RapidPro remote nutrition data collection in Zimbabwe’s Crisis

Zimbabwe’s severe drought and COVID-19 lockdowns created an urgent need for innovative nutrition surveillance. With travel restrictions in place, health authorities could no longer rely on in-person data gathering. In this context, Zimbabwe’s Ministry of Health turned to an SMS-based system, RapidPro, for rapid and remote nutrition data collection. Community health workers and clinic staff, who had been previously trained on RapidPro during previous disasters, were prompted weekly via SMS to send malnutrition data (e.g., MUAC screening counts) directly to a central server. 

This rapid deployment kept nutrition monitoring alive: in just a few months, over 2.5 million child nutrition screening episodes were reported remotely (one survey found ~70% data completeness from 684 clinics), dramatically expanding reach without face-to-face contact. These high-frequency reports, covering the number of children screened, cases of severe/moderate acute malnutrition, vitamin A doses, and stock levels, offered near real-time visibility into the crisis. As a result, Zimbabwe’s health ministry and partners could spot hot spots and supply gaps quickly, ensuring lifesaving interventions reached those most in need.

The Challenge of Monitoring Nutrition in Crisis

Lockdowns and mobility restrictions during COVID-19 made routine nutrition surveys impossible. The normal channels of community outreach and facility reporting broke down just when malnutrition risks were rising. Nutrition partners in Zimbabwe needed a way to continue lifesaving MUAC screenings and data collection at scale without endangering staff. The solution was to adapt digital tools already proven in emergencies. RapidPro, an open-source platform for SMS and digital data workflows, allowed Village Health Workers (VHWs) and nurses to submit weekly nutrition summaries from their own phones, no internet required.

This remote approach addressed multiple challenges: it kept workers safe, enabled frequent (even weekly) monitoring, and supported multi-lingual instructions for diverse communities. By leveraging the ubiquitous SMS channel, RapidPro made the nutrition surveillance system truly accessible during the crisis.

RapidPro: An SMS-Based Nutrition Data System

RapidPro is designed for quick, high-frequency data collection via text messaging. In Zimbabwe, the platform was rapidly scaled up through a strong training cascade: experienced VHWs and health staff who had used RapidPro during Cyclone Idai were refreshed, and new workers were onboarded through district-level sessions. Each week, the system automatically sent prompts to users’ phones; they simply replied with coded responses for key indicators. Because RapidPro runs on basic mobile networks, it bypasses unreliable internet, critical in remote areas.

The software supports multiple languages and provides real-time dashboards, so national managers can immediately see trends. Importantly, RapidPro is not a replacement for Zimbabwe’s main health database (DHIS2) but a rapid feed into it. Data from hundreds of rural clinics flowed directly to the central server, skipping manual entry at district offices. This design greatly shortened the data lag, giving policy makers near-live insight into changing nutrition needs.

Key features of RapidPro for nutrition monitoring include:

• SMS-based reporting: Data from Village Health Workers and nurses is submitted via SMS at no cost to the user.
• High-frequency indicators: The system tracks critical measures weekly, e.g., the number of 6–59 month olds screened for malnutrition[6], children with SAM/MAM, Vitamin A and MNP coverage, and RUTF stock.
• Existing infrastructure: Zimbabwe’s health workers were already trained on RapidPro, speeding up scale-up.
• Multilingual support: RapidPro supports multiple languages on the user side, ensuring all staff can use it.
• Rapid deployment: The platform was turned on in weeks across priority districts, demonstrating exceptionally fast rollout of an enterprise tool.

Together, these features made it possible to collect a continuous stream of “living” nutrition data at a scale and speed not previously possible in Zimbabwe.

Scaling Up MUAC Screening and Weekly Reports

By October 2020, Zimbabwe had extended RapidPro reporting to all 684 high-priority health facilities across 27 districts. These sites, 100% of the targeted clinics, were each sending weekly nutrition reports. Village Health Workers submitted screening tallies directly from communities, which was especially crucial when door-to-door visits were limited. The result was unprecedented coverage: communities reported over 2.5 million MUAC screenings in six months (April–October 2020), compared to 1.1 million screenings in the same period a year prior. This massive increase was made possible by family-led MUAC screening, where caregivers measured their own children under VHW guidance.

RapidPro aggregated all these community figures daily. Impressively, even with the system being new to many, the average reporting completeness reached about 70%, signaling strong user engagement. Every week, decision-makers received dashboards showing how many children were screened, how many cases of wasting were identified, and which facilities were running low on supplies. This near-real-time data loop enabled far faster response than traditional quarterly surveys.

The outcomes speak for themselves. With weekly RapidPro alerts, health officials quickly identified malnutrition hot spots in the hardest-hit districts. In places where screenings spiked, supplementary food and RUTF were prepositioned. Conversely, if a clinic’s reports flagged low turnout, outreach efforts could be ramped up to bring in the missed children. Nutrition cluster leads attribute timely stock-outs prevention and targeted outreach to this agile monitoring system. (See key results below.)

• Mass screening: >2.5 million MUAC screenings reported remotely (Apr–Oct 2020).
• Facility coverage: Weekly data from 684 priority clinics (full scale of response).
• Data completeness: Roughly 70% of expected reports received each week, a high rate in emergency conditions.
• High-frequency insights: District-level trends (e.g., new SAM cases) updated every week, versus months in normal systems.
• Actionable intelligence: Early alerts for nutrition ‘hotspots’ led to targeted interventions (e.g., mobile clinics, food distributions).

These achievements demonstrate RapidPro’s capability for scalable, timely nutrition surveillance in crisis settings, far beyond what was feasible with paper systems.

Training, Partnerships, and Data Quality

A critical factor in RapidPro’s success was human capacity. Zimbabwe’s nutrition cluster, led by UNICEF and the Ministry, invested in a strong training cascade. Provincial and district nutrition officers were trained first, who then trained nurses and VHW supervisors. By May 2020, over 5,000 community health workers had been oriented on the SMS reporting format. Because many had previously used RapidPro, the learning curve was short.

The system also included data validation checks: if a submission was missing or out of range, supervisors received alerts to follow up. This kept data quality high despite the speed of rollout. In practice, VHWs simply sent brief weekly texts (e.g., “5 2 0 10” to indicate 5 SAM, 2 MAM, 0 stockouts, 10 children screened), a process that took only minutes. Because the SMS gateway was reverse-billed, it cost nothing for workers to report.

Partners from NGOs and the government held regular review meetings to use the RapidPro data. Nutrition cluster coordinators in Harare could, for instance, compare district trends side-by-side every week. Success stories from this approach rapidly spread to neighboring countries’ nutrition teams, who cited Zimbabwe’s RapidPro example in regional guidance. In short, a robust human network of training and feedback complemented the technology, ensuring that the 70%-plus reporting rate translated into real program action.

Integration with Health Information Systems

While RapidPro provided agile data flow, planners did not want a parallel “shadow” system. From the start, integration with Zimbabwe’s national DHIS2 health information system was a priority. The plan now underway is to automatically feed RapidPro summaries into DHIS2 dashboards. This ensures Ministry of Health ownership of the data and reduces duplication. Even now, national M&E officers clean and import the RapidPro data into their databases for official statistics. The path is clear: RapidPro data → DHIS2 Tracker → national analytics. By harmonizing digital health efforts, Zimbabwe demonstrates how emergency tools can bolster routine systems.

In practical terms, this means the nutrition cluster isn’t maintaining two separate figures for screenings. Ultimately, all validated nutrition metrics (screened, SAM, MAM, supplies) will live alongside vaccination and other health indicators in DHIS2. This integration also streamlines donor reporting: partners simply pull required outputs from one dashboard instead of chasing paper reports from the field.

Why NGOs and Governments Should Act Now

Zimbabwe’s RapidPro experience shows that digital solutions can safeguard essential nutrition programs even under the toughest conditions. The case is clear for NGOs and governments:

• Speed and scale: RapidPro.app can be deployed globally within 24 hours, immediately linking thousands of health workers to central data.
• Security and reliability: It offers enterprise-grade security (encryption, access controls, audits) and 24/7 support, crucial for handling sensitive health data.
• Flexibility: The platform integrates via APIs into any existing HMIS or management system, so it complements, not replaces, workflows.
• Multilingual and low-tech: RapidPro.app supports multiple languages (including auto-translation and Unicode) and works on basic phones, widening accessibility.
• Managed service: With automated backups, proactive monitoring, and expert support, organizations can focus on program outcomes, not IT maintenance.

By partnering with RapidPro.app, funders can replicate Zimbabwe’s success quickly and securely. The platform’s managed cloud hosting ensures scalability without up-front infrastructure costs. And because it is continuously updated, teams will always run the latest version with minimal effort.

Conclusion

In emergencies, every day counts. RapidPro remote nutrition data collection proved its worth in Zimbabwe, detecting malnutrition surges, guiding stock replenishment, and saving children.

NGOs, governments, and donors should build on this model: adopting RapidPro App today means having a proven, turnkey solution ready for the next crisis. Visit RapidPro App to learn more, request a demo, or start a free trial, and give your nutrition programs the data edge they need.

FAQs

Q: What is RapidPro, and how does it help with remote nutrition data collection?
A: RapidPro is an open-source SMS-based platform for collecting health and nutrition data. In remote nutrition programs, it enables community health workers to submit key indicators (like MUAC screening counts) via text message. This makes data collection fast, cost-free to users, and not dependent on the internet, so programs can maintain high-frequency reporting even during lockdowns. RapidPro’s workflow also supports multiple languages and automated alerts, ensuring timely, actionable nutrition data reaches decision-makers each week.

Q: How did Zimbabwe use RapidPro during the COVID-19/drought crisis?
A: Zimbabwe scaled RapidPro nationwide to track child malnutrition in real time. Health staff and village health workers sent weekly nutrition reports by SMS to a central server. This included the number of children screened for acute malnutrition, SAM/MAM cases, vitamin A supplementation, and stock levels. According to reports, RapidPro captured over 2.5 million community MUAC screenings from 684 facilities, enabling the Ministry of Health to monitor nutrition trends remotely. The data helped identify hotspots and trigger emergency feeding support faster than traditional systems.

Q: What were the key results of using RapidPro for nutrition surveillance in Zimbabwe?
A: The RapidPro system achieved very high coverage and data quality under pressure. About 70% of expected weekly reports were received on time from all 684 targeted clinics, a remarkable completeness in an emergency. Over 2.5 million children (6–59 months) were screened for malnutrition through the SMS reports, revealing both increases in screenings (vs. pre-COVID) and areas with rising SAM cases. Weekly dashboard summaries allowed authorities to redistribute RUTF and launch community feeding quickly. In short, RapidPro’s high-frequency data enabled timely decision-making that saved lives.

Q: Can RapidPro data integrate with existing health systems like DHIS2?
A: Yes. In Zimbabwe, plans are already in motion to feed RapidPro’s outputs into the national DHIS2 database. RapidPro was designed to complement, not replace, the HMIS. Data sent via SMS is cleaned at the national level and can be exported into DHIS2 Tracker for dashboards and analysis. This integration streamlines reporting: health managers will see all nutrition indicators (from RapidPro and other sources) together in DHIS2, improving ownership and sustainability of the system.

Q: Why should NGOs or governments choose RapidPro.app for nutrition monitoring?
A: RapidPro.app is a turnkey, managed hosting service for the RapidPro platform with features tailored for global health agencies. It offers ultra-fast deployment (under 24 hours) and enterprise security (encrypted data, access controls, GDPR compliance). The service includes 24/7 expert support and real-time monitoring of the system, meaning partners can focus on program needs instead of IT. It also supports multiple languages out of the box and has prebuilt connectors for easy integration with tools like DHIS2.