtime allows managers to improve their resource allocation.

After testing the platform’s functionality and subsequently its potential for expansion in Cabo Delgado, Inhambane and Zambézia provinces, the MoH now aims to roll out upSCALE nationwide by 2020 in this third phase of the project. Malaria Consortium will provide technical assistance to build PNAPE’s capacity to implement and manage the platform at all levels of the health system, thereby ensuring ownership for long-term sustainability.