# Strengthening the continuity of HIV care in Tanzania with economic support

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA BERKELEY · 2023 · $155,436

## Abstract

SUMMARY
Financial incentives are an evidence-based intervention to improve engagement in beneficial health behaviors
and services for many priority health issues. Our team has extensively studied the benefits of financial
incentives for people living with HIV in Tanzania, including through the ongoing Rudi Kundini, Pamoja Kundini
(R01MH125746) study. Research from our team and others reveals that financial incentives can increase HIV
testing, enhance linkage to care, and bolster treatment adherence. Yet despite this evidence, few financial
incentive programs have been scaled for HIV and other urgent health threats sub-Saharan Africa. One reason
for this ‘know-do’ gap is that simplified, automated, and secure software for implementing incentive programs
at scale have yet to be developed, evaluated, and shared.
To meet this need, through collaboration with the Tanzanian Ministry of Health and the Tanzanian technology
firm Rasello, we developed an innovative, acceptable, reliable, and scalable software (the “Rasello mHealth
system”) to automate incentive distribution. The software securely sends incentives through mobile money,
monitors HIV care with biometric identification, sends SMS visit and laboratory test reminders, and integrates
with partner databases via application programming interfaces (API). Extensive stakeholder testing has
permitted iterative improvement of the software to seamlessly incorporate into clinic workflows. The software is
being used in the parent R01 (R01MH125746), but it was not designed to align with software engineering best
practices, FAIR4RS principles, or principles of open science, which will limit its impact. Given that this was
unforeseen when R01MH125746 was awarded, the Rasello mHealth system is the focus of this application.
We will first enhance the system’s source code, improve documentation and version management, and adopt
build/test tools for community open-source development (Aim 1). We will then develop standard build and
packaging tools to manage the Rasello mHealth system’s dependencies, produce containerized runtimes, and
containerize the software for a tool registry (Aim 2). We will also refactor the mHealth system software to
incorporate standard interfaces and data formats and replace custom code with standard, hardened libraries
where indicated (Aim 3). Lastly, we will improve performance of the Rasello mHealth system through improved
logging, monitoring, code profiling and optimization; leveraging parallelization and GPUs (Aim 4).
The Rasello mHealth system is a valuable resource for the scientific community, combining many desired
features in a user-friendly platform to securely scale financial incentives for a variety of priority health issues.
As we enter Year 3 of R01MH125746, now is the ideal time to enhance the system according to software
engineering best practices and principles of open science, a need which was unanticipated when the parent
study was funded. These activities will improve...

## Key facts

- **NIH application ID:** 10838775
- **Project number:** 3R01MH125746-03S1
- **Recipient organization:** UNIVERSITY OF CALIFORNIA BERKELEY
- **Principal Investigator:** Sandra I McCoy
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $155,436
- **Award type:** 3
- **Project period:** 2021-08-15 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10838775

## Citation

> US National Institutes of Health, RePORTER application 10838775, Strengthening the continuity of HIV care in Tanzania with economic support (3R01MH125746-03S1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10838775. Licensed CC0.

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