LINDA-FAMILIA

The challenge

There are many ways in which digital technologies can improve healthcare, from efficient management of patient information to text messaging of reminders of clinical appointments. In many sub-Saharan African countries, however, paper-based health systems remain the norm at service-delivery levels, with information then laboriously entered into electronic systems for reporting. 

Although efforts are underway to introduce digital health technologies, implementation is often haphazard. By one estimate, nearly 1,000 separate systems are used in health systems in sub-Saharan Africa.

One area where digital health technologies could have a major impact is in maternal, neonatal and child health. Around 200,000 of the 290,000 maternal deaths occurring each year happen in sub-Saharan Africa, which also has the highest neonatal mortality rate in the world, with infections accounting for an estimated one in four of such deaths. 

The project

The LINDA-FAMILIA project is working with ministries of health in four East African countries (Ethiopia, Rwanda, Tanzania, and Uganda) to introduce and scale up a dozen evidence-based digital health technologies for maternal, neonatal, and child health.

These applications cover a range of uses, including:

• Capture and storage of patient-related information.
• Coordination of patient referrals.
• Support for clinical decision-making.
• Planning health professionals’ work schedules.
• Communication with health service users.
• Data collection, coding and exchange. 

The project has a strong focus on integration with existing systems and long-term sustainability. New tools will be integrated within a widely used health information system (DHIS2), drawing on the flexible functionality of individual-level electronic health registries (eRegistries).

The health ministries of each country are part of the project team and will select which digital health technologies to introduce or scale up. They will also help to co-create the specific design of tools introduced nationally. This work will be informed by an initial landscape review, setting out the current state of digital health in each country. A post-project sustainability plan will be developed in each country to ensure continued use of the new tools. 

In addition to improving care delivery, digital health systems also offer opportunities for research embedded in routine care. To demonstrate the potential of such research, the project will undertake two studies: a cross-country comparative analysis of maternal and neonatal infectious diseases and a clinical trial to assess the impact of text messaging on antenatal care attendance and facility-based delivery. 

Impact

The LINDA-FAMILIA project is working with ministries of health in four East African countries (Ethiopia, Rwanda, Tanzania, and Uganda) to introduce and scale up a dozen evidence-based digital health technologies for maternal, neonatal, and child health.

These applications cover a range of uses, including:

• Capture and storage of patient-related information.
• Coordination of patient referrals.
• Support for clinical decision-making.
• Planning health professionals’ work schedules.
• Communication with health service users.
• Data collection, coding and exchange. 

The project has a strong focus on integration with existing systems and long-term sustainability. New tools will be integrated within a widely used health information system (DHIS2), drawing on the flexible functionality of individual-level electronic health registries (eRegistries).

The health ministries of each country are part of the project team and will select which digital health technologies to introduce or scale up. They will also help to co-create the specific design of tools introduced nationally. This work will be informed by an initial landscape review, setting out the current state of digital health in each country. A post-project sustainability plan will be developed in each country to ensure continued use of the new tools. 

In addition to improving care delivery, digital health systems also offer opportunities for research embedded in routine care. To demonstrate the potential of such research, the project will undertake two studies: a cross-country comparative analysis of maternal and neonatal infectious diseases and a clinical trial to assess the impact of text messaging on antenatal care attendance and facility-based delivery.