MOZAMBIQUE - SALAMA (Public Health)

This video details Mozambique’s journey in adopting Salama, a Digital Public Infrastructure (DPI) solution built on eGov Foundation’s open-source DIGIT platform, to manage large-scale public health campaigns, specifically focusing on malaria control. It provides insights into the challenges faced with previous systems, the benefits of using an adaptable DPI approach, and the key factors for successful implementation and scaling. The practical value lies in demonstrating how reusable digital infrastructure can significantly improve the efficiency, monitoring, and effectiveness of public health interventions in resource-constrained settings.

Synthesized Summary

Mozambique’s National Malaria Control Program (NMCP) faced significant challenges in managing its various large-scale malaria campaigns (LLIN, IRS, SMC) effectively using existing tools like DHIS2 and siloed approaches. These methods lacked real-time data, robust monitoring capabilities, effectiveness tracking, and specific functionalities needed for campaign logistics, such as geo-location mapping, payment tracking for field workers, and inventory management across different campaign types. [01:59-02:18], [03:04-03:35]

To address this, in 2020, the NMCP, under the leadership of Dr. Baltazar Candrinho, decided to adopt a digital approach. They partnered with eGov Foundation to implement Salama, a Health Campaign Management (HCM) system built using the reusable, open-source building blocks of the DIGIT platform – a form of DPI. [02:19-04:50] Salama was designed to be adaptable, allowing localization for Mozambique’s context (Portuguese language, specific workflows, data needs) and integration with existing systems like DHIS2 where necessary. [05:21-07:12], [07:34-07:45]

The implementation emphasized a human-centric design, involving extensive fieldwork (75-100 days) shadowing campaigns, working directly with health workers, gathering feedback through multiple iterations, and conducting usability testing to ensure the tool met the needs of end-users and simplified their tasks. [08:45-10:09], [10:48-11:19] Key benefits realized include real-time data collection and visibility through dashboards, enabling better monitoring of campaign progress, coverage, and team performance. This data-driven approach allows for more efficient resource allocation, quicker identification of stockouts or low-performing areas, and improved overall campaign effectiveness, ultimately contributing to the goal of protecting more people from malaria. [24:28-25:35], [32:32-33:06]

Key Learnings & Recommendations

• DPI Enables Real-Time Campaign Management: Digital platforms like Salama/DIGIT provide crucial real-time data visibility for monitoring coverage, team performance, and logistics during large-scale health campaigns. [24:33], [32:50]
• Reusability Drives Efficiency: Utilizing open-source, reusable DPI building blocks (like DIGIT) significantly reduces the time and cost of developing and deploying solutions for new use cases (e.g., adapting from LLIN to SMC campaigns) or new geographies. [05:41], [18:13]
• Address Specific Needs Beyond Generic Tools: While tools like DHIS2 are valuable, specialized campaign management requires functionalities (geo-location, logistics, payments) that may necessitate dedicated or adapted platforms like Salama/HCM. [03:11-03:35]
• Strong Leadership is Essential: Committed leadership (“champions”) within the government (like Dr. Candrinho) is vital to drive the vision for digitalization, secure buy-in, and navigate implementation challenges. [19:10], [19:44]
• Human-Centric Design Improves Adoption: Focusing on the end-user experience through field research, iterative feedback loops, and usability testing ensures the technology aids, rather than burdens, frontline workers. [08:45], [09:53]
• Build Local Capacity and Partnerships: Successful DPI implementation requires building an ecosystem involving local partners for localization (language, context), training, and long-term sustainability, reducing dependency on external tech providers. [20:37], [23:04], [27:25]
• Unified Platform Overcomes Silos: Consolidating different campaign management functions onto a single platform improves data consistency, simplifies management, and enhances overall program efficiency compared to fragmented systems. [04:10], [14:34]
• Digitalization is a Learning Process: Implementation involves challenges (connectivity, device management, user skills, initial resistance); persistence, belief in the vision, and continuous engagement with teams are key to overcoming them. [25:46], [33:50], [34:14]

Key Visual Information

• Map of Mozambique: Overlays show the geographical context of the implementation. [Throughout]
• Speaker Titles/Affiliations: Text overlays identify speakers and their roles/organizations. [e.g., 00:25, 00:41, 00:58]
• Section Title Cards: Simple text cards introduce different thematic questions being addressed by the speakers. [e.g., 01:33, 04:51, 08:40]
• (Implied) Dashboards/Platform Screenshots: While not shown in detail in the provided transcript context, the discussion implies the use of dashboards for real-time monitoring within the Salama platform. [24:43]

Key Consensus Points & Methodological Spectrum

This video presents a collaborative case study, not a debate. The core approach agreed upon and implemented was:

• Problem: Existing methods for managing large-scale malaria campaigns were inefficient, lacked real-time data, and used siloed tools.
• Solution: Adopt a Digital Public Infrastructure (DPI) approach by implementing Salama, a specialized Health Campaign Management (HCM) system.
• Methodology: Leverage the open-source, reusable building blocks of the eGov Foundation’s DIGIT platform, adapting and localizing them for Mozambique’s specific needs through partnership between the Ministry of Health (NMCP) and eGov Foundation. This involved significant user research and iterative development.

Key Questions Addressed or Raised

Addressed:

• What were the challenges Mozambique faced in managing malaria campaigns digitally? [01:59]
• What is DIGIT and how does it function as a DPI? [01:37]
• How was the DIGIT platform (Salama/HCM) adapted for Mozambique’s specific public health campaign needs? [04:51]
• How were usability and inclusion factored into the design and deployment? [08:40]
• What are the operational benefits of using Salama/HCM at different campaign phases? [11:20]
• What are the key outcomes and impacts observed from deploying Salama? [24:23]
• What are the lessons learned from the implementation process? [21:05], [25:42]
• What factors are needed for successful DPI implementation (leadership, partnerships, capacity)? [19:06], [23:04]

Raised (Implied Needs/Future Work):

• How to ensure long-term sustainability and local ownership of the platform? [Implicit in partnership/capacity discussion]
• How can the Salama platform be scaled to cover all provinces and potentially other health programs within Mozambique? [24:07], [31:45]
• How can real-time data be further leveraged for predictive analytics or improved planning? [Implicit in data benefits]

Stated or Implied Applications

• Malaria Campaigns: Directly applied for LLIN distribution, Indoor Residual Spraying (IRS), and Seasonal Malaria Chemoprevention (SMC). [02:38], [04:13], [12:53]
• Other Health Campaigns: The reusable nature implies potential application for Polio, Tuberculosis, HIV campaigns, or other public health initiatives. [05:34]
• Broader Public Service Delivery: DIGIT platform’s building blocks can potentially be used for other government sectors like sanitation, finance management, or urban services. [00:34]
• Inventory & Logistics Management: Applicable for tracking and managing the supply chain for campaign commodities (nets, insecticides, drugs). [07:49], [21:30]
• Field Worker Management: Used for tracking attendance, performance, and potentially payments for campaign staff. [03:30], [18:51]
• Monitoring & Evaluation: Provides real-time data for program monitoring and assessing campaign performance/coverage. [24:33], [32:32]

Key Terminology Defined

• DPI (Digital Public Infrastructure): Foundational concept of shared digital systems enabling services at scale. [Implied throughout, explicitly mentioned ~04:56]
• DIGIT (Digital Infrastructure for Governance and Inclusive Transformation): eGov Foundation’s open-source platform providing reusable building blocks for various government services. [01:37]
• HCM (Health Campaign Management): The specific application/suite of tools built on DIGIT tailored for managing public health campaigns. [Referenced frequently, e.g., 06:23]
• Salama: The specific name given to the DIGIT HCM implementation in Mozambique for malaria campaigns. [04:38], [30:34]
• Building Blocks: Reusable software components (e.g., registries, workflow engines, data collectors) that form the basis of the DIGIT platform. [01:48], [04:51]
• Localization: Adapting the platform to the specific context of a country, including language, workflows, and local processes. [06:26]
• LLIN (Long-Lasting Insecticidal Nets): A type of malaria intervention campaign. [02:38]
• IRS (Indoor Residual Spraying): A type of malaria intervention campaign involving spraying insecticides inside homes. [04:15], [12:13]
• SMC (Seasonal Malaria Chemoprevention): A type of malaria intervention campaign involving distributing preventative medication. [04:17], [12:53]
• DHIS2 (District Health Information Software 2): A widely used open-source health management information system, mentioned as having limitations for specific campaign needs. [03:05]

Timestamped Outline / Chapters

• [00:00] Introduction: Future goals & Speaker Introductions (Candrinho, Mehra, Tyagi)
• [01:33] What was the journey of developing the DPI? (Problem statement, Intro to DIGIT)
• [04:51] How were the building blocks of DIGIT re-used and adapted for Mozambique’s health campaign needs? (Localization, Reusability)
• [08:40] How was inclusion and usability factored into the design of HCM? (Human-centric design, field work)
• [11:20] How does DPI support campaign operations at each phase and What are the benefits? (Campaign types: LLIN, IRS, SMC)
• [19:06] How can champions drive DPI adoption and scale? (Leadership, Partnerships)
• [21:05] What were the lessons learned from deploying Salama and how were challenges overcome in this process? (Coverage data challenge)
• [24:23] What are the outcomes from deploying HCM (Salama)? (Efficiency, Real-time data)
• [25:42] What lessons have you learned from deploying Salama? (Belief, Team building, Process)
• [31:25] What is the future potential you see with DIGIT HCM (Salama)? (Scaling, Other programs)
• [32:28] Closing Remarks: Benefits summary and future goals.

Related Resources Mentioned

• eGov Foundation: The organization providing the DIGIT platform and partnership. [Mentioned frequently]
• DIGIT Platform: The specific open-source DPI platform used. [Mentioned frequently]
• DHIS2: Mentioned as a comparative system. [03:05]
• (Implied) National Malaria Control Program (NMCP) of Mozambique: The implementing government body.
• (Implied) Co-Develop, DPI Exemplar Stories: Producers/Platform hosting the video.