Notice F0: Reference implementation of the World Health Organization Antenatal Care Digital Adaption Kit

Under Notice F0, Digital Square is accepting applications from existing digital health software tools (with a strong, but not exclusive, focus on point of care tools) that meet the definition of global goods and/or are existing approved Digital Square global goods, to adopt and align to the World Health Organization (WHO) published Digital Adaption Kit (DAK) focused on Antenatal Care (ANC) and showcase themselves as reference implementations of the DAK.

Applications are expected to align and strengthen the shelf-readiness aspects of the technologies and are encouraged to focus on strengthening capacities of new implementers/innovator groups in working and advancing global goods.

The Digital Adaptation Kits (DAKs) are part of the WHO SMART guidelines initiative and include data and health content consistent with WHO’s antenatal care recommendations, generically applicable to digital systems. They are software-neutral, operational, and structured documentation based on WHO clinical, health system, and data use recommendations to systematically and transparently inform the design of digital systems. DAK components include:  

  • Linked health interventions and recommendations; 
  • Personas;
  • User scenarios;
  • Business processes and workflows;
  • Core data elements mapped to standard terminology codes (e.g., ICD);
  • Decision support; 
  • Program indicators; and
  • Functional and non-functional requirements.

In addition to the published guideline, WHO and community have created a HL7 FHIR implementation guide that is to be considered and adhered to in the application. More information on the guide can be found here,

Technologies and software being proposed in the applications must meet the following three minimum requirements to be seen as a global good.

  1. Be an existing software that has been deployed in three or more low-resource contexts.
  2. Be a global public good. Software tools will be considered a global public good if either:
    1. The source code is made available under an Open Source Initiative–approved software license; or
    2. The software is freely accessible and adheres to the Open Definition for access to data; or
    3. Software has been applied to a health domain to manage, analyze, or transmit health-related data.
  3. Content may be considered a global good if it is a resource, toolkit, or data standard that is available under an open license and that is used to improve or analyze health data management processes.

Applications must clearly identify how they plan to incorporate the various components (listed above and in the documentation) of the DAK into their tool, as well as have clearly outlined data exchange / interoperability solutions and metrics and means of testing these components.

Applications must align to the principles of shelf-readiness and where appropriate ensure that the proposed technical development is aligned to the principles of shelf-readiness as a whole and with particular consideration to quality, documentation and installation patterns.

Applications must align their solutions to be part of the Instant OpenHIE project (as appropriate for deployment) and build into the testing approaches and infrastructure to ensure data exchange, showcase the exchange, and provide interoperability profiles required for the World Health Organization(WHO) antenatal care(ANC) Digital Adaption Kit(DAK).

Applicants are required to segment the applications into work packages. Work packages must be modelled around the identified aspects of the DAK, and any aspects of shelf readiness that are being proposed. Care must be given to clearly indicate the gaps, activities, and expected outputs/deliverables that the requested funding will go towards.

Applicants must ensure that the work packages are self-contained and not overly reliant on another. If there is a reliance this must be clearly called out and justified.

Examples of investments that will be made available through this call for applications include (but are not limited to):

  • Aligning a solution to incorporate key data standards and align to workflows;
  • Ensuring that applications can fulfill the data exchange needs of the DAKs;
  • Developing solutions that generating program indicators and reporting needs;
  • Aligning technologies to the DevOps guidelines and containerization deployment that is illustrated through use within the Instant OpenHIE project; and
  • Aligning of technologies to be better framed within the OpenHIE architecture and supporting the required workflows as per the OpenHIE architectural specification (as well as the associated test cases).

The following will be considered out-of-scope, and therefore make the concept note ineligible for funding.

  • Investments that are not applicable outside of a single health program area.
  • Investments in new functionality that are not justified in making the tool a shelf-ready solution.
  • Investments that are aimed to fund the implementation of the solution within a project (i.e., the funding is intended for technical development and not implementation work / activities.).

WHO ANC DAK applications are expected to focus on point of care and patient management systems looking to align and incorporate the various components of the DAK. Applications must include a motivation as to the focus of the selected technology and why the inclusion of this DAK is a valued/important investment tied to health outcomes and opportunities.

Local capacity development

Digital Square is committed to enhancing and expanding the capacities of local enterprises and new team to support the development, enhancement, and deployment of global goods. As such applications are encouraged to seek out opportunities to build local capacity in local teams, new innovators, and expand the global good communities. 

Open source and global access

Work proposed in the applications must align to global access principles and be made available under an appropriate open source license. Applications must clearly outline the licensing of proposed work items in the application.

Click here to access Notice F0 (RFA #2021-055) | Reference implementation of the World Health Organization (WHO) Antenatal Care Digital Adaption Kit

Notice F0 Modification #1: Click here to access the modification

  • November 3, 2021 - December 1, 2021: Concept note development and community review

    Digital Square issues a call for applications, and applicants upload concept notes to Digital Square's public-facing open application platform. In the first few weeks, as outlined by the solicitation, applicants will submit concept notes. Before the final submission other applicants and/or other stakeholders in the community may provide feedback, comments, and suggestions, as well as identify potential areas for collaboration if the early draft of the concept note is published on the platform. Digital Square encourages an agile approach of development with early publication of draft concept notes to the platform and applicants are encouraged to edit and respond to community feedback, on their concept note, during this time. Following this the final version of the concept note must be submitted and applicants must use the concept note template.

  • December 2, 2021 - December 15, 2021:Digital Square review of concept notes

    Following the concept note review, Digital Square (comprised of the technical and operational team representatives) assesses concept notes to ensure alignment with the initiative vision and funding objectives identified in the open application process. Digital Square eliminates concept notes that are not strategically aligned with the above.

    Digital Square identifies a set of short-listed concept notes based on the open application process criteria and emails applicants who are eligible to advance to the application phase.

  • December 16, 2021 - January 12, 2022: Technical application co-creation, comment period and application finalization

    Using feedback received in the concept note phase, applicants will begin preliminary application development.

    Applicants must use the technical application template and post an application iteration on the open application platform in the first 2 weeks.

    Applicants will be able to request interim reviews of their applications. Only one review may be requested from Digital Square, and unlimited reviews from the community are allowed.

    Using feedback, applicants revise the technical application, develop a budget and budget narrative, and submit these to the Digital Square open application platform. Applicants must use the provided technical application, budget, and budget narrative templates.

    The budget and budget narrative are not shared publicly on the platform. Commenters see only the high-level summary budget provided in the technical application.

    At the conclusion of this step, Digital Square will restrict the ability to upload new content to open application platform.

  • January 13, 2022 - February 2, 2022: Peer Review Committee (PRC) review

    The PRC reviews applications according to the Prioritization Framework, notice scope of work technical requirements and evaluates applications as green-, amber-, or red-lit per the PRC Membership Policy. Green-lit applications are recommended for funding immediately; amber-lit applications are recommended for future funding or further exploration; red-lit applications do not fully meet the selection standards/criteria.

    The PRC sees only the high-level summary budget provided in the technical application. Proprietary information including salaries, indirect rates, or other factors are not shared with anyone outside of the investor and Digital Square.

  • February 3, 2022 - February 9, 2022: Digital Square OAP recommendation

    Digital Square compiles the evaluation provided by the PRC by clustering the applications according to the Prioritization Framework for Investment Review Committee (IRC) review, and assigning values based on green, amber, or red light scoring.

    Digital Square creates an investment package recommendation of the highly scored applications, as collated from the PRC reviews and synthesized into a single scoring metric that assigns numerical values to the color associated to the proposals, for the  Investment Review Committee based on the funding round objectives, investor priorities, and Digital Square vision.

  • Feb 10, 2022 - Feb 23, 2022: Investment Review Committee (IRC) review

    Digital Square presents the applications, high-level budget summary, PRC feedback within the Prioritization Framework, and Digital Square recommendation to the IRC.

    The IRC evaluates whether to approve the funding packages and reserves the right to modify the recommendation at their discretion. The recommendation is made to the Digital Square board for ratification and final approval.

  • Award Phase

    Digital Square shares the funder decisions as voted on by the Board with applicants. Upon applicant request, PRC and IRC feedback shall be shared with applicant.

    Funder decisions are contingent on investor approval.

Applications (10 total)

Displaying 1 - 5

BornFyne-Prenatal Management System

Two-sentence Overview: 

Achieving universal health coverage requires digital technologies that can transform the way health data is collected and used and contribute to more equitable, rights-based health policies and primary health care services for pregnant women. This project will help expand the functionalities of the BornFyne-prenatal mangement system's antenatal care feature which is a two-way interactive platform. The BornFyne-antenatal care feature was designed adapting components of the WHO focused antenatal care package. The platform currently uses a strafication system to flags high risk pregnancy during antnatal care visits. This project will enable an expansion of these features and the functionality by incoporating components of the WHO digital adaptation kit for antenatal care.BornFyne project is being implemented by Denis and Lenora Foretia Foundation Cameroon in collaboration with University of Ottawa in Cameroon and Zambia and has the epertise and capacity to deliver.

Application Status: 
Not Approved

DAK-Based OpenMRS 3.x ANC Package

Two-sentence Overview: 

OpenMRS aims to improve patient-care by offering quality, shelf-ready OpenMRS solutions that provide health care workers with a better user experience and are easy for implementers to re-use and deploy. By fostering collaboration among highly experienced community members from multiple organizations and other global goods communities, this investment will be used to iteratively create a standards-based, OpenMRS Version 3 (O3) ANC MVP package that incorporates the Antenatal Care (ANC) Digital Adaptation Kit (DAK) and can be used with the new OpenMRS 3 Framework.

Application Status: 
Approved - fully funded

Make IeDA Maternity a reference implementation of the WHO DAK ANC

Two-sentence Overview: 

The goal of the project is to align Tdh Digital tool for Maternity (IeDA Maternity) and its ANC form developed in Burkina Faso, with the content of the WHO Digital Adaptation Kit focused on antenatal care, as well as the reference implementation guide  for HL7 FHIR data standard to make it a reference implementation of this DAK. The internal Tdh team that developed IeDA Maternity will leverage external resources known for their commitment to open source and public goods to make IeDA Maternity / ANC form a stand-alone, interoperable, open source and ultimately shelf ready reference tool.

Application Status: 
Not Approved

NGANISHA HEALTH SYSTEMS: Reference Implementation of the WHO Antenatal Care Digital Adaptation Kit

Primary Author: Christopher Kato
Two-sentence Overview: 

Our goal is to improve Antenatal Care through the implementation of a community oriented digital health system built to eliminate the barriers to uptake of antenatal services in low resource settings based on the WHO Digital Adaptation Kit for Antenatal Care. The proposed system will sync, and be an extension to our Nganisha Health Information system, an Electronic Medical Record system currently deployed in nine public health care facilities in Uganda in collaboration with the Ministry of Health. Uganda Chartered Healthnet developed and deployed Nganisha EMR/HIS and has been involved in digital innovations since 2004. We have the technical skills, tools and implementation expertise needed to develop and enhance eHealth and health information systems in low resource settings.

Application Status: 
Not Approved

Reference implementation of the World Health Organization Antenatal Care Digital Adaption Kit

Two-sentence Overview: 


  • The scope of the project in its entirety is based on the reference implementation of Digital Adaptation Kit focused on Antenatal Care (ANC). Aim is to create a digital software solution which encompasses the complete ANC life cycle as specified in the WHO ANC FHIR IG.

  • The creation of a digital software solution shall catalyze the adoption of the WHO ANC guidelines, by the digital health systems globally. It shall support clinical informed decision making by the individuals, health workers in the healthcare system. It shall act as an enabler to strengthen the healthcare delivery services and continuity of care.

  • Our team’s cross-functional composition (FHIR and clinical domain specifically) will add value to the implementation process.


Application Status: 
Out of Scope