Lessons from using SALAMA (DIGIT HCM-health campaign management platform) to implement and optimize seasonal malaria chemoprevention in Nampula, Mozambique

Abstract

Mozambique has the fifth highest malaria burden globally, with children under five most affected. To reduce this impact, Mozambique adopted seasonal malaria chemoprevention as a national strategy. In 2024, the National Malaria Control Program, in collaboration with Malaria Consortium and eGovernments Foundation, transitioned from paper-based to digital data collection using the DIGIT Health Campaign Management platform. We describe the digitalization process from planning to implementation and document the lessons. A cascade training and real-time dashboards facilitated data monitoring, stock tracking and supervision. Key results included improved sulfadoxine-pyrimethamine plus amodiaquine administration, enhanced data use for daily decision-making and early identification of outliers. For example, in Moma district sulfadoxine-pyrimethamine plus amodiaquine wastage exceeded 10% on the first day-unusual wastage rates are defined as >5%-prompting immediate targeted supervision which reduced wastage on subsequent days. Challenges including device power constraints, internet connectivity and local technical capacity, which were addressed through training and on-the-ground technical support. The digital approach improved campaign efficiency, transparency, responsiveness and supervision quality. Administrative coverage rates (75-109%) were more consistent with survey-based household coverage (~74%) in the digital campaign than the paper-based campaign which were 93-105% and ~79%, respectively. Importantly, the digital approach allowed for the visualization of the proportion of first-day doses recorded digitally in real time and the direct observation of therapy adherence, an important indicator of seasonal malaria chemoprevention campaign quality. This experience highlights how digital innovations, when well-coordinated and adapted to local contexts, can enhance malaria prevention and provide a case study to inform the scaling digital health interventions across public health programmes in Mozambique.

Keywords: Nampula province; community based health information systems; data use; digital health; malaria; northern Mozambique.

Figure 1

SALAMA community distributors workflow

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SALAMA app—community distributor profile—main page, after login

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SALAMA app—community distributor profile after clicking on the beneficiaries button—for search and add beneficiaries page

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SALAMA app—community distributor profile—household details page

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SALAMA app—community distributor profile—SPAQ delivery

Figure 6

SALAMA community distributor supervisor workflow

Figure 7

SALAMA overall dashboard, for cycle 4

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Location of Nampula province, Mozambique

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SMC paper-based M&E data collection & aggregation

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SMC SALAMA data collection, aggregation and visualization