A National-Scale mHealth Program for South Africa

South Africa’s Ward Based Primary Healthcare Outreach Team (WBPHCOT) program supports underserved communities across all of the country’s 52 districts. Focusing on a range of areas, the program aims to improve nutrition, reproductive health and family planning, primary care for children, and social services and grants for South Africans across the country.

More than 60,000 community health workers have been the heart of this program for decades, but recently, the South Africa National Department of Health (NDoH) has begun efforts to centralize, digitize, and arm this powerful workforce with tools to meet their needs.

Today, the WBPHCOT program’s CommCare applications have been deployed in five districts across South Africa with more than 6,500 CHWs. These workers have registered more than 150,000 households and are providing ongoing service to nearly 500,000 clients.

South Africa’s twin epidemics, TB and HIV, mean that a great deal of emphasis is placed on testing, adherence support, and linkage to care for very vulnerable populations, and these CHWs manage many of their clients’ needs one-on-one for years.

Dimagi’s support of the WBPHCOT program involved much more than just the development of a mobile application. Our team also supplemented the NDoH’s work in a number of complementary aspects of the larger mHealth program:

Training Program Design: Dimagi worked closely with Aurum Health Institute to design a streamlined training program for a central cadre of Master Trainers, including digital manuals, printed content, videos, and web content.

Helpdesk & Implementation Support: We developed a multi-tier tech support network to provide quick resolution of hardware, software, and connectivity issues for all users.

Government Engagement: From the outset, our management team worked side-by-side with other partners on liaising with key national and provincial administrators to present national-scale strategy and act as key participants in various technical working group meetings and funder interactions. 

Technical Assistance on Device Selection & Management: Dimagi provided rigorous device testing services, provided direct support and technical inputs to the RFP for choosing a device vendor, and worked closely with the hardware vendor and telco service provider on the installation of CommCare.

Reporting & Data Use at Scale: Dimagi technology and services staff regularly collaborate with government actors and implementing partners to tailor data exports, design and build reports, and build capacity for strategic data use.

During the initial announcement of the initiative, Former Minister of Health Aaron Motsoaledi said:

“The community health workers within the WBPHCOTs…  form the bridge between communities and healthcare service provision within health facilities. WBPHCOTs will bring healthcare closer to communities, families and individuals, even in the most rural and underserved areas. [This] strategy will contribute enormously to building a sense of ownership in the public health system, with members of the community actively participating in keeping their families healthy and caring for those in need.”

Initial reception of the WBPHCOT program’s CommCare applications have been widely positive, with users describing the tools as “user-friendly and easy to understand.” They also felt the app is “much easier and improves the way service delivery will be handled.”

Work continues on the ongoing improvement of the WBPHCOT system, and Dimagi will maintain its support of the NDoH in sustaining the system through 2020 and beyond. The eventual objective will be to cover all 27 PEPFAR districts, totaling 38,000 users.

For more detail on Dimagi’s engagement with the South Africa National Department of Health, click here.