Digital health innovations hold promise for strengthening maternal and newborn care in low-resource settings. In Mukono District, Uganda, we implemented an electronic health registry (eRegistry) with built-in clinical decision support (CDS), automated reporting, and SMS messaging to pregnant women, aiming to improve care continuity and reduce the reporting burden. The eRegistry captures individual-level antenatal (ANC) and birth data, creating a longitudinal health record across the pregnancy continuum. This system, accessible via Android devices and web platforms, integrates with the national electronic Health Management Information System (eHMIS), enabling real-time automated reporting. More than 13000 clients have been registered in the eRegistry system since July 2024 to date. Pilot assessments of “tracker to aggregate” functionality showed strong consistency between eRegistry-generated reports and those submitted to the eHMIS, validating the system’s reliability for generating accurate aggregate reports. In three facilities, initial discrepancies in ANC1 figures were resolved through data entry validation, and once complete, eRegistry reports matched or corrected the paper-based totals which informed the eHMIS.
We are conducting implementation research to explore automatic linkages of the eRegistry to Civil Registration and Vital Statistics (CRVS), offering a potential paradigm shift in how birth and death events are documented and verified, with significant implications for improving denominator accuracy in health statistics and service planning. Deployment and scale-up are guided by CFIR and iPARIHS implementation science frameworks. A concurrent cluster randomized controlled trial (RCT) is evaluating the impact of the eRegistry on guideline adherence, service utilization, and health outcomes. This work demonstrates the feasibility and value of digital registries in transforming maternal healthcare delivery and measurement, with lessons for scaling sustainable digital solutions within national health systems.
Keywords: Digital health Interventions; digital registry; implementation research; digital adaptation kit; quality of maternal and child health care
