From Pilot to National Impact: How Digitalising Mozambique’s Community Health System Increased Referral Completion by 98% and Expanded Care to 600,000 Households

Community health workers (CHWs) are the backbone of primary healthcare in Mozambique, yet for decades their reach was constrained by fragmented data systems, weak supervision, and geographic isolation. Recognising that technological innovation could bridge these systemic gaps, the Ministry of Health, Malaria Consortium, and UNICEF co-developed upSCALE, a digital health platform integrated into the national electronic community health information system (eCHIS).

Launched nationwide in 2017, upSCALE now supports 3,654 CHWs and 1,000 supervisors, reaching over 600,000 households and registering more than 3 million patients. Retrospective analysis (Jan 2023–Dec 2024) shows transformative impact: 98 % referral completion (8,218 monitored visits), 161 % target achievement for health promotion (17,578 reached), treatment of 14,147 children for priority diseases, and 62,595 new patient registrations. The integration of real-time data into DHIS2 enhanced accountability, enabled rapid decision-making, and informed district-level resource allocation.

Importantly, the digital platform shifted CHW roles from passive service delivery to active system mobilisation, increasing follow-up rates, improving quality of care, and strengthening resilience during health shocks. Mozambique's experience demonstrates how embedding government-owned digital platforms into national systems can convert pilot-scale innovation into nationwide transformation - a scalable blueprint for other low-resource countries seeking resilient, data-driven primary healthcare.