As low- and middle-income countries transition from paper to digital systems, family planning programs can benefit from unprecedented opportunities to improve services. Investments in digital health tools have expanded exponentially, but information on what works—and what does not— remains limited and scattered. As investments have increased, digital applications and data fragmentation have proliferated, but stakeholders are moving towards more coordinated efforts to scale digital health solutions, support countries’ digital health infrastructure, and share evidence-based learnings.
This Digital Health Compendium enables users to explore case studies across a range of digital health technologies used to enhance family planning programs mainly in sub-Saharan Africa, but also in other regions of the world. Digital health applications in family planning programs can be broadly classified as those affecting demand generation, service delivery, supply chain management, and the policy and enabling environment. In many low- and middle-income countries, digital health innovations were adopted earlier in other health sectors, including HIV/AIDS, maternal and child health, and noncommunicable disease prevention and response. As a result, much of the impact evidence is likewise restricted to those sectors. To advance greater adoption of digital technology in family planning programs, more data and information on the challenges, opportunities, scalability, and results are needed. This compendium aims to consolidate emerging information and data on applications of digital technology in family planning programs to inform adoption and scale-up of successful approaches.
All of the case studies were submitted by the implementing organizations and include a description of the digital health intervention, program context, and, if available, important findings and lessons learned through rigorous evaluations or program data. The compendium facilitates a quick search for case studies based on the target user for digital health intervention, building block for the digital health enabling environment, family planning program classification, and country location. The case studies give policy and program decisionmakers insights on real-world applications of digital health, promising practices, challenges, and other lessons that can be applied to current and future programs.
Regional Director, Africa
The information below appeared in the original case study.
BBC Media Action
Ghana Health Service
University of Southern Maine
World Health Partners
Bill and Melinda Gates Foundation
Johnson & Johnson
Government of Norway
Director of Innovations in mHealth
Client, Health Care Provider, Data Services Provider
Services and Applications
Demand Generation, Service Delivery
This case study was originally published in the mHealth Compendium Volume 1, developed by the African Strategies for Health project, implemented by Management Sciences for Health with support from the U.S. Agency for International Development (USAID). Updates to the original case study appear in the final section of this case study.
The MOTECH Suite delivers an integrated set of complementary mHealth applications that are scalable, sustainable and readily deployed. The collaborative community of development organizations behind MOTECH Suite has provided an open-source platform addressing the core needs of mobile health, creating a widely-deployed mHealth platform across a wide range of geographies and health interventions.
MOTECH Suite has been used by the Ghana Health Service to increase demand for antenatal care while simultaneously collecting service delivery information from community health workers. In six cities in India, MOTECH Suite is being used to provide care and treatment reminders to HIV-positive patients. In Bihar, India, BBC Media Action has developed services to increase frontline health workers communication skills and knowledge of life-saving maternal and child health behaviors. CARE also uses a MOTECH Suite system in Bihar to track pregnant women, mothers, and children under one along the continuum of care with specific protocols on birth preparedness, delivery, postnatal care, and exclusive breast feeding. World Health Partners is extending timely, quality access to tuberculosis diagnosis and treatment to Bihar’s rural population. World Vision has deployed MOTECH Suite-based maternal, newborn, and child health services in Afghanistan, Mozambique, and Zambia and has plans for scaling to Sierra Leone, Uganda, Tanzania, and Zambia.
MOTECH Suite comprises a set of complementary open source technologies from a consortium of partners, including Dimagi, Grameen Foundation, InSTEDD, OnMobile, ThoughtWorks, University of Southern Maine, and others. The MOTECH Suite consortium has core funding from the Bill and Melinda Gates Foundation, as well as project-specific funding from Johnson & Johnson, Government of Norway, and USAID, among others.
MOTECH Suite functionality includes inter-operable workflows within and across five key functional areas: improving demand for health services, managing patient data, improving frontline worker performance, managing the last-mile supply chain, and tracking patient compliance with treatment. Capabilities include:
Common features of MOTECH-based applications are listed below.
MOTECH Suite has supported Ghana’s Mobile Midwife Program for more than two years. There, MOTECH covers 46 facilities and over 1,100 active mobile midwives, and has more than 21,000 registrants. It has delivered nearly 58,000 SMS and voice messages, provided training for 165 CHWs, and uploaded over 134,000 patient records.
The Ghana program is considered a great success. It is being expanded into three new districts in 2012-2013 and the Ghana Health Service is taking on increased management responsibilities as part of a planned transition to deployment across the entire country.
Key lessons in using the MOTECH Suite platform in Ghana include:
MOTECH Suite has great potential to make a difference in the quality of health care delivery and status. The program is steadily growing in scale and maturity and has a strong consortium of partners contributing both technology and field implementation expertise.
The MOTECH implementation in Ghana began in 2010 and ended in 2015, when the project ended. In Ghana, MOTECH consisted of two mutually supporting mobile phone applications: Mobile Midwife and the Client Data Application (CDA). Rural women experienced Mobile Midwife as an automated voice message service that delivered weekly educational messages to their mobile phones, timed to their gestational age or the age of their infant. Community health nurses engaged with the CDA to digitize information on the health services they provided and to better track and deliver care to women and infants. Aspects of the CDA were leveraged by the Ghana Health Service to design and develop the e-Tracker tool—the android app that provides an offline alternative to its traditional online web-based data capture and reporting tools—which is currently still in use.
Key lessons learned from the MOTECH implementation in Ghana summarized in the 2015 report include:
A system like MOTECH could work on a national scale in Ghana, provided certain practices and adaptations were put into place:
Innovative public-private partnerships are needed for a system like MOTECH to be sustainably financed and operated on a national scale in Ghana. Scaling up MOTECH’s client data system could be particularly challenging, given the training and monitoring required.
Mobile health solutions intended for broad use within the public health sector should be designed for national rollout from the beginning to ensure that key components are fully integrated into government management structures and practice standards. For this to happen, government at the highest levels needs to lead strategic decisionmaking about technology and implementation choices.
More details on the experiences and lessons learned from the five years of MOTECH implementation in rural Ghana are available here.
Original Case Study
Information was excerpted from:
MOTECH Suite: http://motechsuite.org
Mobile Technology for Community Health in Ghana; What it is and What Grameen Foundation has Learned So far; Second Edition: September 2012 http://www.grameenfoundation.org/sites/default/files/MOTECH-Lessons-Learned-Sept-2012.pdf
Mobile Technology for Community Health in Ghana: http://healthmarketinnovations.org/program/mobile-technology-for-communityhealth-motech
Grameen Foundation, “Mobile Technology for Community Health in Ghana: What It Is and What Grameen Foundation Has Learned So Far,” September 2012,
Grameen Foundation, “Using Mobile Technology to Strengthen Maternal, Newborn, and Child Health: A Case Study of MOTECH’s Five Years in Rural Ghana,” 2015,
Note: this project update was produced by PRB based on the references listed above.