Uganda's Experience with Real Time Monitoring: mTrac and U-Report

This report reviews two real time monitoring initiatives in Uganda that utilize Rapid Short Message Service (RapidSMS) technology: mTrac and U-report. mTrac is a routine data system that uses RapidSMS to accelerate the submission of community and health facility data from local to district to national levels, including disease surveillance, malaria treatment and drug stock indicators. This new system replaced the older paper-based reporting system and makes it possible for staff at health facilities to use their own mobile phones to report on stock levels and usage rates for anti-malarial medicines, with data made instantly available on a web-based dashboard to government managers. To improve response and strengthen accountability, the system also incorporates crowd-sourcing reports of service delivery complaints through an anonymous SMS hotline. In addition to providing information in a timelier manner and making information more accessible, mTrac has found widespread acceptance across local and national levels, and Uganda’s Ministry of Health has taken full ownership of its operation. Although mTrac was initially piloted in a few selected districts in late 2011, it is expected to cover all 5,000 health facilities across the country in 2013.The early experiences of mTrac offer a number of important lessons for RTM. First, the success of the rolling out of mTrac in Uganda suggests that such this type of routine data system could be adapted in many countries to achieve both cost-savings and more efficient and accurate monitoring of key supply and demand health indicators in vulnerable areas. Second, adapting multiple reporting mechanisms can maximize the quality of information received by a RTM initiative. In the case of mTrac, this is achieved by cross-checking the SMS data submitted by the health facilities with information received from the anonymous SMS hotline as well as independent reports sent by volunteer health teams at the community level. Third, RapidSMS reporting holds vast potential to enhance the inclusivity and effectiveness of service delivery systems that are tracked by integrated RTM initiatives. Not only has the electronic reporting system reduced leakage of drugs from the public health system, but mTrac has also introduced more transparency and accountability into the health system, empowered district and national managers with actionable information and helped to ensure the availability of antimalarial treatment for all Ugandan citizens. Lastly, mTrac demonstrates that systematic RTM initiatives can also serve as effective sub-national service delivery tools and support decentralization objectives.U-report, in contrast, was conceived as a social and community-based monitoring system that uses RapidSMS. It offers young Ugandans a chance to voice their opinions on issues that they care about by giving them access to a free SMS service through which they can send in text messages, respond to polls, and receive factual information and results. UNICEF developed the software application and built a web platform for managing communications between the social monitors, called U-reporters, and the central managers. Although the overall objective is to empower youth in general, specific issues tackled by U-reporters often address the needs of vulnerable children, and U-report further possesses the capability of soliciting information from specific areas as well as age groups that are vulnerable. Regarding uses, U-report raises awareness on different issues, supports community-led development, fosters information sharing, including with parliamentarians, and serves as a tool for local and national policy advocacy. At the end of 2012, there were more than 170,000 U-reporters across Uganda (average of 24) and over 200 polls posted on the website..