Mobile Phones As Surveillance Tools: Implementing and Evaluating a Large-Scale Intersectoral Surveillance System for Rabies in Tanzania

Abbreviations: GPRS, General Packet Radio Service; GSM, Global System for Mobile communication; IHI, Ifakara Health Institute; LMICs, low- and middle-income countries; mHealth, mobile-phone-based health; PEP, post-exposure prophylaxis; SMS, short message service or text messaging Provenance: Not commissioned; externally peer-reviewed Summary Points * Surveillance is critical to manage preventative health services and control infectious diseases. [...]most surveillance in low-income countries is paper-based, provides negligible timely feedback, is poorly incentivised, and results in delays, limited reporting, inaccurate data, and costly processing. * The potential of mobile technologies for improving health system surveillance has been demonstrated through small-scale pilots, but large-scale evaluations under programmatic implementation remain rare. * An intersectoral mobile-phone-based system was developed and implemented for rabies surveillance across southern Tanzania. Since 2011, the system has facilitated near real-time reporting of animal bites and human and animal vaccine use (almost 30,000 reports) by over 300 frontline health and veterinary workers across a catchment area of 150,000 km2 with >10 million inhabitants, improving data quality, timeliness, and completeness while reducing costs. * The surveillance system infrastructure is a platform that can be further developed to improve services and deliver health interventions; for example, generating automated personalized text messages (SMS) to alert patients to their vaccination schedules improved their compliance with regimens.