First ever digitization of Primary Health Care (PHC) services in the country through Model Urban PHC clinics (Aalo clinics) project

The digitization of Primary Health Care (PHC) services in Bangladesh through the Aalo Clinics model marks a significant milestone in the country’s journey toward modern, efficient, and patient-centered healthcare delivery. Introduced as the first fully digitized PHC initiative at scale, the Aalo Clinics project has drawn widespread attention from visitors and stakeholders for its innovative service delivery approach, particularly because digitization at the PHC level has historically lagged behind the limited automated systems seen in a few private tertiary hospitals.

The initiative began with CMED Health’s development of the Integrated Digital Healthcare Platform (IDHP), an outpatient-focused software system equipped with a user-friendly interface and monitoring dashboard. After thorough orientation sessions with key stakeholders at UNICEF, this platform was used until September 2023. The turning point came when the Directorate General of Health Services (DGHS), through its Management Information System (MIS) unit, directed Aalo Clinics to transition to the government-endorsed OpenMRS+ platform — an open-source global digital health system originally designed for hospital settings. Despite the challenges of adapting such a system for PHC-level services, CMED accepted the task and initiated the transformation. A series of coordination meetings among UNICEF, the Aalo Clinics management, the MIS unit, and the PHD-led consortium guided the process, outlining steps that included procuring three levels of servers — clinic-level, CMED-level, and MIS-level — followed by a trial installation of OpenMRS+ at the Karail and Mirpur Aalo Clinics in November 2023. This transition required major customization to reflect the functionalities of the previous IDHP system, along with extensive troubleshooting, especially during trial operations at the Karail clinic. Supported closely by UNICEF’s e-HIS team, CMED resolved the technical glitches, leading to full approval and subsequent rollout of OpenMRS+ to all six Aalo Clinics over the following two months. Staff were trained through multiple orientation sessions, and by December 2023, all clinics had fully operational digital systems, establishing a historic achievement in PHC digitization in Bangladesh.

The digital workflow within the clinics is structured around specific staff roles and devices: receptionists use tablets to record basic client information and issue serial tokens; clinical assistants input detailed registration data using tablets and sync patient queues to a display monitor with audio prompts; paramedics use Bluetooth-enabled digital instruments to perform screenings, with results automatically captured in the system; and doctors utilize laptops connected to printers to document medical history, prescribe treatment, and generate investigation referrals.

Building on this foundational digital system, UNICEF introduced a second-phase set of enhancements designed to accelerate service efficiency and strengthen the digital ecosystem. Among these, the Digital Queue Management Module — launched in 2024 across all clinics — significantly improved service flow by creating a structured, three-tier queue system managed by receptionists, clinical assistants, and paramedics. In 2025, an automated billing module was integrated, standardizing service rates, enabling instant digital invoices, and ensuring transparent and accurate financial records. Additional modules currently under development include a public dashboard for monitoring clinic performance, an official Aalo Clinic website, a comprehensive module for Normal Vaginal Delivery (including antenatal, postnatal, and newborn care documentation), a radiology/sonology module, and solutions to integrate community-level OpenSRP data with clinic-level OpenMRS+, as well as linking National ID (NID) information with the national Shared Health Record (SHR) system. Together, these advancements aim to create an end-to-end digital ecosystem that connects community, clinic, and national health information platforms.

The digitization journey of Aalo Clinics has therefore become more than just a technology adoption story; it represents a collaborative, adaptive, and forward-looking reform effort that enhances efficiency, improves patient experience, strengthens accountability, and sets a new benchmark for PHC service delivery in Bangladesh. The collective commitment of government agencies, development partners, and technical teams has transformed the Aalo Clinics into a model of innovation — offering both inspiration and practical evidence for scaling digital PHC solutions nationwide.