Building a Digital Health Ecosystem for Maternal Care
How Wits University is transforming maternal health through community, collaboration, and low-tech innovation
In South Africa, Nigeria, and Kenya, maternal health systems are under pressure. Clinics are overcrowded, frontline workers are stretched thin, and women—especially in rural or low-connectivity areas—often face long waits or missed appointments. But at the University of the Witwatersrand (Wits), a new model is emerging—one that blends digital innovation with deep community engagement to reshape how maternal care is delivered and accessed.
Through the Digital Innovations for Maternal Health in Africa (DIMA Health) initiative, supported by the Research and Innovation Systems for Africa (RISA) Fund—implemented with UK International Development support, Wits is leading a multi-country effort to make maternal health more accessible, efficient, and equitable. The approach, which cuts across the RISA portfolio, is simple but powerful: build tools that work for the people who need them most, and embed them within systems that already exist.
Pregnant mothers-to-be often have to travel long distances for simple, routine check-ups, only to spend over 6 hours waiting at a clinic, before eventually being turned away due to overcrowding. These commonly encountered delays not only jeopardise maternal and newborn health outcomes but impose heavy out-of-pocket costs (transport, childcare, and lost income) on financially stretched families.
“No mother should have to choose between her health and feeding her family. When long waits and costly journeys stand in the way of routine care, it is the women and children who pay the highest price.” – DIMA Health staff member
At the heart of DIMA Health is a low-tech appointment booking and self-queueing system intended to combat this challenge, which is accessible via WhatsApp, USSD, and SMS. Designed for women without smartphones or internet access, the tool allows pregnant women to schedule and check in for maternal health visits remotely-cutting down on wait times, thereby reducing the burden both on clinics and on the mothers in question. As one programme trainee noted, ‘when mothers wait all day at the clinic only to be sent home, they feel forgotten. With DIMA, I can help them book their visits, remind them, and make sure they are seen. It saves their time, their money, and sometimes even their lives.’
Ministries of Health in Nigeria and South Africa have acknowledged the potential of this tool to dramatically reduce waiting times, cut missed appointments, and minimise avoidable costs for underserved rural communities: local partners have expressed strong support for the initiative, with one community based organisation leader noting that ‘For us as a community organisation, DIMA is more than a tool—it is a bridge. It connects mothers to care without the endless waiting, and it strengthens trust between clinics and the families we serve.’ This success has clearly been noticed: government officials are currently preparing to deploy this accessible digital health system in a pilot programme across Lagos State, Nigeria; Nairobi County, Kenya; and Gauteng Province, South Africa.
But DIMA is more than a digital health tool—it’s a growing ecosystem. Through the DIMA Health Government Collaboration Network, Wits has brought together policymakers from South Africa, Nigeria, and Kenya, along with WHO African Region (AFRO) representatives, to co-design data-driven solutions to maternal health challenges. This collaboration has helped align innovation with national priorities and accelerate policy uptake:
Meanwhile, the DIMA Health Maternal Health Champions Network is empowering communities from the ground up. Over 50 “Ma’ambassadors”—trained female health champions—are now active in Nigeria and South Africa. These women support patient registration, send appointment reminders, and deliver health education in their communities. Their work is backed by a comprehensive training curriculum developed in partnership with institutions such as the University of Ibadan and the Perinatal HIV Research Unit. By embedding these trained community champions (Ma’ambassadors), who work in lockstep with the offline booking system tool, DIMA Health have ensured that the most marginalised populations—including adolescent mothers, and rural women with limited access to education and healthcare—are not left behind. Training materials for the Ma’ambassador project were adapted to low-literacy contexts, and all designed tools are accessible in multiple local languages to increase audience reach.
To support learning and scale, Wits launched the DIMA Academy on the African learning platform, Pfunzo. The Academy offers accredited training in maternal health and digital literacy, aligned with national community health worker (CHW) frameworks. It has quickly become one of the platform’s top 10 most accessed features. Hospitals and health groups are now using the Academy to amplify maternal health discussions and strengthen the workforce—ensuring the project’s impact continues beyond its initial funding.
The Academy’s reach is global. Monthly webinars hosted by DIMA have drawn over 400 participants from 30 countries, creating a vibrant space for pan-Africa knowledge exchange. Policy briefs developed by the team have been accessed by hundreds of users, shaping maternal health strategies across the continent.
Research is another cornerstone of the initiative. Through the DIMA Health Research & Knowledge Exchange Network, Wits has partnered with institutions in Nigeria and South Africa to build a community of practice. This burgeoning network is developing collaborative tools and research platforms—like Africahied, a pan-African database of over five million indexed publications—to support evidence-based decision-making in maternal health.
The results are already visible. In Lagos, the Ministry of Health is exploring how DIMA’s queueing system could be used in general outpatient services. In Gauteng, departments of health and transport are considering its integration into school-based and youth outreach programmes. NGOs and community-based organisations are adapting the tools for broader use in local health planning. What began as a pilot to improve maternal health access is now catalysing systemic change. DIMA Health is not just a set of tools—it’s a platform for collaboration, learning, and empowerment. By combining low-tech innovation with high-impact partnerships, Wits is helping to build a maternal health ecosystem that is inclusive, scalable, and sustainable.
For the women who no longer have to wait hours for basic healthcare, for the Ma’ambassadors championing change, and for policymakers shaping the future of regional health systems, DIMA is more than a project. It’s a lifechanging movement that proves mothers-to-be can dream of a brighter future for themselves, as well as their children.
The RISA Fund (2020-2025) is a multi-country initiative funded by the UK government, designed to strengthen research and innovation systems across Africa. It brings together two complementary programmes under the Foreign, Commonwealth and Development Office’s (FCDO) Research and Evidence Division—Strengthening Research Institutions in Africa (SRIA) and African Technology and Innovation Partnerships (ATIP)—to harness synergies and drive systemic change.