Article Text
Abstract
MomConnect is a national initiative coordinated by the South African National Department of Health that sends text-based mobile phone messages free of charge to pregnant women who voluntarily register at any public healthcare facility in South Africa. We describe the system design and architecture of the MomConnect technical platform, planned as a nationally scalable and extensible initiative. It uses a health information exchange that can connect any standards-compliant electronic front-end application to any standards-compliant electronic back-end database. The implementation of the MomConnect technical platform, in turn, is a national reference application for electronic interoperability in line with the South African National Health Normative Standards Framework. The use of open content and messaging standards enables the architecture to include any application adhering to the selected standards. Its national implementation at scale demonstrates both the use of this technology and a key objective of global health information systems, which is to achieve implementation scale. The system’s limited clinical information, initially, allowed the architecture to focus on the base standards and profiles for interoperability in a resource-constrained environment with limited connectivity and infrastructural capacity. Maintenance of the system requires mobilisation of national resources. Future work aims to use the standard interfaces to include data from additional applications as well as to extend and interface the framework with other public health information systems in South Africa. The development of this platform has also shown the benefits of interoperability at both an organisational and technical level in South Africa.
- Child Health
- Health Systems
- Maternal Health
- Public Health
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
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Footnotes
Handling editor Seye Abimbola
Contributors CS, PD, DR, VS and TF were part of the team that designed and developed the MomConnect technical platform and maintain it through its ongoing operations. PB led the mobile maternal health task team on behalf of the NDoH from inception and provided critical inputs to the design and development of the technical platform as well as final sign-off. ANP and MB contributed early inputs to the design and development of the system from a technical and public health aspect. All authors contributed to writing and reviewing the manuscript.
Funding MomConnect is supported by a consortium of local and international funders, including the United States President’s Emergency Plan for AIDS Relief (PEPFAR), the United States Agency for International Development (USAID), the Johnson & Johnson Foundation, UNICEF South Africa, ICF International, Elma Philanthropies, Cardno Emerging Markets and Regenstrief Institute. The mobile operators in South Africa—Cell C, MTN, Telkom Mobile and Vodacom—afforded generous discounts on the commercial cost of SMS messages and USSD sessions.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement The anonymised, aggregate data set for figure 3 is available from the South African National Department of Health by application to the corresponding author.