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The Health Systems Trust (HST) invites proposals to develop a business case for the comcare mobile health (mhealth) application used by Community Health Workers (CHWs) to be piloted in five health districts

Opportunity closing date: 07 November2022


Completed proposals should be submitted in ENGLISH and must be received not later than 23H59 on Monday, 07 November  2022 in electronic PDF version, duly signed and dated.

Submission enquiries should be made by 04 November 2022, 17h00 to:

Technical enquiries on the proposal content must be made, on or before 04 November 2022, 17h00 to

Health Systems Trust (HST) is a leading organisation in South Africa's public health arena focusing on health systems strengthening, research, and strategic support for implementation of priority health programmes. Since its establishment in 1992, HST has contributed significantly to the development of the national health system. Subscribing to a Primary Health Care approach, HST actively supports current and future development of a comprehensive health system, through strategies designed to promote equity and efficiency in health and health care delivery in southern Africa.


In 2018, the National Department of Health (NDoH) in partnership with the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) successfully developed and piloted the mobile health (mHealth) application for CHWs in two health districts. Subsequent to that, the mHealth application was successfully rolled out in three additional health districts. In total, five districts implemented the mHealth application in three provinces as follows: Ekurhuleni in Gauteng, uMgungundlovu in KwaZulu-Natal, Dr Kenneth Kaunda, Bojanala and Ngaka Modiri Molema districts in the North West Province. 

Following the mHealth review which was commissioned by the NDoH in 2017, ComCare was the preferred application for use in the community by the CHWs. The Comcare application developer, Dimagi was then contracted to develop and deploy the application as per the approved implementation plan. PEPFAR appointed Aurum Health Institute as the implementing partner to oversee the contracting of service providers and the implementation of the ComCare application.

There was no formal review of implementation of the ComCare application by CHWs in the five districts by the Department of Health (DoH). At this stage, it is critical for the DoH to conduct a review on the implementation of the mHealth application to assess the ComCare application's benefit to the CHWs and the health system as a whole. This review comes at a time when the NDoH is in the process of reviewing and updating the Policy Framework and Strategy for Ward Based Primary Healthcare Outreach Teams (WBPHCOTs) which expires end of March 2024. The findings of the review will provide an understanding on the cost vs. benefit of the mobile application in the community as well as user experience in order to motivate for resources to strengthen the implementation of mHealth for CHWs.


To develop a five-year CHW mHealth business case for resource mobilisation in support of implementation of the application in the relevant Government Departments across all provinces. 

Scope of Work

A service provider is required to:

  • Undertake a review of the implementation of the ComCare application in five health districts listed above. 
  • Provide recommendations on the use of mHealth by CHWs and its relevance in the context of other reporting systems used by the DoH including the Health Patient Record System (HPRS) to enhance National Health Insurance (NHI) implementation.
  • Develop a 5-year business case for the implementation of the ComCare mHealth application for CHWs in the context of the Policy Framework and Strategy for Ward Based Primary Healthcare Outreach Teams (WBPHCOTs).



The review will include both primary and secondary data collection. The primary data collection will cover the following:

Data collection from the developers of the ComCare application (Dimagi), the implementing partner (Aurum Health Institute), CHWs, Outreach Team Leaders (OTLs), the Master Trainers who were involved in the training on the application and provincial IT managers who supported the roll out.

Interviews with the NDoH, Provincial and District Health Managers who participated in the project.

Secondary data collection will cover the following:
  • Local, regional and international literature review on the existing published and unpublished research on the implementation of similar mHealth for CHWs in order to benchmark against international experience.
  • Review of the existing reports or documents on the implementation of the ComCare application.
  • Review of the Policy Framework and Strategy for the WBPHCOTs.



The review will be conducted over a period of 6 months from the date of contracting.


  • CHW mHealth application review draft report.
  • PowerPoint presentation on the final findings.
  • Consultation with stakeholders on the draft findings.
  • Business case for mHealth application for CHWs.
  • Final review report.
The service provider will also ensure that feedback on the evaluation and the business case is shared with the relevant participants in the National, Provincial Departments of Health as well as the implementing partners and Dimagi.



The service provider/organisation to be considered should have the following skills:

  • Senior researcher with more than five years' experience in evaluation research using both qualitative and quantitative research methods. 
  • Health economics background or actuarial expertise in health.
  • Health programmes monitoring and evaluation background and experience.
  • Have undertaken at least five projects in the public health system within the context of PHC.
  • Undertaken a minimum of three cost-benefit analysis projects.
  • Knowledge of in Human Centric Design frameworks is an added advantage.
  • Knowledge or experience in mHealth applications implementation at community level.
  • Excellent communication and report writing skills.



  • A technical proposal as per scope outlined in this Request for Proposals (RFP). The proposal must include:
    • A high-level project plan indicating deliverables and project duration.
    • An organogram of the project team structure clearly indicating the positions of the team members.
    • The proposed budget.
    • The proposal length should not exceed five pages excluding cover page (detailed budget, work plan, and organogram must be attached as annexures).
  • Provide the following supporting documentation:
    • CVs of the project manager and key team members.
    • Organisation profile.
  • References to contracts/projects of a similar nature completed in the past five years. Please include the name of the organisation, description of contract, date of contract, contact persons, and contact details where such project was undertaken.
  • References or link to published or unpublished related work.
  • Tax clearance certificate of individual/entity.
  • Proof of Bank Account.
  • BBB-EE certificate of entity.
  • Latest audited financial statements of entity.
  • Certificate of incorporation of entity with ID numbers and names of directors/members.
  • Police clearance for directors/main members or individual applying.
  • Declaration of any conflict of interest, or a statement of truth that none exists.
  • Three verifiable letters of reference and HST has the right to contact these references.



The consultant will be contracted through HST. Administrative requirements including submission of invoices and other aspects will be guided by HST policy, processes and project requirements.

In terms of the work outputs, the consultant will report to the Chairperson of the CHW Policy Review Technical Task Team (TTT), delegated by the CHW TT to undertake CHW Policy related activities. The Policy Review TTT will provide oversight and strategic guidance on the work plan and will share progress with the CHW TT. The Service provider/organisation together with the TTT will develop the project work plan which will outline the milestones and timelines including feedback sessions on progress.


The advert will be open for seven days from the date of advertisement. All submissions must be received not later than 07 November 2022 at 23h59.

Offers must be clearly marked with the bid reference. Late bids will not be accepted. Bidders are requested to ensure that the submission instructions, as stipulated in this document; are adhered to. Failure to do so will result in disqualification of proposals.

Submissions should be made to


  • Each proposal will be assessed first on its compliance followed by technical merits and then on price. The proposal with the best overall value will be recommended for approval.
  • An evaluation panel will consist of NDoH members, CHW TT and HST. HST will finalise the contract with the selected service provider.
  • Responses deemed not to meet all of the mandatory submission requirements may result in the proposal being disqualified from further consideration.


The mHealth Review Terms of Reference (ToR) document is available upon request.