Over a period of ten months, the MoHCC will work closely with the Vital Wave team to accomplish the following: 1) strengthen the Zimbabwe digital health system through the creation of a central client registry based on the existing component of the Impilo platform in accordance to global standards (e.g., OpenHIE), and 2) package and distribute the standalone client registry as an open-source global good to be used in other low-resource settings.

Zimbabwe offers a unique opportunity to develop and contextualize a client registry solution to benefit the MoHCC and the global digital health community at large. Recently, the MoHCC created a unified vision for a national, locally built EHR (Impilo), which has high-level support under the Permanent Secretary for Health and Child Care. Multiple government agencies, donors, and implementing partners have backed this vision, which centers on a patient-level system as a central component of the national digital health architecture. Most importantly, this vision and the unification of stakeholders has already realized initial funding investments. Therefore, the advantages to this project opportunity and approach are numerous, including:

Supports and benefits complementary investments: The funding from this project will support and benefit from complementary investments made by other donors such as PEPFAR/CDC, UNFPA, Cordaid Memisa, the Global Fund, and GAVI to improve Impilo system functionality, develop new modules, and extend deployment to additional health facilities. Alignment and support of investments such as this, exemplifies The Principles of Donor Alignment for Digital Health as well as increases the overall impact of investment funds.  

Builds on existing, testable technology already in operation: The MoHCC has already driven the design and initial implementation of the Impilo client registry. This locally appropriate solution was derived through a human-centered design approach, focusing on health worker and facility needs. Any enhancements made can be pushed out and immediately tested at the 146 health facilities already using the Impilo platform, resulting in a robust, tested client registry and global good that is fit-for-purpose.

Strengthens overall Zimbabwe health system including COVID-19 response, chronic disease management, and medical research: A central client registry will benefit other areas of the health information system. For instance, it will provide valuable patient identification data and services for direct-to-beneficiary applications now being rolled out for the national COVID-19 response, including self-registration, suspected case reporting, and contact tracing. It will yield the ability to uniquely identify patients across multiple service delivery points and systems to improve longitudinal tracking of clients including linking mother and baby pairs, as well as the ability to provide de-identified clinical data for research. It will also provide visibility into silent transfers of patients with chronic disease (e.g., HIV and TB) between facilities which would otherwise be recorded as patients lost to follow up.

Together, the consortium partners will work collaboratively on all activities to build capacities of MoHCC staff and leverage their current partnership, such as work to establish a Community of Practice for the Impilo platform to accelerate progress toward global good packaging and dissemination. In addition, the MoHCC and Vital Wave are already successfully executing work throughout the COVID-19 pandemic. Best practices and established project processes will be employed for this opportunity as well.