Kilimanjaro ULTRA 2020

A Digital Delivery Register for Reproductive Health in Low Resource Settings


Perinatal morbidity and mortality rates are high and notorious for unreliable and incomplete documentation in low income countries (LIC). Nevertheless clinic and hospital delivery registers offer complete, basic perinatal data and are ubiquitous. But, being paper based, they quickly become unusable unless coded on forms for digital re-entry. Crucially, they miss home deliveries, especially in remote areas where the most vulnerable families live. Our simple mobile open source deliver register (ULTRA), which can be implemented on the District Health Information Software (DHIS2) server platform is planned to exploit and extend this existing resource.


To prove that we can replace inefficient generic, paper-based, delivery registers with a simple, low-cost, mobile electronic delivery register.


ULTRA accepts online or offline data entry on a mobile, tablet or desktop, and can store data storage on local servers. This project is planned for the Kilimanjaro Region, Northern Tanzania, which has 44,000 births annually. Four of the seven districts in the region will be randomly selected to test ULTRA for recording perinatal data for home births. The minimal dataset, will be based on core data and a Delphi survey. ULTRA+ is similar to ULTRA but has more core data (WHO) augmented by requirements determined by Delphi to suit local needs. In both phases, we will test the system’s usability and acceptability by users, its cost compared to existing system and sustainability. Throughout, we will engage with stakeholders at annual workshops. Impact: This proposal prioritises “Gender equality” of the “A Better World” strategy and with SDG 3 and 5, highlighting the importance of improving maternal and child health. ULTRA will enable audit and quality control for maternal health services. It will be an inbuilt service tool which can also measure the impact of interventions. If this works in Kilimanjaro, it can work anywhere.

Principal Investigators:  Dr. Ali Khashan, Dr. Simon Woodworth

Kilimanjaro Ultra 2020 Study Team and Volunteers: Dr. Modeta Mitao – Study Coordinator, Francis Pima – Research Assistant, Gustarv Nyka – Technician, Allen Lyimo – Technician, Allen Senkoro – Technician KCRI, Martha Mwalugaja – Project Manager, Lucy Munishi -Research Assistant Volunteer – KCRI