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Mozambique, 31 May 2017: Self-made mHealth trouble-shooter

© UNICEF Mozambique/2017/Rodrigues

By Nelson Rodrigues

Innovation is more than just technology, it’s about being creative, resourceful and able to learn and adapt. During a recent field trip, I met with Belafonte Jaime who is a perfect example of this.

Belafonte Jaime works in Metuge District Health Department where he coordinates the activities of 19 community health workers. Since the upSCALE project started, Belafonte decided to learn about mobile applications management and troubleshooting mobile phones to ensure that as many children and families as possible in his district benefit from improved community-based healthcare.

When I visited Metuge district, the rainy season had started and road access beyond the capital city of Pemba was difficult. Muddy roads transform short distances into slow, lengthy routes that deny people access to adequate healthcare. The Ministry of Health is implementing the ‘Agentes Polivalentes Elementares’ strategy, which includes the deployment of approximately 3700 community health workers, or APEs as they are commonly known, throughout Mozambique.

Recently, UNICEF in partnership with Malaria Consortium has taken this support a step further through the implementation of upscale, an mHealth programme designed to improve the quality of care provided by the APEs (Community health workers). As part of the programme, the APEs are equipped with mobile devices with pre-installed software that supports the consultation workflow, improving the quality of the healthcare. In addition, the devices record patient history files and household information.

For a successful implementation of upSCALE, a change in practice is needed. When I first met Belafonte he was carrying two mobile phones with him.

“In our last monthly meeting two APEs informed me that their devices were not working properly,” Belafonte told me. “I decided to try to solve the situation. In one of the phones the application shortcut was missing, so I had to re-install it. As for the other phone, I think it’s a hardware problem because I can’t turn it on!”

He explained that with the introduction of the programme he saw an opportunity to improve his work as well as that of the APEs, by improving the quality of services and generating faster, more reliable statistics. But in order to do so, he needed to have as many devices as possible operational. Without ever receiving training or instructions to do so, Belafonte learnt how to manage the mobile devices, and how to troubleshoot them either by remote or direct support.

Belafonte also identified community health workers that seemed better at handling the mobile application and designated them as focal points to provide support to three other community health workers to create a peer support network.

He explained, “It’s extremely hard to reach the communities, especially in the rainy season. The best solution is to have a good first line of response in the community. These devices and applications help the community to be able to deliver such a response. For me, it generates data and statistics so I know what is happening in communities. Can you imagine how many silent cases there would be if I didn’t have the statistics?” “It also has a positive impact in the consultation procedures as the APEs are reminded of which questions to ask and what exact prescriptions to provide to children. And while the increase in the quality of the procedure is the most important, in the future we might even get to have maps so I’ll be able to pinpoint exactly which households have specific issues!”


For more information, please contact:
Claudio Fauvrelle, Tel +258 21 481 100, Email:



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