Notice C

Promoting the collaborative development of proposals for investments in digital health global goods

Digital Square supports investments in digital health global goods, which are tools that are adaptable to different countries and contexts. Mature digital health global good software is software that is (usually) Free and Open Source (FOSS), is supported by a strong community, has a clear governance structure, is funded by multiple sources, has been deployed at significant scale, is used across multiple countries, has demonstrated effectiveness, is designed to be interoperable, and is an emergent standard application.

We are using an open proposal process. Your concept notes and proposals will be publicly posted, giving you and other submitters the opportunity to find collaborators and provide and receive feedback from your peers.

Concept-Notes (48 total)

Displaying 46 - 48

Upgrade the core technology of Connect for LifeTM to enable large-scale implementations in multiple disease areas and many geographies under an open source model

Notice C Opportunity: 
Announcement C0: Global Good Software Development and Support

Executive Summary

Medication or preventive measures are available for many diseases; however, we still see significant challenges with their correct use, especially in poor countries. We have learned that lack of disease knowledge and both social and geographical isolation, are drivers for non- compliance and low adherence, leading to poor health outcomes. In HIV, it can make the difference between living a normal life or dying.

Through its Global Public Health organisation (GPH), Johnson & Johnson (J&J) aims to deliver integrated evidence-based solutions to address complex global health problems in HIV/AIDS, tuberculosis, mental health, soil transmitted helminths and vaccines. Within J&J GPH, the Disease Management Programs team researches & develops innovative solutions to strengthen the healthcare system in resource limited settings. One of our digital health solutions is Connect for LifeTM, which was built on top of the Open Source platform MOTECH of the Grameen foundation, and made available to implementers for patient support programs across the world, especially in Africa and Asia.

The mHealth platform Connect for LifeTM is supporting the patients, health care provfessionals (HCPs) and program managers in developing countries. It interacts with patients using basic mobile phones and with HCPs through a web-based interface on tablet or PC. Connect for LifeTM is being used since 2014 and is currently supporting six implementations in HIV/AIDS in Uganda, India and the Philippines. The obvious next step is to maximize the impact of Connect for LifeTM through large-scale implementations. The aim of this project is to progress the core technology of the Connect for LifeTM digital tool in view of maximizing its adoptability and global utility as an open source global good. This project will set the foundation for a sustainable Connect for LifeTM service delivery to maximize outreach, optimize local support, reduce the cost of implementation and facilitate large-scale programs.



Consortium Team

Prime Organization: Janssen Pharmaceutica NV, Global Public Health division, Turnhoutseweg 30, B-2340 Beerse, Belgium.


a) Profile of organization’s relevant qualifications

Johnson & Johnson operates over different 250 companies worldwide, together "the Johnson & Johnson family of companies". The company works in three broad divisions; Consumer Healthcare, Medical Devices and Pharmaceuticals. Janssen Pharmaceutica NV, which is part of the Pharmaceutical division of J&J, conducts research and development activities related to a wide range of human medical disorders, including immunology, neurology, cardiovascular and metabolic diseases, infectious diseases, vaccines and oncology.

In 2014, within J&J a Global Public Health (GPH) organization was created to address complex global health challenges by harnessing resources and expertise from across the entire J&J organisation, combining research and development capacities, access to care and advocacy with the aim to advance health around the world with a specific focus on low and middle income countries (LMICs) and underserved populations. The Disease Management Programs (DMP) team of Janssen Pharmaceutica is part of this worldwide J&J GPH division and designs, develops and implements evidence-based solutions that empower patients and support appropriate use of therapy to ensure optimal outcomes.

One of the solutions created within J&J GPH provides services supporting patient management, counselling, self-monitoring and interventions. Patients are provided with relevant and reliable information using widely available mobile devices and other digital media. The general aim is to increase the efficiency and effectiveness of healthcare and the programs are designed and developed in close partnership with local experts to ensure maximum integration in the local healthcare environment. The J&J GPH team creates partnerships with HCPs, nongovernmental organizations (NGOs), academic institutions, care providers, global patient organizations and governmental departments to enable locally-owned and sustainable implementation of disease management solutions. It is in this context that our digital health platform Connect for LifeTM was created and applied. Up until now, the maintenance of the Connect for LifeTM platformand the development of new functionalities were taken up within the J&J GPH team.


b) Profile of relevant experience and examples of related work.

The proposed project falls under the direction of Romain Rutten, VP Disease Management Programs within J&J GPH, who is leading a dedicated team of project leaders designing and developing patient support programs in close partnership with local experts. Already in 2010, Romain Rutten co-created an IVR software piloted by Janssen and the Grameen Foundation in India, which was called TAMA (Treatment advice by Mobile Alerts) ( /index.php/implementations) to support HIV patients in project UNITE in India. Early qualitative work suggested that the TAMA software was usable and viable in the real-life settings of people living with HIV, and it had many desirable effects on their treatment adherence. Further improvement and generalization of TAMA led to the development of the Connect for LifeTM platform, which was launched in 2014.


MOTECH (Mobile Technology for Community Health) open source platform owned by Grameen Foundation: Our team has provided improvements on three releases of MOTECH (1.1, 1.2, 1.3). Specifically, the following work was performed: MOTECH 1.1:Fixed loading fragment bundles by MOTECH; MOTECH 1.2: Fixed mds history class loader bug, unsecured cms-lite module endpoints for retrieving stream and string contents. MOTECH 1.3: Fixed loading properties in config file mode.


 As part of the J&J GPH portfolio, the EBODAC project aims to develop communication strategies and tools to promote the acceptance and uptake of new Ebola vaccines, and to help the right person receive the right vaccine at the right time. Specifically, EBODAC is working to ensure that the investigational vaccine regimen is well accepted and successfully used in the context of a clinical trial in Sierra Leone; while also preparing to maximize the impact of the potential deployment of a future Ebola vaccination programme.


EBODAC is based on 3 pillars:

•           Communications and community engagement to provide correct information tailored to local context, to build trust and manage rumors. Based on requirements from partners and the clinical team, J&J GPH developed a flipchart to support the Informed Consent Process with drawings from a local artist. J&J GPH has developed a Test of Understanding to ensure the volunteers have understood the information.

•           Biometric identification to identify study participants and uniquely recognize them on a next visit: The solution evolved from a robust but rather big box (i.e. integrated iris scan and fingerprint proven to work in support of election process) to a mobile tablet version to scan the iris of individuals as of the age of 2-year old. For this part of the project, J&J GPH did a landscaping of the options, gathered requirements to customize the selected solution to the project needs, funded the software development and trained local operators. In addition, J&J GPH conducted research on the usability of the biometric identification tool in minors.

•           Mobile technology to send visit reminders and support clinic capacity management. Some of the requirements of this pillar were defined by J&J GPH. J&J GPH took care of the integration between the biometric solution, the Electronic Data Capturing (EDC) system, and the mobile technology. Based on this integration, a given time and event schedule from the study protocol is sent from the EDC to the mobile system to drive optimal compliance to the study protocol for vaccinations and other type of visits. The EDC system is also triggering the mobile solution to send missed visit reminders or stop the messaging for participants that haven withdrawn from the study. The information on planned visits and type of visits is used to report on the available capacity to facilitate new bookings and manage clinic capacity.



c) Qualifications of key members of the proposed project team

The J&J GPH core-project team and members of the Joint Steering Committee will be the Technology Leader Piet Knaepen, the Connect for LifeTM Business owner Annik Willems, and an expert developer Avinash Agrawal. Piet Knaepen will oversee the technical transfer of knowledge between J&J and Beehyv, while Annik Willems will lead the effort to make Connect for LifeTM open-source and give directions on the general business model around the platform. Part of her mandate is to make sure the platform reaches an adequate level of maturity to fit the selected model. Avinash Agrawal is the senior developer in charge of the Connect for LifeTM platform. His role in this project will be to provide all necessary knowledge to Beehyv for them to proceed with the upgrade of the platform maturity. He will also be responsible to handle any technical issues or requests from Beehyv.


Romain Rutten will also be part of the Joint Steering committee and will ensure that the planned activities and deliverables align with the strategy of J&J GPH for Connect for LifeTM, which is to maximize impact by leveraging the platform and its capabilities to support underserved populations at different levels of the health care system. Given his experience in technology and data management/reporting, he can ensure that the needs are addressed at all levels.


Finally, the team will rely on the senior project manager Anny Fortin, who has long experience in coordinating activities linked to international collaborations, especially those involving LMICs. Anny Fortin will be managing the project at the operational level in order to meet the expected timelines, milestones and deliverables.


Related J&J GPH CVs are presented in Appendix 1.



d) Number of years in operation

Janssen Pharmaceutica was founded in 1953 (i.e 65 years of operation) and became part of Johnson & Johnson in 1961. The Global Public health organization of J&J was created in 2014.



Partner organization:  BeeHyv Software Solutions. 


a) Profile of organization’s relevant qualifications

BeeHyv Software Solutions is a niche software development firm that has built several effective ICT4D solutions. Their customers include several start-ups (including many from the Silicon Valley) and Beehyv staff works around the latest technologies (Web development, Mobile App development, Server Side development, Visualization, Reporting, Machine Learning, Natural Language Processing, Cloud Services, and Automation Testing). They have been working closely on large scale initiatives in India for the government sponsored by Bill and Melinda Gates Foundation (BMGF), USAID and other funding agencies.  All their developers are graduates of the Indian Institute of Technology (IIT) and BITS Pilani, the best engineering institutes in India.


b) Profile of relevant experience and examples of related work.


National Scale Up for Mobile Academy and Kilkari done for Ministry of Health and Family Welfare (govt. of India). This project is being implemented in collaboration with BBC Media Action, IMI mobile and BMGF. BeeHyv is the software development and support partner in this project. 


Both these IVR based services are built on top of the open source MOTECH platform.  Messages are delivered in the local language.  Kilkari sends out scheduled health alerts to pregnant women and mothers of infants. Mobile Academy gives comprehensive self-paced training via IVR to Field Level Workers (ASHA workers) – they get a certificate at the successful completion of the course.


The platform is integrated with the government’s MCTS and RCH databases to get the beneficiary and FLW details.  A robust MIS system caters to users at different levels of administration.  Kilkari is live in 13 states in India with a total of around 2.5 million subscribers.  Mobile Academy is live in 13 states in India with a total of around 0.6 million subscribers.  16 x 5 SLA based production support with BeeHyv staff stationed at the Government’s data center in Gurgaon (Delhi).


MOTECH (Mobile Technology for Community Health) open source platform owned by Grameen Foundation.  Beehyv was the development partners for over 3 years contributing in the development of several modules of MOTECH.


NHRR (National Health Resources Repository). This project is performed for the Ministry of Health, Govt. of India. A comprehensive profil of all public and private healthcare providers will be provided as part of this project. The vision driving NHRR is to create a standardized and secure IT-enabled repository of India’s healthcare resources to strengthen evidence-based decision making and develop a platform for citizen and provider centric services. BeeHyv has received funding from BMGF for this program for building out the technology in collaboration with Indian Space Research Organization (ISRO) using their Bhuvan GIS platform.


Outbreak Responder – Clinical Decision support tool (Android app) for diarrheal disease outbreak response. Developed for Dr. Eric Nelson, a physician-scientist initially working with Stanford University School of Medicine and now with University of Florida.  The tool prescribes treatment as per WHO protocol.


This app was made to work in resource limited settings in places with intermittent internet connectivity. Lack of weighing scales in the hospitals necessitated a modality for age-based weight estimation.  Identification of the patient is done using biometrics (fingerprint).  The backend web application for reporting has the ability to track each incidence of the disease on the map of Bangladesh at a fairly minute level.  


The outcome of comprehensive pilots was adherence to guidelines for prescriptions of IV fluids, antibiotics and zinc.  The results of the pilot were published in the PLOS journal for tropical diseases. The next phase will be a randomized control trial.


Gyanjyoti and Brightfuture Android apps developed for Johns Hopkins Center for Communication Programs.  These apps are used by front line workers in India and Pakistan for promoting use of family planning methods. Both these apps are built on top of the open source OppiaMobile learning platform that leverages Moodle for authoring and publishing content.


These apps run Google Cloud Messaging (GCM) client in the background that allows the admin to manage each device (like resetting password, controlling the camera, etc.). Support for local languages (Hindi and Urdu) is foreseen.


Support and enhancements to MOTECH implementations for TAMA (Treatment advice by Mobile Alerts for HIV patients), RefDB (centralized data repository for BBCMA apps), World Health Partners TB application and CARE CCS (tool for mobile workers to cover 1000-day window of pregnancy). This project was done for the Grameen Foundation in collaboration with J&J.


Android apps developed for CARE International for monitoring very low birth weight babies (vlbw) - in collaboration with and funded by BMGF


c) Qualifications of key members of the proposed project team

Connect for LifeTM is built on top of the MOTECH platform of the Grameen Foundation.  The core members of the team from BeeHyv who will be working on making Connect for LifeTM scalable have deep expertise in the MOTECH platform. The Beehyv architect, Haritha, is well versed in MOTECH and has worked on designing several modules. The Beehyv project Manager, Sai Rahul has been instrumental in the huge success of NSP (built on top of MOTECH) and has a very thorough knowledge of the whole application and every aspect of the production system. The team leaders and senior developers, including Atish, have worked on coding several of the modules of MOTECH.  The Beehyv developer Vishnu has been working on the largest implementation of MOTECH, National Scaleup Project (NSP) of Mobile Academy and Kilkari. The Beehyv support engineer has been a core member of the support team looking after the NSP system in production.  Bindu is a senior QA engineer who has worked on several projects at BeeHyv. 


Related Beehyv CVs are presented in Appendix 2.



d) Number of years in operation

Established in January 2007, 11 years of operation.


 Project Description

Background and rationale

TAMA was initially developed to support HIV patients in India in partnership with the Grameen Foundation, building on their MOTECH platform, which had a track record in mobile finance, agricultural and health applications in resource-constrained countries. The development of TAMA was based on ethnographic and behavioral studies, and stakeholder feedback (see Supporting Treatment of People Living with HIV / AIDS in Resource Limited Settings with IVRs, Appendix 3). The objective was to focus on LMICs and underserved populations. Patient interviews and formative research revealed that although mobile phone penetration was high, most people favored using basic feature phones and preferred voice calls over text due to a high level of illiteracy. TAMA was therefore targeted to address this gap in the technology ecosystem and was designed to leverage available and appropriate technologies to optimize inclusion. Subsequently, the configurability of the platform was enhanced to maximize its applicability and was renamed Connect for LifeTM.


The MOTECH framework has Voice Response (IVR) and SMS text functionalities but does not include either configuration capability to send and receive communications from patients, nor the feature to produce built reports. Connect for LifeTM is built as a user-friendly web-interface providing configurable functionalities (Figure 1). More specific, the current version of Connect for LifeTM provides IVR and SMS functionalities including but not limited to medication reminders, clinic visit reminders, health tips and a functionality to support symptom reporting by the patients. At the clinic and program level, data collected through the Connect for LifeTM platform also allows HCPs and program managers to track the patients, analyze results at the patient population level, create reports that can be sent to authorities, and plan capabilities that are required to adapt and improve service delivery and strengthen the health system.



Figure 1. Schematic representation of the functionalities of the Connect for LifeTM digital tool.



For instance, in India, a support program including a Connect for Life™ service (m-Maitri) was implemented by SAATHII, a non-profit NGO, to provide HIV positive pregnant women with voice health messages on their mobile phones. Topics covered include information on nutrition, safe delivery practices, infant care and the importance of HIV treatment adherence. The service also sends automated reminders when an infant diagnosis test or immunization is due and collects responses about treatment adherence rates. Results are shared with community health workers to triage women most at need for immediate and closer follow up. Comparative analysis showed strong evidence that the service increased retention in the care cascade of mother and baby pair and led to higher rates of completion of infant diagnosis tests (publication in preparation).


In another collaboration with MDACS (Mumbai District Aids Control Society), the main local health system need was to have access to a reliable system to manage the high HIV patient inflow and reduce lost-of-follow-up rates, taking into account an understaffing challenge. Therefore, J&J GPH supported them in using Connect for LifeTM for patient tracking and tracing, and to improve their reporting capabilities. MDACS is currently exploring to use Connect for LifeTM to implement and roll out a differentiated care model for their patients.


Connect for LifeTM is fully configurable and can support prevention, treatment adherence and information campaigns around any types of diseases and conditions. The configuration of Connect for LifeTM does not necessitate developer skills. The back-end of the platform is structured to allow HCPs to mention the disease to be supported (free text), and to select the way services will be presented in the Web user interface (Figure 2, upper panel). Health messages, treatments, normal ranges for laboratory values, location of an appointment, symptoms can also be freely configured to customize the platform to the needs of a support program, and more than one condition can be followed at the same time (Figure 2 lower panel).  The labels of the platform are currently available in English, both in the back-end and the Web user interface. However, the content of the platform (i.e. patient support content), can be delivered in any language without limitation. For instance, in a current implementation in India, a given patient can choose between two different local languages to receive his health information while in another implementation in Uganda, three local languages are currently available.







Figure 2. Extracted visuals for configuration of services (upper panel) and drug regimen per condition (lower panel).


In a newly developed project in Rwanda targeting the prevention of schizophrenia relapse (see user stories in Appendix 4), the intention is to use Connect for LifeTM to educate both patients and immediate caregivers on the disease and the importance of medication adherence to reduce the risk of relapse. Weekly health tips are therefore sent to reinforce information that has been provided by the doctor or nurse in the hospital to increase both patient and caregiver engagement. The ambition is also to increase the visibility of the HCPs to their patient population to avoid lost to follow-ups.


Use of Digital Health Technologies


Connect for LifeTM is a simple but elegant health platform leveraging the availability of the open source framework MOTECH, the high penetration of mobile phones in patient populations, and the convenience of a web interface that HCPs and program managers can access from any type of device connected to the internet. Connect for LifeTM was developed to adhere to the principles of digital development. It provides the unique value of creating a direct two-way interaction between patients and HCPs using simple, appropriate and inclusive types of technologies. The architecture of Connect for LifeTM is presented in Figure 3.





Figure 3. Connect for LifeTM architecture




Problem statement

In the current implementation model, the Connect for LifeTM platform is provided by J&J GPH to local partners under a free license. For each of the past implementations, the initial role of J&J GPH was to understand the challenge and the processes that need improvement or strengthening and make the tool and related knowledge available to the local partner. J&J GPH team can only support projects that align with its focus areas. Once Connect for LifeTM is in place, the local implementer needs to gradually take full ownership of the tool, but this requires J&J GPH to maintain local support until the implementer is technically and financially mature enough to continue the program independently. In addition, integrations to other software applications, such as lab management systems, are currently customized in each implementation, and the currently supported interoperability standards from MOTECH have not been implemented. Although very usable in R&D context, the current implementation model proves to be lengthy, expensive and labor intensive and is not favorable to efficient adoptability and program scale-ups. As the platform has been validated in terms of acceptability and impact on health outcomes, it is now the time to make it widely available and overcome the current limitations.


Overarching project framework and scope for this funding application

Our ultimate goal is to reallocate the responsibilities around the Connect for LifeTM digital tool to local IT organizations capable of performing the hosting, configuration, contracting with an Interactive Voice Response (IVR) provider, maintenance, support and implementation services. The service package needs to be designed as an easy-accessible service with quick and flexible set-up (SaaS like) without the need for IT skills in the implementing organization (clinic, NGO, …). We see the following project phases to be part of our trajectory:


Development of a strategic roadmap for strengthening and expanding the portfolio of Connect for LifeTM: this includes the identification of a long-term strategy and vision to screen new opportunities for the tool, including potential grant funding revenue streams or sponsors to fund both support programs and further software development, and maximize outreach and marketing to acquire more implementation sites and local partners. The implementation of a long-term strategy for Connect for LifeTM has already been initiated and guided the decision of partnering with Beehyv.


Generalization of the core technology Connect for LifeTM digital tool in view of maximizing its adoptability: This includes making the tool available as an Open Source Software, in line with the Principles for Digital Development (,

and bring the Connect for LifeTM platform to an adequate level of software maturity. This project phase is the scope of the present funding application and the associated technical approach to maximize the adoptability and global utility of Connect for LifeTM is described in the following section of this document.


Development of a service model that meets global, regional and local requirements at a fair and reasonable price to support long term sustainability. The model will need to address all applicable policies such as privacy, regulatory and others. Beehyv will be developing the model for India in close collaboration with GPH J&J. The measurement of success for J&J GPH will be the impact the platform will create on patients (i.e this is not-for profit). This phase falls out of scope of the current application and will be funded by J&J via a bilateral agreement  with Beehyv.


Support of new implementations at scale and local capacity building. this includes the provision of resource management across various locations by means of a mixture of onsite/offsite and remote working models to talor the needs of the programs where Connect for LifeTM is being implemented. This is also outside the scope of the current funding application and will be addresses by the newly developed business model(s) (see above).



Technical Approach to Maximize Connect for LifeTM Adoptability and Global Utility


Our hypothesis is that bringing Connect for LifeTM to a new level of maturity is the first step towards a sustainable deployment model of the platform that will subsequently enhance country utilization and country strategy and will open access to additional funding and revenue sources for future implementers.


The following plan highlights specifically the steps to be performed:


Work package 1- Make the platform open source:

The strategy for releasing Connect for LifeTM under open source will be designed by the Joint Steering Committee in support of the future business model around Connect for LifeTM.  The J&J and Beehyv legal departments will provide the necessary input related to the specificities of the different possible open source licenses.

The type of open source license under which the platform will be released needs to be selected. Three main categories of licenses are possible: copyleft, permissive and partial copyleft. In addition, the code will be made available for download from the most suitable distribution point. The administrator of the source code will be responsible to perform ongoing auditing of the code as it gets contributed, including compiling of new releases.   A software roadmap will be maintained, describing currently planned and resourced development activities.  


Work package 2- Improve the core software of Connect for LifeTM:

2.1 Improve installation, end-user and technical documentation

Beehyv will test the current implementation and user documentation in order to determine what improvements need to be made so that any new user can install and configure the Connect for LifeTM for its specific setting with a minimal amount of support from developer community.


One proposed project is to automate the setup process so that adopters of Connect for LifeTM can setup the application without any technical support. For this, a user interface would be created in which users would enter their perceived load and they would be provided with a selection of optimal configurations. Upon selecting the configuration, an automatic script would create cloud instances and deploy everything, and the application would be ready to use.


We also want to improve the technical documentation to the point that developers can customize and add new functionalities to Connect for LifeTM without relying on help from the J&J GPH team. Online courses or tutorials will be created to address common development and deployment tasks.  Core business workflows and functional requirements will be documented using use cases and user stories, that will also be made publicly available. All updated and newly developed technical documentation will be released under a Creative Commons license (see work package 1).

 2.2  Create integrations modules to improve interoperability and data accessibility

We will develop integrations for a selection of relevant platforms (e.g. OpenMRS, LIMS) by providing a default mapping between Connect for LifeTM data fields and data in the respective external platforms, along with documentation on how to adapt it for each implementation. MOTECH, the backbone of Connect for LifeTM, already offers several modules for integration with other external platforms (Commcare, Care Services Discovery Module (CSD), DHIS2, HL7, Hub, ODK, OpenMRS, RapidPro) ( The most relevant of these modules will be selected as basis to build our own modules on top. Additionally, we will build the functionality for Connect for LifeTM to be able to integrate with other platforms through APIs, a functionality currently not available in MOTECH.


 2.3  Insure scalability 

Scalability was integrated in the initial design and development of Connect for LifeTM. We will validate that aspect of the software by performing load & stress testing. A formal test plan with adequate numbers of all types of users (patients, HCPs, Program/cohort managers) will be developed and executed, documented, and the results will be made publicly available. Based on the test results, issues will be investigated and, where appropriate, optimization to the software will be planned and executed.

The work from Work Package 1 and Work Package 2 will be consolidated in a new Open Source version: Connect for Life v2.0.



Work Package 3- Strengthen the implementer and developer community around Connect for LifeTM


 3.1 Consolidate Community Engagement and Governance


J&J GPH has initiated the creation of a user community governance around Connect for LifeTM by organizing in July 2018 a symposium bringing together all implementers from India, the Philippines and Uganda that make use of the software for patient support. In addition, the J&J GPH project leaders are constantly interacting with implementing teams all over the world. We aim to keep this user/developer community alive by organizing another user/developer meeting in 2019 and take this opportunity to launch a Connect for LifeTM open forum on the most appropriate digital platform (Reddit for instance). The Reddit board will be used by the community to exchange on Questions/Answers, Development Challenges, services, use cases and user stories.


We also want to bring the implementers in direct contact with the local developers to create a dialog to guide the future development of the software. By the end of this project, we will formalize the community structure by including a technical advisory group and user community representatives with documented roles and responsibilities to direct the continued development of Connect for LifeTM. In addition, we will launch a core developer community on an appropriate platform (Slack chat for instance), that will be linked to the user/developer community. The developer community will be led by the most appropriate developer to get traction from the larger digital community (to be decided). The community leader will be responsible for administering the platform and answering questions from the user community and the developer community. The developer platform will also be the stage to showcase the different contributing developers and acknowledge their work to stimulate them to further develop the platform.


By the end of the project we want to attract one additional consortium partner that can support implementers in Africa, and one technology support partner (IVR provider for instance) with a strong relevance for the Indian implementations to support our future service model. Discussions have already been initiated with potential candidates.  Finally, we will make sure Dimagi and BMGF are informed on our activities in relation to the MOTECH framework. We aim to exchange feedback and explore mutual improvement of specific modules and potential funding opportunities.

 3.2 Improve Multi-Lingual Support


The Connect for LifeTM software is available in English, which covers most of the current implementations. However, depending on the selected strategy, we commit to translate in one additional language the full user web-interface for the HCPs, and the full implementation/user documentation to support internationalization requirements. The most appropriate language will be selected by the Joint Steering Committee to support the overall Connect for LifeTM business strategy. By moving User Interface (UI) component labels to configurable items, the larger digital community will also be able to provide suggestions for localized translation files once the platform is open source.




Workplan and Schedule


A GANTT chart of the project is presented in Appendix 5.


A detailed project plan will be prepared by Beehyv at the onset of the project, including a detailed study of the third-party integrations in view of selecting the most appropriate ones. The Joint Steering Committee will be installed at the project start. Within three months from the project start, we hope to select the most appropriate open source model for releasing the platform and this with support of the J&J and Beehyv legal departments, and release the current version (Version 1.0) of the platform already as an open source application.


Work on the software and documentation improvements will be initiated as soon as the project team has agreed on the detailed plan and will continue until the end of the project. Our aim is to have a first integration module delivered by Beehyv by month 3 and have at least another 2 to 4 modules ready by the end of the project. The load and stress protocol will be completed by the end of month 2 and we plan to have the final report available by month 10.


The work around community engagement will also be initiated by month 2. We are aware that the strategic planning around the building and maintenance of the digital community (users and developer) and the governance thereof are pivotal to the future success of Connect for LifeTM as an open source software platform. The kick off of the digital forums around Connect for LifeTM will be part of a larger dissemination plan that will be built with the help of internal J&J and external intelligence.


The release of the open source Connect for LifeTM Version 2.0 is planned for the end of the project period.



Project deliverables and outcomes


Specifically, this project will generate the following outputs in terms of milestones and deliverables:


Milestone #

Work package #




Joint Steering committee is established



Connect for LifeTM V is available as Open source



First integration module available from Beehyv



Connect for LifeTM community symposium held



Load & stress testing completed

Deliverable #

Work package #




Detailed project plan including Work Break Down and Feature list



Connect for LifeTM version 1.0 code publicly available



Technical documentation available under Creative Common License



User documentation made available



Community structure documented including roles and responsibilities



On line community hub launched



Minutes for Connect for LifeTM symposiumpublished



Report on stress testing available



user web-interface and implementation/user documentation translated in one additional language



3 integration modules available



Connect for LifeTM version 2.0 released with updated documentation



The specific activities funded under this application will allow the creation of a new open source version of Connect for LifeTM (version 2.0), which will be the basis for the development of a scalable implementation and service model that will accelerate the application of the Connect for LifeTM platform in additional disease areas and geographies. This work is pivotal for the subsequent building of local capacity, better alignment with new implementations with local regulations and overarching programs and the increase in opportunities for long-term cross-fertilization between different implementations. We expect that this new utility model will allow the different implementing teams and potentially also the developers, to access new types of funding for their work, both nationally and globally.


 2-sentence Overview


Connect for LifeTM is a fully configurable mhealth platform creating a two-way interaction between patients and health care professionals that can support prevention, treatment adherence and information campaigns around any types of diseases and conditions.  

The proposed project will progress the Connect for LifeTM software to the next level of maturity to support optimal adoptability and global utility under open source.


 Community Feedback


As part of the proposed project, our approach to create and strengthen the user and developer communities around Connect for LifeTM is described in the Work package 3, section 3.1 of this proposal.


In addition to the current application, an extensive dissemination plan will be designed as part of the service model of Connect for LifeTM to increase awareness on this digital platform. Next to the creation of the digital user/developer community, the plan will include dissemination strategies such as publications in specialized journals, blogs, large-public articles, as well as poster or oral presentations at mHealth or Public Health conferences.


 Use cases, User stories


User cases and user stories are presented in Appendix 4.


 Digital Health Atlas

Four current initiatives in India, the Philippines and Uganda have recently been registered on the Digital Health Atlas. The assessment tool available in the Atlas will now be proposed to the project leaders and project teams currently deploying these initiatives as an additional way to potentially increase the scale of their impact.

 Self-Assessment on the Global Goods Maturity Model

Our current rating of Connect for LifeTM on the Global Goods Maturity Model is: 4 for Global Utility, 2 for Community and 7 for Software (Refer to Appendix 6 for full assessment). We expect that the current project will allow us to bring the scores to 5, 7 and 8 respectively. We also expect a further increase of the Global Utility score up to 8 within 3-5 years from the end of the funding period.


#Health education

#Notifications and reminders for appointments, medication adherence, or follow-up services

#Patient engagement

#Symptom reporting


#Analysis and report creation


#Patient feedback


#Lab results notification


 Budget narrative

The budget narrative is presented in Appendix 7.

 Detailed budget

The detailed budget is presented in Appendix 8.

Application Status: 
Approved - partially funded


Notice C Opportunity: 
Announcement C0: Global Good Software Development and Support


We would prefer to prioritize the remaining work packages from our Notice B proposal.

Application Status: 
In Scope

Zero to mHero: A Packaged Workflow for Technologists

Notice C Opportunity: 
Announcement C0: Global Good Software Development and Support

I. Executive Summary

mHero is a two-way, mobile phone-based communication system that connects ministries of health and health workers, developed by IntraHealth International and UNICEF in 2014 and now deployed in seven countries. mHero links the RapidPro communications engine with an InterLinked Registry and iHRIS, an established global good human resource solution for health systems. At present, this complicated software technology stack is difficult for technologists who want to experiment with mHero and has limited adoption.

Zero to mHero promises to make mHero much easier to launch, test, and deploy by developing a standardized and streamlined containerization, orchestration, and configuration of mHero, using Docker or a similar technology. We will also revise the configuration to use mCSD, a FHIR-compliant profile.

With these enhancements, software developers, health program staff, and policy-makers will better understand how to use mHero to support their programs, add new features, and be empowered as users, then as contributors, and eventually as maintainers of the platform.

II. Consortium Team

For 39 years in 100 countries, IntraHealth International has partnered with local communities to make sure health workers are present where they’re needed most, ready to do the job, connected to the technology they need, and safe to do their very best work.  IntraHealth has a long history of developing successful data tools for digital health applications. From mobile apps to management software to multi-language interactive voice response, we offer health workers and managers the tools and technologies they need to do their very best work.

We develop solutions that are open source, data-driven, sustainable, and collaborative. As a pioneer in the field of health workforce informatics, we’re committed to using technology, information, and analytical approaches to support the people at the center of our health systems.

This intervention will be led by the following IntraHealth staff and supported by a full range of health experts, project managers, and software developers:

  • Richard Stanley, Digital Health Product Manager, has over 20 years of experience in information and communication technologies, including directly supporting the development of RapidPro, a core mHero technology, and developing dockerized solutions.

  • Ally Shaban, Global Health Workforce Technologist, has over 7 years of experience in software analysis, design, development, and implementation in both East and West Africa, including leading implementation of mHero in Liberia and Sierra Leone.   

  • Luke Duncan, Digital Health Assistant Director, has over 20 years of experience in software development, including leading the developing of iHRIS, the flagship human resources solution for global health, and multiple data interoperability standards and reference designs to connect iHRIS, DHIS2, and OpenMRS.

  • Emily Nicholson, Technical Advisor, has over 10 years of experience leading and supporting digital health solutions including mHero, iHRIS, OpenHIE, DHIS 2, and OpenMRS. 

The United Nations Children's Fund is a United Nations program headquartered in New York City that provides humanitarian and developmental assistance to children and mothers in developing countries. UNICEF has spent 70 years working to improve the lives of children and their families in 190 countries and territories around the world.

UNICEF created the RapidSMS open source platform in 2007, and later on, RapidPro, a free and open source framework designed to send and receive data using basic mobile phones, manage complex workflows, automate analysis, and present data in real-time. 

UNICEF staff will support the design and testing of the new mHero configuration and workflow processes, including:

  • Sean Blaschke, Technology for Development Business Analyst, East and Southern African Regional Office, has over 18 years of experience supporting health and technology programs and operations in 21 countries in sub-Saharan Africa,

III. Project Description

Problem Statement

Open source technology has a reputation for requiring a high degree of technical knowledge to install and operate.mHero, a two-way, mobile phone-based communication system to connect ministries of health and health workers, is no exception.

mHero was developed by IntraHealth International and UNICEF in 2014 to support health-sector communication during the Ebola outbreak in Liberia as a USAID Grand Challenge winner. mHero linked the RapidPro communications engine with an InterLinked Registry and iHRIS, an established global good workforce solution for health systems, to support efforts to fight the Ebola epidemic. mHero helped health workers report on new cases; broadcast messages about care and prevention; share training information; and allow for real-time coordination between them and the ministry.

mHero builds on best practices in using Short Message Service (SMS) and Interactive Voice Response (IVR), which are widely and successfully used to create reminders, alerts, and surveys to engage populations, such as frontline health workers.

Launching the mHero stack requires an OpenHIM console and server (with MongoDB), a mediator (microservice), OpenInfoMan, and additional OpenInfoMan libraries, as well as iHRIS and RapidPro. Each software is open source and available at its respective website. contains more information about its configuration and deployment in health systems.

However, as mHero hasn’t had funding directed toward software development, it is still a complicated software technology stack that is difficult for technologists to launch and test. This has limited its adoption to IntraHealth programs in Angola, Burundi, Cote d'Ivoire, Trinidad & Tobago, Malawi, and Mali, in addition to Liberia.

Technical Approach

We will work with UNICEF to develop comprehensive use cases that will guide our efforts to make mHero much easier to launch, test, and deploy. We will develop a standardized and streamlined containerization, orchestration, and configuration of the mHero stack using Docker Compose or a similar technology. We will also revise the configuration to use mCSD, a FHIR-compliant profile.

We will then test our configurations with UNICEF staff to ensure that software developers better understand how to use mHero to support their programs, add features, and be empowered as users, then as contributors, and eventually as maintainers of the platform.

mHero then can be adopted by ministries of health for disease surveillance, where there is existing demand, and government staff can expand it for other health worker communication use cases.  

Use of Digital Health Technologies

Work Plan, Schedule, and Deliverables

Month 1-2: Phase 1 - Functionality Research. We will start this project by reviewing the existing mHero software stack and documenting the multiple steps required to launch the platform. We will validate our RapidPro steps and use cases with UNICEF. We will create a plan to optimize the current process, developing the most streamlined configuration protocol that still allows for system customizations. We will also revise the mHero workflow to use mCSD, a FHIR profile, and test the results to ensure compliance with the FHIR standard. Deliverables:

  • Documented workflows with a mCSD profile.

Month 3-4: Phase 2 - Workflow Development. We will develop the containerization and orchestration workflow using open source tools, like Docker Compose, with the goal of making the process and documentation easy to follow for a competent software developer who is familiar with containerization. We will test this workflow with UNICEF staff. Deliverables:

  • A beta version of the software solution and documentation.

Month 5-6: Phase 3 - Beta Testing. Next, we will test the process and documentation with interested developers and UNICEF staff to make sure that they can truly go from zero to mHero. This testing process will also include debugging and feature development to increase the usability of the launch process. Deliverables:

  • A release candidate version of the software and documentation.

Month 7-8: Phase 4 - Release and Promotion. Finally, we will upload a release candidate version of the software and related documentation to GitHub. We will develop a marketing campaign to make sure that the software developers, program implementers, and policy-makers that make up the global health community are aware of mHero’s new ease-of-use. Deliverables:

  • A published release candidate and executed marketing campaign.

A GANTT chart of the project can be found at

Digital Health Atlas

mHero Registration:

Monitoring and Evaluation

IntraHealth International has robust monitoring and evaluation processes to ensure project compliance and success.

We will start this engagement with a deep discussion with representative software developers and policy-makers to confirm our initial needs assessment and create a clear future vision, with documented success criteria.

As we proceed through the software development process, we will monitor our progress to make sure that we are still building toward our future vision. We will bring in other global health community members to ensure our work has the greatest overall utility.

Once the software is developed and we begin publicizing its utility, we'll evaluate our overall efforts to measure how well we've met our initial objectives and the extent to which the new software is changing the way software developers approach mHero deployments.

IV. Two-Sentence Overview

Zero to mHero will make mHero much easier to launch, test, and deploy, and allow software developers, health program staff, and policy-makers to incorporate interoperable SMS and interactive voice response systems into their country health programs.

Digital Square will be supporting a standardized and streamlined containerization, orchestration, and configuration of mHero, using Docker or a similar technology, and revising the configuration to use mCSD, a FHIR-compliant profile.

V. Community Feedback

Our key engagement point with the broader digital health community will be through our advisory group, made up of representative software developers and policy-makers. This group will be initially populated by existing mHero users and UNICEF staff, and we’ll aim to quickly expand this group by bringing in health experts and technology practitioners from their respective communities and the Global Digital Health Network, and similar technology and policy communities.

We expect this advisory group to give regular input and guidance on the technology solution design and the context in which it will work, including:

  • Use cases to inform software development and testing
  • Software architecture to ensure interoperability with existing systems
  • Software documentation and code that’s usable by a wide variety of stakeholders.

As we proceed through the development process, we’ll engage with the advisory group with regular check-ins at the start and end of each phase, to make sure that we are still building toward our future vision. We will also bring in stakeholders from across the greater digital health community at the end of each phase to ensure our solution has the greatest overall utility across multiple countries.

VI. Use Cases, User Stories

HMIS Software Developer

A software developer in a ministry of health can gain greater familiarity with RapidPro, and quickly connect it to their existing health systems using the zero to mHero solution. The software developer can also use the mHero FHIR interface to extend its functionality to any other system that also uses FHIR. For example, the developer could connect mHero to their laboratory testing and reporting systems to generate automatic SMS alerts of test results for health workers and update DHIS 2 Tracker.

UNICEF Country Office Staff

An experienced RapidPro user in a UNICEF country office, many of which have heavily invested in RapidPro, can use the zero to mHero solution to better understand the health ecosystem, and connect their existing programming to national health information systems. For example, their U Report system, which is based on RapidPro, could be configured to automatically alert the relevant health workers when a high-importance response is received in U Report. 

Disease Surveillance Software Developer

Software developers who are supporting ministries of health can use the zero to mHero solution to quickly establish robust electronic Integrated Disease Surveillance and Response (eIDSR) frameworks, and other alerting systems, and connect them to existing health services. This builds on the original mHero use case with a lower technical barrier to entry for country system managers.

Health System Support Software Developer

Software developers who are supporting health system strengthening activities can use zero to mHero to quickly develop educational content for health worker pre-service and in-service training and learning objectives, remind health workers about their expected duty stations and shifts, and collect data from them on their working conditions and patient health outcomes—connecting all of these activities to existing government systems for better tracking and analysis.

VII. Self-Assessment on the Global Goods Maturity Model

The self-assessment for mHero can be found at

VIII. Tagging

  • mHero
  • Docker
  • FHIR
  • Containerization
  • Orchestration
  • Software configuration
  • Deployment workflows
  • Human resource management
  • Data coding
  • Data exchange
Application Status: 
Pending Review & Investment