Building for USSD: Digital Health Without Smartphones

"Even the smallest drum can echo through the whole village." — African proverb

When people think of digital health, they often imagine shiny apps, slick dashboards, and AI-powered insights on a smartphone. But let’s be real: not everyone in Africa owns a smartphone—or even has access to stable internet.

Yet, people still fall sick. Mothers still need antenatal care. CHWs still need to file reports. Lives still hang in the balance.

So, how do we reach millions of underserved people with healthcare tools they can actually use?

Simple: Build for USSD.

🧾 What is USSD?

USSD (Unstructured Supplementary Service Data) is that magical code you type into your phone—like *123#—to buy airtime or check your M-Pesa balance.

It works on:

• Feature phones (kabambes)

• No internet

• Real-time, session-based connections

It’s fast. Cheap. Ubiquitous. And perfect for reaching people who live beyond the smartphone economy.

📍 Why USSD Still Matters in 2025

“The goat that has no tail must learn to rely on the wind.” — East African saying

In digital health terms? When your users have no smartphone, you build for the tools they do have.

Here’s the reality:

• Only ~45% of Africans own a smartphone as of 2024 (GSMA, 2024).

• Rural areas and women are less likely to have smartphones or internet.

• Most households have at least one feature phone.

• Internet costs are still high in many regions (up to 10–20% of income).

📊 Source:
GSMA. (2024). The Mobile Economy Sub-Saharan Africa 2024. https://www.gsma.com/mobileeconomy/sub-saharan-africa

👩🏾‍⚕️ Case Studies: USSD in African Health Innovation

1. m-TIBA (Kenya)

A health financing platform that allows users to save, pay, and receive funds for healthcare via USSD.

USSD Code: *253#
🔗 https://mtiba.com

“It’s saved me from choosing between buying food and buying medicine,” says Achieng, a mother of two in Kisumu.

2. MomConnect (South Africa)

Launched by the Ministry of Health, MomConnect provides maternal health tips via SMS and USSD to over 2 million pregnant women.

Women simply dial a code and start receiving weekly pregnancy messages tailored to their due date.

📄 DOI: 10.1371/journal.pmed.1002370

3. M-Jali (Kenya)

Built for CHWs to register households and report health cases in low-resource areas—all via USSD.

“I don’t need to walk to the clinic anymore just to submit my reports,” says Jane, a CHW in Bungoma.

🧠 Key Design Tips for Building USSD Health Solutions

1. Keep Menus Simple (Max 5 options per screen)

Too many choices = user drop-off. Guide them step by step.

2. Minimize Session Time (USSD times out fast!)

Design flows that take <2 minutes to complete.

3. Use Numeric Inputs Only

No need for letters or typing. Let users select:
1. Book an appointment
2. Check test results
3. Talk to a nurse

4. Offer Local Languages

Default to the region’s common languages (e.g. Kiswahili, Luganda, Hausa).

Tip: Use clear, polite prompts. No jargon!

🧠 Bonus: How to Launch a USSD Health Service

Step 1: Choose a Shortcode

Work with a mobile network operator (MNO) to register a unique USSD code (e.g. *123#).

Step 2: Build the Logic (Flow Tree)

Sketch all the options, menus, and conditional branches like a chatbot.

Step 3: Partner with an Aggregator

Companies like Africa’s Talking, Hover, and RapidPro help integrate and manage USSD flows across networks.

🔗 https://africastalking.com
🔗 https://community.rapidpro.io

Step 4: Pilot, Iterate, Translate

Test with real users. Listen. Iterate. Then scale.

🚀 What USSD Can—and Can’t—Do

👀 What Startups Say

“USSD let us reach patients in Turkana without needing internet, smartphones, or even clinics.”
— Founder, RuralHealth KE

“Our web app flopped. The USSD version took off. Because it met people where they were.”
— Digital Health Lead, Abuja

💬 Final Thought

“A man who uses a machete on grass doesn't need a bulldozer.” — African wisdom

The flashiest tech isn’t always the most effective. In Africa, inclusion is innovation.

So if your goal is to build truly impactful health solutions, don’t just think smart—think small.

The future of African health might not be app-powered. It might just be USSD-powered.

Would you like a sample USSD flow template, wireframe, or low-code tool recommendation to build your own?

Let’s make health tech that works—for everyone, everywhere. 🧡📞