In Tanzania's healthcare facilities, there is insufficient comprehensive client feedback data. Typically, client feedback is provided via paper and pen through suggestion boxes, exit interviews or via hotlines. However, through these mechanisms low volumes of feedback are shared, often in an unstructured format and not enough reaches the management levels of local and central government. 60 per cent of clients say that existing feedback mechanisms are inadequate. As a result, client voices are not sufficiently heard within healthcare decision making. This lack of communication undermines trust in the healthcare system and hampers the utilisation of essential services, leading to negative healthcare outcomes.

Afya Pamoja is working with the Government in Tanzania to develop an innovative healthcare platform that amplifies citizens' voices to improve healthcare. Using free and anonymous SMSs, patients can provide direct feedback about the services they receive at healthcare facilities using their mobile phones. The data collected through patient surveys provides healthcare managers with actionable insights on the quality-of-service delivery based on the experiences of citizens. The platform can enable the sharing of updates and outbound health information to patients to help close the feedback loop and foster trust and engagement.

In close collaboration with the government and UNICEF, the organisation piloted the intervention across 150 healthcare facilities, which serve a total of 50,000 pregnant women per year. Ninety per cent of mothers who used the platform stated an increased knowledge of services, and 71 per cent stated that it improved their trust in the healthcare system. Since launching, 60 per cent of these health facilities have utilised citizen voice insights provided through the platform to inform their decision-making processes. As a result, 5 per cent more pregnant women chose to deliver within a health facility setting.