A mobile health platform that connects refugees to life-saving preventative care including prenatal check-ups, childhood vaccinations, and other health services in Turkey.

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Alysa St Charles
Program Manager


MEDAK, Field work and implementation




MEDAK, Field work and implementation


Grand Challenges Canada.
FastForward Accelerator
Mass Challenge Accelerator



Target Users

Client, Health Care Provider, Health System Manager, Data Services Provider

Enabling Environment Building Blocks

Strategy and Investment, Services and Applications

Family Planning Program Classification

Demand Generation, Service Delivery


The United Nations (UN) estimates that by 2050, 200 million people worldwide will be displaced from their homes in the wake of rising political conflicts and the acceleration of climate emergencies. Refugees face not only crises but a morbidity-mortality rate that is 60 times greater than more stable populations. Moreover, displaced women and children are at the highest risk of illness and death, and are also most likely to experience barriers to healthcare. [1]

HERA is named after the powerful Greek goddess and also stands for Health Recording App. It is a digital platform that exists to close healthcare gaps for displaced women and children, by connecting them to life-saving preventative care including prenatal check-ups and childhood vaccinations through their smartphones. Even as health services are available through relief agencies or host governments, demand-side barriers to accessing these services exist. These include language hurdles, xenophobia, and a lack of established medical records. Eliminating these demand-side barriers is crucial to increasing uptake of preventive services by refugee women and children. HERA works to diminish these barriers by providing health information in native languages, automatically calculating prenatal visit or vaccine schedules, and acting as a secure place to store individual medical data safely.

Data is self-reported by the user and supported with photos of their medical record. This is intentionally designed as an empowerment tool for the refugee end-user to capture and store their own personal health information (PHI).

There is no current integration into a clinic or hospital databases, but this may be considered for future pending data security navigation. Finally, data is stored locally, allowing for retrieval of medical records without access to the internet. (Image1) 


While most government and relief agency responses to displacement target increasing healthcare supply, the gap between refugees and preventative health care will remain until demand-side barriers such as language and health system navigation are eliminated. [2] HERA was launched in Turkey, the host country with the largest refugee population in the world. Even though healthcare is free for refugees in Turkey through a national program, high morbidity-mortality rates within these populations indicate there is a low uptake of the healthcare available.



HERA is an open-source mobile health (mHealth) platform designed by field experts, physicians, and refugees in Turkey. While specific Syrian refugee data in Turkey is challenging to obtain beyond market surveys, in a recent study with over 1,000 participants, 95.5 percent of Palestinian refugees in Jordan reported having a mobile phone. [3] Given the high projected levels of smartphone penetration, we concluded that mHealth approaches may be viably leveraged for refugee-directed interventions without physical provisions for smartphones at this time. [4] Appointment reminders are calculated after the app is downloaded and current health information is filled in. Refugees then receive push notifications about upcoming appointments regardless of connection to the internet.

HERA addresses additional challenges to refugees when needing health care, including offering health and medical information in their native language and locating emergency services or primary care clinics. [5] HERA advertises to target groups through direct service providers such as refugee health clinics and grassroots organizations [5], a strategy specific to the context of Turkey, where the majority of refugees are dispersed throughout the country in informal settlements rather than in refugee camps. HERA is also an agile app, meaning it is easily adjusted to respond to public and global health events, including pandemics.

HERA currently offers critical and up-to-date COVID-19 information to users in their native language, thereby eliminating language barriers between COVID-19 safety information and Turkey’s refugee populations. [5,6] HERA also has cost-effective capabilities to assuage financial concerns about refugee health. A return on investment projection for HERA suggests that, because HERA has an impact on vaccine and check-up compliance with implications for reduced morbidity and mortality from vaccine-preventable disease and pregnancy-related complications, HERA is both life-saving for refugees and a cost-effective tool for countries they migrate to.


HERA’s pilot study was completed in Turkey with the Syrian refugee population through an ethics review board-approved scientific study. This population was selected because Syrians make up approximately 3.8 million out of Turkey’s 4 million refugees. This study, centered on Syrian pregnant women and women with children under the age of two years as end-users, concluded it is highly feasible to implement a mHealth intervention for refugee groups. [5] The pilot study also concluded that automated reminders are a high-value alternative compared to other healthcare reminder methods. Above all, HERA found that refugee women have and are comfortable using smartphones and already use them to receive critical health information. Feedback was solicited from HERA users through interviews and focus groups.

HERA users were positive, with almost all stating that 1) HERA helped them with medical appointments; 2) HERA users were pleased they could keep their records digitally; and 3) supplementary health blogs within the app contributed to improved knowledge of current health issues, including the COVID-19 pandemic and any related government restrictions, information, and symptom descriptions. When evaluated by independent organizations such as Harvard Innovation Lab, Just One Giant Lab (JOGL), and Mass Challenge Accelerator, HERA scored highly among similar digital health interventions.

However, HERA’s unique differentiator is that it successfully provides users with regular reminders of prenatal and vaccination appointments for difficult to reach, vulnerable refugee populations. Overall, users and evaluators view HERA as an easy-to-use and valuable app for improving vaccines and prenatal care access.


  • Further prospective research is needed on the feasibility of mHealth platforms in hard-to-reach populations regarding mHealth impact on targeted health behavior change and patient-centered outcomes. In addition, since the mobility of refugee populations lends some instability when surveying HERA users, ongoing effort must be made for high-quality studies even amongst vulnerable or difficult to access populations.
  • Smartphone usage and connection to cell provider networks may be inconsistent or change over time for users.
  • Reminders should not only be push notifications but also SMS messages and automated phone calls to include users who do not have smartphones or access to a data network strong enough for phone apps.
  • There are many concerns about health data privacy and therefore a data protection explainer video is necessary to complement HERA’s instructional user video.


Global health efforts must adapt to meet the realities of mobile, displaced populations, especially as refugee populations are expected to increase in upcoming decades. Mobile phones will also grow to be more important in health interventions and data collection as cell phones continue evolving into a necessity rather than a luxury. [2,5,7,8] HERA locates health disparities and confronts them by targeting vaccines and prenatal care by a preventive health approach. Vaccines, particularly for children, are essential to prevent disease in refugee camps and other close living conditions.

HERA makes accessing vaccines easy by both providing a vaccine schedule and locating nearby health clinics. The same goes for prenatal care: The earlier on in pregnancy, the mother’s health is monitored, the healthier the pregnancy, birth, and newborn period. Ultimately, mHealth interventions such as HERA are empowerment instruments that restore control over health to refugees themselves. [2]

With HERA, refugees maintain sovereignty over their health by carrying health records with them, communicating, and navigating the host country’s health system.


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  5. Surmeli, A., Narla, N.P., Shields, A.J. and Atun, R. (2020). Leveraging mobile applications in humanitarian crisis to improve health: a case of Syrian women and children refugees in Turkey. Journal of Global Health Reports.
  6. Narla, N.P., Surmeli, A. and Kivlehan, S.M. (2020). Agile Application of Digital Health Interventions during the COVID-19 Refugee Response. Annals of Global Health, [online] 86(1). Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7566526/ [Last accessed 19 February 19th, 2021].
  7. Domek, G.J., Contreras-Roldan, I.L., Asturias, E.J., Bronsert, M., Bolaños Ventura, G.A., O’Leary, S.T., Kempe, A. and Bull, S. (2018). Characteristics of mobile phone access and usage in rural and urban Guatemala: assessing the feasibility of text message reminders to increase childhood immunizations. mHealth, 4, pp.9–9.
  8. Severi, E., Free, C., Knight, R., Robertson, S., Edwards, P., and Hoile, E. (2011). Two controlled trials to increase participant retention in a randomized controlled trial of mobile phone-based smoking cessation support in the United Kingdom. Clinical Trials: Journal of the Society for Clinical Trials, 8(5), pp.654–660.
  9. Tobe, R.G., Haque, S.E., Ikegami, K. and Mori, R. (2018). Mobile-health tool to improve maternal and neonatal health care in Bangladesh: a cluster randomized controlled trial. BMC Pregnancy and Childbirth, [online] 18. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5902947/.


  1. HERA (2021). HERA Digital Health. website: heradigitalhealth.org [Last accessed December 3rd, 2021)
  2. App Store for iPhones: https://apps.apple.com/us/app/hera-medak/id1485708770 3. Google Store for Android and others: https://play.google.com/store/apps/details?id=com.wdt.hera.app