Fondation Pierre Fabre

A mobile based system to improve Tuberculosis treatment compliance 

Main beneficiary countries:
India - Uganda

About the sponsor

ZMQ Development

ZMQ is a “Technology for Development” social enterprise, which develops and implements practical technology linked tools & solutions to empower communities by providing timely information and connecting them with life-saving services, thus achieving sustainable development. There is a huge gap in provisioning information and services to rural, under-privileged and isolated communities. And this has been for hundreds of years. With the advent of technology, especially, it is seen that these technologies can bring in transformative changes by substantially improving accessibility, affordability and effectiveness of social programs, thus enabling human development. ZMQ’s theory of change is to provide “information & services” to isolated, marginalized and rural communities in a timely and accessible way, which often makes difference between life and death.


ZMQ works on multiple social issues using technology which are healthcare, education and livelihood generation. ZMQ’s approach to solve these social problems is based on a system-changing approach rather than mere technology enablement approach. This can be explained by stating the fact that various policies and their processes relate to critical issues like health, education and livelihood were designed some 30-50 years back by the national or statement. These processes have are based on ‘Top-down Manual Model’ with a strong observation/supervision approach. This older approach makes the solution exclusive (non-inclusive), target audiences are treated as mere beneficiaries and the solution works in isolation. With the ubiquity of mobile networks and the reach of cell-phones in the hands of communities, ZMQ uses this system-changing approach by integrating communities as part of the solution, making an inclusive model, where target audience are part of the solution (stakeholders) and works in a holistic manner. This approach of ‘Fully-technology linked community model’ (also a ‘Bottom-up Technology Model’) empowers communities and give them more control of information and services, which they never earlier had.


Using this methodology, ZMQ has been a pioneer in using mobile technology and has accomplished successfully over 80 behavior change projects using mobile phones and also created over 25 system changing solutions on:


  • mHealth - HIV/AIDS, Tuberculosis, Maternal & Child Health, Immunization, Polio, Family Planning, Mental Health;
  • mEducation - Entry level literacy tools for out of school children; Changing the Madarsa education
  • Livelihood Generation – Skills development for women, Your Story Telling System
  • Diversity and Inclusiveness, Human Rights – IncLudo Program


ZMQ’s mission is to provide affordable services and solutions to rural and marginalized communities to enhance their lives, thus increasing their standard of living using mobile technology. ZMQ’s key approach is “High Impact - Low Cost” model, recognized world-wide. Our objective is to bring down the cost per beneficiary under one rupee, which we have successfully retained for years by keeping it to Rupee 0.40 to Rupee 0.55 (40 to 55 paisa) for all of our scaled up projects. The key to the success of ZMQ programs is accessibility, affordability and effectiveness. This is why ZMQ is often referred as “One Rupee” technology company, based on ‘Gandhian model’.

Sector: Organizational: Communities, public authorities, NGOs, associations, foundations, etc.

Country of origin: India

The organisation has:

Full-Time Equivalents
Service providers

Initiative overview

Healthcare themes targeted

  • Infectious diseases

Stage of development:

  • Routine project/operational

Area where initiative is utilised

  • International (in several countries)

Initiative start date

  • 04/01/2014

Initiative end date

  • 03/31/2020


Financing method

  • Public (grant/subsidies, call for proposals/call for tender, etc.)
  • NGO
  • Government agency (i.e AFD, USAID, etc.)
  • CSRs as kind donation of mobile phones

Economic model(s)

  • Subsidies
  • Advertising
  • Donations

About the initiative

TB is the oldest and one of the largest killer diseases in the world. Almost over 80% of the Tuberculosis cases in world are from 22 High Burden countries including India, China, Russia, Pakistan, South Africa, Kenya, Burma, Ethiopia and Afghanistan. The patients infected with Tuberculosis have to take medicine regularly for 6 months to get fully cured. The medicines are very strong. If you miss the dose, the disease of TB can turn into a severe form of TB called MDR (Multi Drug Resistant) TB. Treating this takes 2 years and is 10 time more expensive. Also, majority of TB patients are poor and weak, and they have to travel all the way to the center to take medicine. We are addressing the problem of TB treatment and cure to be more streamlined and effective.  It is solved by adopting a new innovation of ZMQ called Active Compliance and Treatment System (ACTS) for TB adherence and treatment.

The key objective of ZMQ is to establish Technology linked Development Model in Health, build stronger community linkages with the Public Health Systems, build digital tools for capacity building – Knowledge, Attitudes and Practice (KAP) in patients, families, communities and rural women and high-risk groups (vulnerable) access to Health Systems. ZMQ has developed solutions for different aspects of TB Management, multilevel awareness building, Community Supportive Supervision, Strengthening DOTS and Strengthening Patients adherence for both TB and MDR-TB. The whole approach of building bottom-up approach of combatting TB where communities (also patients) are in-charge of management disease is building of Active Ground for TB Control, which is by provisioning sustained flow of digital communication tools at the community around TB disease, its Risks, Prevention, Care & Support, Symptoms, issues around Stigma and discrimination, Diagnosis, Treatment and Adherence.


ZMQ has a strong digital Communication for Development division to develop digital communication and behaviour Change tools on TB for communities, families, youth and women in SHGs. This process is of deploying learning, capacity building and behaviour tools at community level are called ‘Active Ground Building for Combatting TB’. In the expanding environment  of mobile and reach of digital connectivity, it becomes important to provision sustained flow of variety digital communication tools on TB like m-Learning, Games of TB and other related issues, Audio-Visual, digital stories etc. . Under the initiative we have developed new technology linked model for combatting TB through a bottom-up approach where patients, families and communities engage actively in building awareness, case finding, treatment management and active compliance and adherence. The whole methodology developed is called ACTS – Active Compliance and Treatment System.

ZMQ have developed an innovative technology linked model for combating TB through a bottom-up approach where patients, families and communities engage actively in building awareness, case finding, treatment management and active compliance and adherence. The whole methodology developed is called ACTS – Active Compliance and Treatment System. In partnership with Revised National TB Program of India and State TB program of Delhi and Haryana States.  ZMQ has deployed the program in 3 districts in India – Mewat in Haryana (3500 Patients, Population of 1.21 million); Jehangirpuri & Magolpuri in Delhi (2200 patients, Population of 980,000). Also, ACTS being deployed in Uganda in 2015 in partnership with National TB and Leprosy Program Uganda and is covering 7 TB Centres in 2 Districts namely Wakiso and Kampala with a 1000 patients covering a population of 560,000.

Fields of application:

Health professional training - Information, education and communication for behaviour change (IEC) - Patient monitoring and medical data

Target audience

  • Healthcare professionals and structures (hospitals, healthcare centres/clinics, health networks)
  • Patient family/entourage
  • Children and Communities for Active Behaviour Change Communication

Initiative objectives

  • Decreased mortality
  • Decreased morbidity
  • Reduced suffering

Key figures

18400 Number of beneficiaries since launch

140 Number of users per Month

Materials used

  • Cellular (mobile) phone
  • Smartphone
  • Computer
  • Connected objects

Technologies used

  • Internet
  • Geolocation
  • Mobile app (Android, iOS, Windows Phone, HTML5, etc.)
  • IoT – Internet of Things

Offline use


Open Source


Open Data


Independent evaluation

evaluated independently


Revised National TB Control Program (RNTCP), India

Organizational: Communities, public authorities, NGOs, associations, foundations, etc.

National TB and Leprosy Program (NTLP), Uganda

Organizational: Communities, public authorities, NGOs, associations, foundations, etc.


Industrial: Startups, enterprises, etc.


Industrial: Startups, enterprises, etc.