2021 Annual Report

Building the future: finding hope in challenging times

Intro

Dichotomous progress: Rewards and challenges in a relentless year

2021 offered a moment of exceptional contrast – a duality of challenge and achievement as the world braved another complex year in the face of devastating COVID-19 surges, the unknown of new variants, and continued loss and isolation that will echo for years to come. That duality – the bright spots and the moments of struggle – seeped into every corner of Medic’s work, into the lives of our 90+ teammates and their families, and throughout every health system we’re proud to partner with in 15 countries. 

We were fully remote, yet deeply connected. The pandemic called for urgency, and we answered with thoughtful precision, building tools that are human-centered and informed by research. We prepared for national scale and focused on community-level care, listening and learning from health workers in order to design tools that are customized for their needs, in their neighborhoods, to make quality care delivery accessible to everyone. 

2021 presented a coupled reality, and we’re proud of our team and partners who led with tenacity, vision, and humanity to meet adversity with opportunity. As we look back, we celebrate both the challenges and achievements that propelled us towards new areas of collaboration, stewardship, and impact.

Present urgency, 
future preparedness

We translated the challenge and urgency of pandemic response into the foundations for lasting health system strengthening. As community health workers (CHWs) continue to play a pivotal role in primary care and pandemic response – and who must be paid fairly for doing so – we honed and expanded the capabilities of the Community Health Toolkit (CHT) to ensure continuity of care when and where it’s needed most.

Local ownership,
national scale

The pandemic also magnified the importance of community-level health intervention and national leadership and autonomy. As of 2021, six national Ministries of Health (MoH) – Mali, Kenya, Uganda, Nepal, Niger, and Zanzibar – selected the CHT as a tool of choice for their national community health systems. Collectively supporting more than 350,000 CHWs, these six countries are now connected by the shared goal of equipping this vital workforce with CHT-based digital tools to achieve universal health coverage in the years to come.

CMMB-XH1F8079

Flourishing vision,
steadfast values

We matured, significantly enhancing the CHT Core Framework’s well-established codebase as we scaled 59 active CHT projects – or app instances – alongside 75 community-based, international NGO, and MoH partners. Together, the CHT supported 22.7 million caring activities and more than 41,400 CHWs in 16 countries across Africa and Asia. As technical stewards of the CHT, we emphasized a deep focus on product and program quality, adding the most users to the CHT in any year since its inception. 

Achievements, positives, successes, and connections outshined the challenges. The CHT became an established digital health global good, joining the ranks of world-renowned organizations using technology to strengthen and ease the burden on health systems. We held strong to our values, expanding our focus on universal health coverage, informed consent, human-centered design, and beyond. 

In Medic’s 2021 annual report, we invite you to join us as we look back on a dichotomous year and the challenges and achievements we experienced – as a community – while the world mobilized to end the pandemic, prevent the next, and achieve health equity for all.

What we value

Humanity

Human-Centered
everything

Creativity

Bring the right things
into existence

Solidarity

Building equitable community
health system together

Openness

From code to communication, collaboration is key

Initiative

Self-motivated to
take action

Impact

Global reach of the Community Health Toolkit

8,889

Total new users

The most users ever added in a single year

Caring activities per year

2018
8.5 Million
2019
11.6 Million
2020
19.2 Million
2021
22.7 Million

69.3M

Caring activities
(all-time)

41,403

Active users
(2021)

302,000

Total new households registered

6M

Households registered (all-time)

Burundi

Village Health Works (VHW) and Medic and have collaborated since early 2017 to develop mobile-based care coordination to strengthen community health service delivery and coordination in Kigutu, Burundi.

DRC

In Goma, DRC, we partner with Médécins Sans Frontiéres (MSF) to support the Ministry of Health in deploying an open-source system to assist health workers in monitoring at-risk patients/cohorts during the ongoing COVID-19 pandemic. The tools enable

Ghana

In Ghana, we partner with Rural Health Collaborative to deploy automation of antenatal care (ANC) reminders to increase uptake of ANC at the community level and increase facility-based delivery rates.

 

India

Through a unique partnership within the Skoll Foundation’s global network of awardees, Barefoot College and Medic came together in 2017 to leverage low-cost mobile technology to reduce maternal and newborn mortality and morbidity in India.

Kenya

Launching our work in 2011, Medic has spent more than a decade working alongside implementing partners such as CMMB Kenya, Safari Doctors, Living Goods, Health Right International, Christian Aid, Kilifi Kids as well as county governments of Siaya, Kisumu and Vihiga to design and deploy custom CHT applications.

Malawi

Medic has been working with PIH since 2018 to implement the CHT across a network of  530  CHWs  in the Neno District of Malawi. The CHT supports CHWs and their supervisors in care coordination for ANC, PNC, IMM, IMCI, FP, NCD, TB, HIV, Malnutrition, Hospitalization, and eTrace.

Mali

In Mali, Medic has worked in deep collaboration with Muso since 2014 to support 450 of Muso’s health workers and supervisors with integrated care workflows and health worker performance management.

Nepal

For nearly a decade, Medic has worked in partnership with Nepal’s Ministry of Health and Population (MoHP) and provincial and local governments to harness technology for community health systems strengthening. This work builds on efforts that began as a pilot in Baglung district in 2012.

Niger

In Niger, Medic has partnered with Épicentre and Médecins Sans Frontières to develop and deploy an app supporting the Ministry of Health’s COVID-19 alert management and investigation efforts.

Philippines

In the Philippines, CHT Technical Partner International Care Ministries has developed a Community Health Champion App in collaboration for  ANC, Postnatal Care and family planning now used by nearly 1,300 community health champions.

South Africa

In South Africa, Medic is partnering with University of Washington’s International Training and Education Center for Health (I-TECH) and the Aurum Institute Center for HIV-AIDS Prevention Studies (CHAPS) on a randomized controlled trial (RCT) adapting a two-way texting (2WT) solution to make post-surgical follow up for voluntary medical male circumcision (VMMC) more efficient, streamline in-person care, reduce provider workload and decrease patient burden while maintaining the quality of care.

Togo

Medic has worked with Integrate Health (IH) in Togo since 2017 to support digitally-enabled CHWs, midwives, clinical mentors, supervisors, and nurses. Health workers actively use CHT-based apps to support antenatal care (ANC), family planning, integrated community case management (ICCM), malnutrition, and postnatal care (PNC). 

Uganda

Medic has worked in Uganda since 2016 to design and deploy digital health apps powered by the Community Health Toolkit in partnership with Living Goods, BRAC, Strong Minds, Intrahealth International, and Malaria Consortium.

Tanzania - Zanzibar

In Zanzibar, Medic supports D-Tree International, who partner with the Zanzibar Ministry of Health to implement the CHT-based Jamii ni Afya app as part of their digital health program to Community Health Volunteers (CHVs) and Supervisors to provide health services within their communities.

Zimbabwe

Medic, Zim-Ttech, and the ZAZIC consortium have partnered for 3 years beginning with an RCT studying post-operative two-way texting for voluntary medical male circumcision client follow-up that involved over 700 clients.

0

Countries with active CHT implementations

0 %

WHO Digital Health Interventions supported by the CHT

0

Active CHT-based
apps

0

Unique workflows supported
by CHT-based apps

The CHT has been selected as the national platform for digital community health in 6 countries, with roadmaps to scale to their collective 360,000 Community Health Workers.

Tools

Stewarding community, leading innovation

As steward of and core contributor to the CHT, Medic is committed to ensuring the platform’s capabilities and technical framework are simultaneously maintained and advanced, but also to supporting the CHT’s usability and adoption by the community at-large. It is our belief that stewarding and investing in the CHT as a digital public good is the best pathway to scale digital community health around the world – and may be the only path to local technical ownership and financial sustainability in Low- and Middle- Income Countries (LMICs).

Insights garnered through global implementation and deep collaboration lead Medic to pursue a product roadmap that accelerates growth among our network of implementing and technical partners so that others can build CHT apps with greater ease, autonomy, and speed for last mile communities.

Championing advancement of the Community Health Toolkit

Medic and a group of leading organizations serving last-mile communities launched the CHT as a digital global good and open-source project to support the development of digital health interventions, achieve universal health coverage and advance global health equity. We iterated on core framework versions 2.x and released versions 3.0 and 3.1.

2018

The CHT Forum was launched to serve as an open space for conversations, collaborative resource development, and free support from the CHT Community of Practice. We released core framework versions 3.2, 3.3, 3.4, 3.5, 3.6, and 3.7.

2019

The CHT Documentation website launched as a comprehensive resource to learn how to design, build, implement, and maintain CHT apps. New resources continue to be added to make app building easier, quicker, and more efficient. We released versions 3.8, 3.9, and 3.10.

2020

The CHT Community Round-up Call series launched to inform the community about recent product releases and future planned initiatives. We released versions 3.11, 3.12, and 3.13 – each of which included new features requested by both our developer community and health workers that use the tools each day.

2021

Technology stewards are people with enough experience of the workings of a community to understand its technology needs, and enough experience with technology to take leadership in addressing those needs.

John David Smith, Nancy White and Étienne Wenger

Authors of Digital Habitats: Stewarding technology for communities

In 2021, Medic enhanced the CHT’s Core framework, inspired our community to think creatively by developing innovative product concepts and prototypes, and created a suite of new resources for the community. Explore some of the key initiatives and enhancements below:

Community Health Information Systems Technical Working Group – Leveraging OpenHIE

Medic participated in a collaborative technical working group with Dimagi, Ona, the Community Health Impact Coalition (CHIC) to review the current state of community health information systems (CHIS) interoperability. By leveraging Instant OpenHIE’s off the shelf readiness, coupled with the use of HAPI FHIR as an industry standard back end, the consortium created a prototypical Lost to Follow-Up use case, published on the OpenHIE wiki. The technical outputs of this working group can be found on GitHub.

Accompaniment

Continued partnership, new opportunities

From the pandemic’s origins, our COVID-19 response efforts were informed by the experiences and learnings from prior fast-evolving crises with significant public health implications, including earthquakes in Nepal and Haiti.

In 2021, we bolstered our efforts, focusing on the roles of companion and champion as we accompanied MoH partners in nationally-coordinated response leadership.

Medic’s long history and proven track record in pandemic preparedness and response have led to key national selections of the CHT in six countries. We designed for ease-of-use while preparing for scale, and national recognition of the CHT is proof that this dichotomy is working.

Below, Medic teammates – service designers, project managers, program heads, and more – tell the story of accompaniment in crisis. From challenge to achievement, product launch to CHW training, explore how Medic and our partners responded to the pandemic with long-term vision, investing in direct, community-led care.

Spotlights: Highlighting both product + partnership strides + project-specific metrics in tandem. Challenge - collab - design - iteration - solution - impact/ecosystem

Mali

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Design Features: Lorem ipsum dolor
Partner feature: MUSO
Health system impact highlight: Lorem ipsum dolor sit amet, consectetuer adipiscing elit

Fatou Title

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Design Features: Lorem ipsum dolor
Partner feature: MUSO
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Loukman Title

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Design Features: Lorem ipsum dolor
Partner feature: MUSO
Health system impact highlight: Lorem ipsum dolor sit amet, consectetuer adipiscing elit

Marina Title

    Uganda

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    Design Features: Lorem ipsum dolor
    Partner feature: Living Goods (RCT), BRAC, Malaria Consortium, iCHOS, UNICEF w/ quote from e.g. LG
    Health system impact highlight: Lorem ipsum dolor sit amet, consectetuer adipiscing elit

    Brian Designation

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    Design Features: Lorem ipsum dolor
    Partner feature: Living Goods (RCT), BRAC, Malaria Consortium, iCHOS, UNICEF w/ quote from e.g. LG
    Health system impact highlight: Lorem ipsum dolor sit amet, consectetuer adipiscing elit

    Joviah Designation

    "Lorem ipsum dolor sit amet, consectetuer adipiscing elit, sed diam nonummy nibh euismod tincidunt ut laoreet dolore magna aliquam erat volutpat. Ut wisi enim ad minim veniam, quis nostrud exerci tation"

    Design Features: Lorem ipsum dolor
    Partner feature: Living Goods (RCT), BRAC, Malaria Consortium, iCHOS, UNICEF w/ quote from e.g. LG
    Health system impact highlight: Lorem ipsum dolor sit amet, consectetuer adipiscing elit

    Raymond Designation

    "Lorem ipsum dolor sit amet, consectetuer adipiscing elit, sed diam nonummy nibh euismod tincidunt ut laoreet dolore magna aliquam erat volutpat. Ut wisi enim ad minim veniam, quis nostrud exerci tation"

    Design Features: Lorem ipsum dolor
    Partner feature: Living Goods (RCT), BRAC, Malaria Consortium, iCHOS, UNICEF w/ quote from e.g. LG
    Health system impact highlight: Lorem ipsum dolor sit amet, consectetuer adipiscing elit

    Paul Designation

      Malawi

      "Lorem ipsum dolor sit amet, consectetuer adipiscing elit, sed diam nonummy nibh euismod tincidunt ut laoreet dolore magna aliquam erat volutpat. Ut wisi enim ad minim veniam, quis nostrud exerci tation"

      Design Features: - I-TECH 2WT, PIH
      UHC mode, household level scaling, product research
      Geospatial

      Health system impact highlight: Lorem ipsum dolor sit amet, consectetuer adipiscing elit

      Phillip Designation

      "Lorem ipsum dolor sit amet, consectetuer adipiscing elit, sed diam nonummy nibh euismod tincidunt ut laoreet dolore magna aliquam erat volutpat. Ut wisi enim ad minim veniam, quis nostrud exerci tation"

      Design Features: - I-TECH 2WT, PIH
      UHC mode, household level scaling, product research
      Geospatial

      Health system impact highlight: Lorem ipsum dolor sit amet, consectetuer adipiscing elit

      Chrisgone Designation

      "Lorem ipsum dolor sit amet, consectetuer adipiscing elit, sed diam nonummy nibh euismod tincidunt ut laoreet dolore magna aliquam erat volutpat. Ut wisi enim ad minim veniam, quis nostrud exerci tation"

      Design Features: - I-TECH 2WT, PIH
      UHC mode, household level scaling, product research
      Geospatial

      Health system impact highlight: Lorem ipsum dolor sit amet, consectetuer adipiscing elit

      Mourice Designation

      "Lorem ipsum dolor sit amet, consectetuer adipiscing elit, sed diam nonummy nibh euismod tincidunt ut laoreet dolore magna aliquam erat volutpat. Ut wisi enim ad minim veniam, quis nostrud exerci tation"

      Design Features: - I-TECH 2WT, PIH
      UHC mode, household level scaling, product research
      Geospatial

      Health system impact highlight: Lorem ipsum dolor sit amet, consectetuer adipiscing elit

      Elijah Designation

      "Lorem ipsum dolor sit amet, consectetuer adipiscing elit, sed diam nonummy nibh euismod tincidunt ut laoreet dolore magna aliquam erat volutpat. Ut wisi enim ad minim veniam, quis nostrud exerci tation"

      Design Features: - I-TECH 2WT, PIH
      UHC mode, household level scaling, product research
      Geospatial

      Health system impact highlight: Lorem ipsum dolor sit amet, consectetuer adipiscing elit

      Sue Designation

      "Lorem ipsum dolor sit amet, consectetuer adipiscing elit, sed diam nonummy nibh euismod tincidunt ut laoreet dolore magna aliquam erat volutpat. Ut wisi enim ad minim veniam, quis nostrud exerci tation"

      Design Features: - I-TECH 2WT, PIH
      UHC mode, household level scaling, product research
      Geospatial

      Health system impact highlight: Lorem ipsum dolor sit amet, consectetuer adipiscing elit

      Korir Designation

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      Design Features: - I-TECH 2WT, PIH
      UHC mode, household level scaling, product research
      Geospatial

      Health system impact highlight: Lorem ipsum dolor sit amet, consectetuer adipiscing elit

      Kitsao Designation

        Team

        Fully remote, deeply connected

        Ecosystem

        Committed collaboration, dedicated support

        Edit
        • Community Health Impact Coalition
        • Digital Public Goods Alliance
        • Fast Forward
        • iCOHS
        • Innovations in Healthcare
        • Unlock Aid
        Edit
        • A Better World Fund
        • Anonymous
        • Amazon Web Services (AWS)
        • Bohemian Foundation
        • Mr. Bruce F. Campbell
        • Children’s Investment Fund Foundation
        • The Chicago Community Foundation
        • Code and Theory
        • Crown Family Philanthropies
        • Digital Square
        • Dovetail Impact Foundation
        • The ELMA Foundation
        • Fast Forward
        • Foundation for Innovative New Diagnostics (FIND)
        • The Horace H. Goldsmith Foundation
        • The Horace H. Goldsmith Foundation
        • Google.org
        • The Herrnstein Family Foundation
        • Johnson & Johnson
        • Merrill Schneider Foundation
        • Mulago Foundation
        • Panorama Global
        • The Pfizer Foundation
        • The Ray & Tye Noorda Foundation
        • Rippleworks, Inc.
        • Rockefeller Foundation
        • Sall Family Foundation
        • Silicon Valley Community Foundation
        • Skoll Foundation
        • UCLA BioBusiness
        Edit
        • Barefoot College
        • Beehyv
        • BRAC
        • CMMB
        • DataKind
        • Dimagi
        • D-Tree International
        • International Care Ministries
        • Ilara Health
        • Integrate Health
        • International Training and Education Center for Health (I-TECH)
        • JKUAT
        • Last Mile Health
        • Living Goods
        • Malaria Consortium
        • Médecins Sans Frontières
        • Muso
        • Ona
        • Palladium
        • Partners in Health
        • Rural Health Collaborative
        • Safari Doctors
        • SunyaEk
        • Totohealth
        • Triggerise
        • UNICEF
        • University of Washington
        • VisorTech
        • Village Health Works
        • VMMC Zimbabwe
        • Ministry of Health, Kenya
        • Ministry of Health, Mali
        • Ministry of Health, Niger
        • Ministry of Health, Uganda
        • Ministry of Health, Zanzibar
        • Ministry of Health and Population, Nepal

        Meet the board

        In 2022, we’re focused on thriving. We’ll use our human-centered approach to shape the wider digital health ecosystem while continuously working to position the CHT as the leading digital public good in community health. As we begin to imagine a future alongside the perpetual presence of COVID-19, our collective work to achieve universal health coverage, health worker rights, and health equity for all continues.

        Dr. Krishna Jafa

        Chief Executive Officer

        New leadership, enduring mission

        The power of our community, teammates, and shared values outshined the challenges of 2021, and we kicked off a new year with energy and transformed leadership.

        In March, we welcomed Dr. Krishna Jafa as Medic’s new CEO. A physician, epidemiologist, and public health executive, Krishna joins us with 25 years of deep expertise in health system design and strengthening, digital health innovation, and global partnerships. As a visible and visionary leader in the movement for global health equity, Krishna will build community, create space and momentum for change, and continue the legacy of values-driven leadership into our second decade of work.

        Finances

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