Digital health vision: could MomConnect provide a pragmatic starting point for achieving universal health coverage in South Africa and elsewhere?

### Summary box Digital health, the use of digital, mobile and wireless technologies for health,1 is being positioned as a transformative agent, particularly in low-income and middle-income settings, where mobile connectivity has reached unprecedented penetration and ubiquity.2 3 Multilateral initiatives such as the Roadmap for Health and Measurement and Accountability advocate the ‘use of the digital revolution to scale-up health interventions and engage civil society’, and monitor health systems’ performance and accountability to beneficiary populations.4 Over the past decade, numerous digital health strategies have emerged to address long-standing health system challenges, and achieve national and global goals including the United Nations Millenium Development Goals (MDGs) and United Nations Sustainable Development Goals (SDGs).5 6 Despite the global abundance of digital health implementations, few have achieved national-level scale or become institutionalised as routine practice within the Ministries of Health. Furthermore, successes are often defined as technical accomplishments, instead of demonstrated impact on programme or health outcomes.7 MomConnect, in South Africa, represents a rare example of a nationally scaled and government-supported digital health initiative. Core functionalities within MomConnect include unique registration of pregnant women; targeted communication in …