The Surveda tool sends SMS and phone calls to respondents via mobile network operators (MNOs). To use the Surveda tool at scale, it is necessary to set up agreements with MNOs. These agreements are primarily business arrangements between parties, in which costs and other terms are agreed upon.

In parallel to forming these agreements, it is also necessary to have discussions about how the Surveda tool connects to the MNO infrastructure.  Even though the Surveda platform is compatible with most of the technologies used by MNOs, it’s important to have these discussions on the details as early as possible to avoid delays. Sometimes it can take some time to sort through technical details.

For the NCD Mobile Phone Survey, InSTEDD provides free technical assistance to MoHs to establish agreements with MNOs. InSTEDD supports MoHs through all phases of setting up MNO agreements, from both the business and technical elements.

Process for Setting up MNO Agreements

The process of setting up an agreement with an MNO is a predominantly a business arrangement between various parties, rather than a strict technical task. For the NCD Mobile Phone Survey, the business element is between the MoH and the MNOs, and InSTEDD will support this process on behalf of the MoH. In this agreement, the rates for the SMS messages and voice calls are negotiated as well as other terms.

Figure 1. MNO Agreement Process

Figure 1 illustrates the general process that begins with understanding the local context and ends with a formalized relationship between the MoH and an MNO. Throughout the process, the MoH is trained on the business and technical aspects involved.

Contractual Framework for MNO Agreements

Within the context of the Bloomberg Data for Health Initiative, a contractual framework has been developed to provide the MoH technical assistance in engaging with MNOs. In general, the following agreements will be made among the MoH, the MNO, and InSTEDD as the lead technical assistance provider:

  1. Introduction Letter: The first document to be presented is the formal introduction of InSTEDD, the technology implementer to the MoH. This is important to ensure the necessary institutional support for the technology partner throughout this process.

  2. Non-Disclosure Agreement: The Non-Disclosure Agreement is established between the MNO and the technology partner - this allows important technical details to be shared between the two parties regarding equipment, network configuration, etc.

  3. Technical Services Agreement: The agreement is established between the MNO and the technology partner. This agreement defines the technical terms and conditions of the MNO connection.

  4. Content Services Agreement: This is the central agreement that will provide a sustainable relationship between the MoH and the MNO. In this agreement, the terms of service, roles and responsibilities and escalation procedures are all defined.

Note: This is a generalized framework which may be adapted to the country context.

In-Network vs. Out-of-Network 

It can be advantageous to work with multiple MNOs for a given country, although this is not always required. The main advantage of working with multiple MNOs is lower MNO costs as well as increase overall coverage. Working with multiple MNOs can lower costs for the MoH by using more in-network calls – i.e., those calls where both the sender of the call and the receiver of the call are subscribers of the same MNO. For in-network calling, MNOs generally incur very little expense and can offer cheaper rates than when the sender and receiver are not on the same network. Phone calls or SMS messages sent from one MNO to another are referred to as out-of-network calls, and because additional fees apply, these rates will be higher.

Alternative Approach: Mobile Network Aggregator

In some countries, there exist businesses that seek to make it easier to work with MNOs. These companies aggregate the connections to MNOs and are referred as aggregators.  Aggregators take the time to establish the direct connections to MNOs themselves and then sell the use of these combined/aggregated connections as a business. The main advantage of using an aggregator is that considerable time can be saved by not having to set up and maintain a direct connection to the MNO. The disadvantage is these aggregators charge a transaction fee and this fee is often higher than what could be negotiated with the MNO directly. Aggregators are not available in all countries and the choice of how and when to use an aggregator is part of the process of determining the rollout strategy for each country.

The Surveda survey tool can work indistinctly and simultaneously with both direct connections to MNO and aggregator-mediated connections. Once the channels are established, there is no difference between MNOs versus aggregators from the perspectives of tool users or respondents.


When conducting an SMS or IVR survey, the messages for SMS and phone calls for IVR will originate from a specific number. How a respondent perceives that number may influence their willingness or interest in responding to the SMS or answering the voice call. In many cases, special shorter numbers can be used to distinguish the phone call or SMS message from other calls people may receive. In most countries, these shorter numbers appear more official than typical numbers, which are generally longer. These special numbers are called shortcodes and can be obtained from the MNO and other regulatory bodies. For example, 911 is a short code that people call in the United States for emergency medical assistance or the police. However, some people may have negative connotations of shortcodes – e.g., spam or premium services billed at higher rates. The positive and negative connotations of shortcodes vary by country, so it is important to understand the specific country context.

It’s important to note not all MNOs will offer shortcodes in the same way.  The availability of shortcodes, their fees, and time to set up will vary. For example, shortcodes may take a significant amount of setup time for some MNOs but less time for others. Understanding what shortcode options are available from the MNO, the extent to which they have been used in the country, and whether shortcodes are viewed positively or negatively, are all components of the landscaping process.