Digital transformation of campaign delivery: a mixed-methods costing and efficiency analysis from Mozambique's seasonal malaria chemoprevention programme

Authors: Bryony Simmons, Neide Canana, Ivan Alejandro Pulido Tarquino, Alfredo Covele, Abdul Mussa, Clésio Pedro, Christian Rassi, Liberty Bunce, Lesong Conteh

Digitalisation of the seasonal malaria chemoprevention campaign in Nampula, Mozambique, although incurring slightly higher costs than the paper-based campaign, has the potential to be a strategic and potentially economical approach to improving the efficiency and quality of large-scale campaigns, with significant operational benefits measured through personnel time savings.

Background
Digital tools can improve the efficiency and effectiveness of large-scale health campaigns, yet evidence on their economic value remains limited. Mozambique introduced a digital platform (SALAMA) for 2023/2024 seasonal malaria chemoprevention (SMC) delivery in Nampula province, reaching 1.5 million children. This study quantified the incremental costs and operational benefits of digitalisation compared to the 2022/2023 paper-based campaign.
 

Methods
We conducted a mixed-methods costing and operational efficiency analysis. Incremental financial and economic costs attributable to digitalisation were estimated from a programmatic perspective, excluding core SMC campaign costs. Operational benefits were measured through personnel time savings; health outcomes were not modelled. Data sources included financial records, documents, interviews, and focus group discussions. Scenario analyses projected future costs.
 

Findings
Digitalisation incurred an incremental cost of US$1,013,330 (67 percent financial, 33 percent economic), or US$0.66 per child treated — an 8 percent increase from the paper-based campaign. Costs were attributed to training and supervision (28 percent), digital equipment (25 percent), operations (25 percent), digital human resources (17 percent), and planning and software development (6 percent). An estimated 37,450 person-days were saved (US$240,000 potential saving), which could lower the unit cost to US$0.51 per child treated if realised through reduced staffing. Future scenarios projected reductions with digital and programme efficiencies. Stakeholders reported improved data availability, accuracy and decision-making, while noting connectivity problems, device issues and variable technology literacy.
 

Interpretation
While incurring upfront costs, digitalising SMC using locally adapted digital public infrastructure represents a strategic and potentially economical approach to improving large-scale health intervention efficiency and quality.

Citation: The Lancet Regional Health — Africa, 2026; available online 19 April 2026: 100054.