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 6 - 10

Reference Implementation of WHO Antenatal care Digital Adaptation Kit through CommCare

Two-sentence Overview: 

Please note that this part has changed since the submission of the Concept note

The objective of this project is to create a reference application using the Open Source CommCare platform to implement the operational requirements pertaining to WHO Antenatal care recommendations in digital systems. This reference application that is proposed to be developed  will provide functionalities for digital tracking  and include features such as workflows, decision support, scheduling logic, reporting indicators, etc, that can be used by  community health community health workers and their supervisors for  enabling key health services  targeting the improvement of key health indicators  and monitoring of performance metrics .

High-Level Budget Summary 


Work Package 1 : Development of a MVP mobile application that aligns with the guidelines prescribed by WHO Digital Adaptation Kit:

Work Package 2 Finalization of mobile application that aligns with the WHO DAK guidelines

Work package 3: Product information and documentation

Total Cost (USD)

Total Project Costs





Application Status: 
Not Approved

Strengthening Antenatal Care Components and Improving Shelf-Readiness

Primary Author: Wendy Leonard
Two-sentence Overview: 

E-Heza Data Solutions is a point-of-care digital health platform that improves maternal health outcomes by increasing a woman’s engagement in her care, easing workloads for frontline health workers, improving quality of care through implementation of best practice World Health Organization (WHO) guidelines, and promoting accurate data collecting and reporting while strengthening existing electronic medical record (EMRs) systems. E-Heza aims to be a reference implementation for the WHO Digital Adaptation Kit (DAK) for Antenatal Care (ANC) by aligning with the DAK while improving shelf-readiness by aligning with Instant OpenHIE to add an interoperability in order to provide a deployable package that can easily share data with other software.

Application Status: 
Not Approved

Supporting a FHIR Native Reference Implementation of the ANC Smart Guidelines

Two-sentence Overview: 

We propose creating a 100% FHIR native reference implementation of the WHO Digital Adaption Kit (DAK) for Antenatal Care (ANC). This will allow the application to be configured directly with L3 guidelines represented as FHIR resources, in the ANC DAK FHIR Implementation Guide.  We will develop this using Google's Android FHIR SDK and OpenSRP FHIR Core - both of which we have been active in the development of over the past year.

Application Status: 
Approved - fully funded

Supporting Digital Cascade of Care for Antenatal Care

Two-sentence Overview: 

Everwell Health Solutions Pvt. Ltd. (“Everwell”) is excited to submit this concept note to Digital Square in support of Notice F0: Implementation of the World Health Organization Antenatal Care Digital Adaptation Kit.

We propose to enhance our platform, the Everwell Hub, 1) to support antenatal care management as per the WHO Antenatal Care Digital Adaption Kit and 2) enable sophisticated case management for pregnant women with pre-existing conditions/ comorbidities in a single platform. While the Hub is fully featured and in use in 15 countries across multiple diseases supporting nearly 2.6 Million registrations per year, the current structure is not adapted for antenatal care and supports one disease/ condition at a time. This proposal outlines enhancements that will enable us to create workflow based systems and empower users to track complex pregnancy journeys and also manage multiple medical treatments such as TB, HIV, diabetes for pregnant women within a single web and mobile user interface.

Application Status: 
Not Approved

Tamanu for Antenatal Care

Two-sentence Overview: 

This project will expand the functionality of Tamanu, our patient-level electronic medical record, to address the healthcare needs of expectant mothers in line with the World Health Organization’s Digital Adaption Kit focused on Antenatal Care. BES designed Tamanu and has led its successful implementation in Fiji, Samoa, and Nauru, alongside other digital health solutions we have delivered across more than 12 countries in Asia, Africa, and the Pacific region.

Application Status: 
Not Approved