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Smartcare is a portable integrated electronic health record (EHR) system currently deployed in Zambia and Ethiopia. It is one of the largest EHRs in use in Africa today. It was designed in Africa by Zambians with support from International partners to be robust, even in environments with little or no telecom and unreliable power. It was designed to inter-operate with paper systems during a protracted transition. It is a sustainable EHR Surveillance and Confidentiality sensitive micro-data research system that can be used to support monitoring and evaluation, and supports the Health Management Information System.