Telehealth is no longer a luxury. For an island like Zanzibar, a call center serves as a vital bridge, connecting families to life-saving health services.
The Zanzibar Afya Call Center is a toll-free hotline (115) where people can call trained health workers for advice, referrals and health information. It puts trusted information within reach of anyone with a phone, regardless of distance or cost.
Today, the call center responds to a wide range of health needs, but its potential is even greater. By reducing delays to care, especially for mothers and newborns, it plays a pivotal role in saving lives. That’s why VillageReach, together with the Zanzibar Ministry of Health and partners, is charting a five-year strategy to transform the call center into a durable, trusted and people-centered part of primary health care.
This work is part of a larger vision across Africa to make timely, reliable health information as accessible as medicines and clinics.
The challenge we must solve
Many health systems face similar, layered challenges around telehealth and hotlines:
- Unequal reach (urban bias, poor access in rural areas/islands and remote communities)
- Variable quality of information and referral pathways,
- Low financing and unclear governance,
- Fragmented technology and data that don’t feed decision-making and
- Limited capacity for continuous improvement
When hotlines are ad-hoc or donor-driven without a sustainability plan, the service can stall just as communities begin to increase their use. Furthermore, these barriers are particularly visible in maternal and newborn care, where even minor delays can determine survival.
VillageReach and Zanzibar MoH staff with partners from m-Mama, Reach Digital Health, DMI, CIHEB Tanzania, WHO and PharmAccess at the development of Zanzibar’s 5-Year Telehealth Strategy, September 2025. Photo credit: Said Shaaban
How we design lasting telehealth systems?
At VillageReach, we design telehealth strategies aimed at strengthening communities, improving service delivery, enhancing the health system and creating an enabling environment. This multi-level plan produces systems that are both practical and sustainable.
The core principles we bring to every country partnership are:
- People-centered design: the telehealth service must be trusted, culturally appropriate and easy-to-use for callers with different languages and literacy levels.
- Integration with primary care: hotlines are gateways and therefore should be linked with referral systems, facilities and community health workers.
- Data-driven governance: use call data and user feedback to improve clinical guidance, staffing and resource allocation.
- Sustainability first: from day one, we align on financing, governance roles and realistic operational costs.
- Technology and interoperability: choose tech that is maintainable, secure and can exchange data with national health information systems.
- Local ownership and capacity strengthening: build the skills necessary for the Ministry and local partners to run, monitor and evolve the service.
From strategy to action
Rather than arriving with a ready-made plan, we design solutions with ministries, implementers, funders, researchers and private partners, aiming to agree on a shared vision and craft a clear path to get there.
Typical elements of the strategies we develop:
- A clear vision and service model (who the hotline serves, hours in use, services offered),
- A governance and financing plan (roles, cost model, transition timelines),
- A technical architecture that supports secure call handling, analytics and referrals,
- Quality assurance: governance, agent training and supervision,
- An operational implementation plan with 1-, 3- and 5-year milestones; and
- A monitoring & learning framework so decisions are guided by evidence.
Across Tanzania, Zambia, Kenya and Malawi, our teams have supported governments in translating these building blocks into operational plans by strengthening call-agent competency and referral linkages and designing simple dashboards that show who is calling and why.
Call centers and telehealth lower barriers created by distance, cost and information gaps. In island contexts like Zanzibar, a trusted voice on the phone can be the difference between delayed care and timely help. For example, linking the call center with emergency transport initiatives, such as M-Mama, could help ensure that women in labor or experiencing complications can find safe passage to facilities.
Furthermore, when integrated with the health system, telehealth helps with triage, reduces unnecessary facility visits, improves care continuity and feeds real-time data back into planning.
Scaling for sustainability and resilience
Workshops and roadmaps are just the beginning. The real test lies in operationalization; moving from strong plans to funded, owned and quality-assured services that evolve with changing needs and technologies. That’s why we’re focused on:
- helping Ministries cost and budget services realistically,
- strengthening partner coordination to ensure role clarity,
- piloting pragmatic technologies that scale and
- embedding continuous improvement so the service adapts to new demands.
Working side by side with the Zanzibar Ministry of Health and its partners to shape a five-year plan is one tangible step in a longer journey. It is a clear expression of our commitment to lasting telehealth that improves lives.
Zanzibar Call Center Agents and staff with the Zanzibar MoH and VillageReach Team. Photo credit: Ronald Ngeno
How you can support this journey:
If you care about expanding access to quality health information and telehealth:
- invest in locally owned operational plans (not only pilots),
- fund the early years of transition so governments can take over costs,
- support data systems and analytic capacity and
- join multisector partnerships such as the Global Telehealth Community of Practice that link health, communications and technology.
A shared commitment to lasting telehealth
Telehealth is not a luxury; it is a powerful enabler. When built around a clear vision, embedded in local systems and backed by sustainable financing, a call center becomes an integral and reliable part of primary health care. That’s the course VillageReach and partners are setting with Ministries across the region and it’s the standard we bring to Zanzibar as it charts its next five years.