Table 3 Reported strengths and benefits to the implementation of the digital health platform WelTel in East Africa

Timely diagnosis and response

“It's real time. Being able to communicate if me as a mother to be I do have a problem.” [Patient – Maralal, Kenya]

“Help clients who respond with "Not Okay" while they're at home.” [HCP – Rwanda]

“It has helped many who are in need through SMS [..] which is faster” [HCP – Maralal, Kenya]

“Timely identification of opportunistic infections” [Policy Maker – Rwanda]

“It addresses early referrals and interventions to be taken in case of a patient/client having a complication. The client will text, and the ambulance will go for the patient.” [Policy Maker – Wamba]

“Reference 1: 0.32% coverage

WelTel is directly reaching the beneficiary compared to other existing solutions which is reaching to the beneficiary through CHVs” [External Stakeholder – Wamba]

Cost-effectiveness

“Less human resources required in comparison to other alternatives” [Policy Maker – Maralal]

“ Is cheap since I don't incur any charges as a client” [Patient – Maralal]

“There is no cost for the users. The cost for the implementer is limited and there is an efficiency in using WelTel.” [Policy Maker – Rwanda]

User-friendliness

“User friendly to the staff because it’s easy to use and also for the client” [HCP – Wamba]

“Yes—It's a simple tool that even the illiterate can understand.” [HCP– Wamba]

“It is easy for writing the message than talking with the nurse”

“Yes The message only reaches the WelTel personnel from the code 40,540, hence it is private” [Implementation Team Manager – Wamba]

Security and safety

“Yes…because my privacy is safe” [Client – Maralal]

“The message is coded. Therefore the confidentiality is respected.” [Policy Maker – Rwanda]

“She is the only one who receives the messages from the client/patients” (referring to the Implementation manager) [Client – Wamba]

Appointment attendance

“The intervention works well since it reminds clients of when they are supposed to come to the clinic. This has significantly reduced dropouts and improved Skilled Birth Attendance at the facility.” [External Stakeholder – Maralal]

“Yes, this is because through the SMS the client is reminded on when to come for clinics.”

[HCP – Maralal]

“For youth is very acceptable as they don't want to hold program card every time.” [HCP – Rwanda]