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.
Easy-to-adapt family planning reference application, built to support frontline health workers working in family planning
Health Solutions Lead
Ona (lead technology partner on the OpenSRP platform; technology partner to develop the WHO FP reference app on top of OpenSRP)
WHO (FP guidelines developer)
UNFPA (FP guidelines implementation)
2018 - 2020
17 countries around the world
Client, Health Care Provider, Health System Manager, Data Services Provider
Services and Applications, Standards and Interoperability, Workforce
Access to family planning (FP) leads to a reduction in unintended pregnancies, risky abortions, and maternal and child mortality. Women with access to FP make informed decisions on the number and spacing of children and when to have them. However, unmet FP need is projected to remain greater than 10 percent globally until 2030 with 214 million women of reproductive age in developing countries not using modern contraception. Disparities between countries is also an issue; twice as many women in developed countries are using modern contraceptives compared to women in developing countries. All this is due to challenges in FP access, demand, and availability.
Globally, countries recognize the potential of digital technology to address these challenges, but they struggle to identify and scale appropriate digital solutions. A multitude of mobile apps and tools to support front line health workers (FLHW) exist, but rarely do they speak to one another or readily integrate into the country’s existing or planned health information ecosystem. While countries deal with these interoperability challenges, implementation partners are likewise challenged by the complexity of adapting these solutions to meet their unique contexts, and often resort to “build-from-scratch” models—instead of investing in existing, open source digital health solutions.
The World Health Organization (WHO) is investing in the development of Accelerator Kits for health content areas, including FP. Accelerator Kits are designed to accompany WHO guidelines with the aim of making the guidelines practical and more easily incorporated into health systems. The Accelerator Kit for Family Planning contains business process workflows for FP, minimum required data elements, and reporting indicators. The kits are software-agnostic, meaning any digital health tool geared for FLHWs can adapt and use them.
Open Smart Register Platform (OpenSRP) is one such digital health tool that is being used to make the adoption of the WHO Accelerator Kits easier and more practical. To date, Ona has partnered with WHO to develop a reference module in OpenSRP for antenatal care (ANC) and FP. This was based on WHO guidelines and using the content from their ANC and FP Accelerator Kits. A reference module simply means the software is referencing the WHO global guidelines to support routine ANC or FP primary healthcare. The OpenSRP FP reference module will be made available to countries as a digital health solution that already incorporates all of the minimum data and content requirements from the WHO Accelerator Kit.
While countries may choose different digital health solutions, the benefit of the WHO FP reference module follows that of the 80/20 rule, whereby 80 percent of the solution exists and can be used as-is, while 20 percent needs to be built or adapted to the specific local context. For countries that do not have an existing FP digital health solution for FLHWs, or for countries that need to update their FP guidelines, the reference module can help them get there faster.
OpenSRP is an open source digital health tool and global good geared towards FLHWs, working both in communities and facilities, that allows them to register and track the healthcare of their clients. It combines client registration, identification and management, decision support, work planning and tasking, reporting, and mapping workflows to enable health workers to provide comprehensive and quality care across the Reproductive, Maternal, Newborn, and Child Health continuum of care.
As the WHO FP reference module and Accelerator Kit are expected to launch in 2020, we do not have any evaluation or results data ready to share at this time.
The WHO and the United Nations Population Fund (UNFPA) have identified—and will invite—six countries in sub-Saharan Africa to a workshop to kick-start the implementation of the Accelerator Kit and reference app. During the workshop, countries will learn about how the WHO Accelerator Kits and accompanying OpenSRP reference module for FP works. Countries will develop implementation plans for how they plan to take the Accelerator Kit and the FP reference app to their country, and how these tools can be adapted to help them achieve better FP outcomes (for example, FP coverage, FP quality of care, access to FP commodities, etc.) in their local context. As part of adopting the Accelerator Kit content and reference app, countries will be able to take up a common reporting framework for FP that will allow the results from different countries to be interpreted and analyzed together.
By launching the Accelerator Kits and reference modules for health domains, such as ANC and FP, the WHO aims to give countries the tools and means to more easily and efficiently adapt their guidelines. An easier, faster, and more cost-effective adoption process will ultimately benefit health workers, the health system in which they operate, and ultimately, the clients that they serve. Building on the previous work to develop a “reference” ANC module in OpenSRP, Ona is now partnering with WHO to build and release a reference app for FP, which will be used by FP service providers to register their FP clients and provide appropriate and comprehensive FP options and counseling. Countries will be able to more easily adapt the reference FP module to suit their specific needs and requirements instead of developing a solution from scratch.