This piece was originally published on PSI Impact: Digital Tools for UHC

By Jabulani Mavudze, Director of Strategic Information and Evidence, Population Solutions for Health Zimbabwe; Aleck Dhliwayo, Information Systems Manager, Population Solutions for Health Zimbabwe; Staci Leuschner, Senior Country Representative, PSI Zimbabwe

In Zimbabwe, health workers faced a grueling challenge: there simply wasn’t enough support – providers trained to provide services, and transportation to get the providers to their clients– to deliver post-operative care to men who had undergone voluntary medical male circumcision (VMMC).

Population Services International (PSI) and Population Solutions for Health (PSH) with financial support from USAID and the Bill and Melinda Gates Foundation deployed the Workforce Application (WFA), a self-care smartphone application that allows clients to self-care post-VMMC procedure through zero-rated text or WhatsApp. Zero rating allows the client to send self-care messages back to the WFA at no cost, providing a free pass for self-care messaging activities. WFA was integrated with DHIS2 to provide health actors with real-time oversight into timely provider follow-ups and ensure the clients’ self-care reports to the WFA are consistent with their condition to demonstrate efficacy.

Providers can now focus on clients reporting concerns or seeking in-person reviews, reducing the work burden and lowering costs associated with in-person follow-ups.

Clients who use WFA self-care receive daily prompt messages to report their condition, concerns, or request additional wound care instructions. In the DHIS2 dashboard, previously identified words within client messages and clients who do not report self-care on specific days, set off an automated series of events resulting in a provider being notified to follow-up.

• In Zimbabwe: 62% of eligible VMMC clients choose to participate in post-operation self-care through WFA.
• 55% of WFA participants continued to self-care through the platform for the entire day seven post-operation monitoring.

Of the 8,138 retained in the entire WFA monitoring period:
• 83% reported “I am OK” after receiving prompts for reporting adverse events (AE) symptoms;
• 3% requested repeat instructions from WFA;
• 4% reported complications;
• 10% reported concerns for provider follow-up, resulting in provider follow-up

Enhancing DHIS2’s interoperability with other digital solutions for consumers presents an excellent opportunity to elevate the practicality and relevance of open-source DHIS2, which is widely used by Ministries of Health and implementing partners. DHIS2 can offer instantaneous data reporting and yield more effective outcomes with complete integration.