Q1 2021 Impact Report

Introduction

At Medic, Q1 2021 offered an opportunity to learn from the challenges of 2020 and take heed of the hope and opportunities ahead in 2021. We did a lot, and we did it together.

We accompanied – our technical partners building and transforming health systems to respond to COVID-19, our Ministry partners committed to maintaining essential care despite disruptions, and the Community Health Toolkit (CHT) contributors who responded quickly to the needs of health workers and supervisors, built new workflows and guides, and remained human-centered in all we do.

We launched – a new brand, a new tagline, a new website, a new release of the CHT Core Framework, and a new caring metric.

We renewed – welcoming new teammates and CHT contributors, collaborating on new research with established partners, and aligning collective goals to our organizational values.

We built tools for people who care. In our Q1 2021 impact report, explore all the ways we’re living out our values alongside our partners, health workers, and the health systems we’re proud to support.

our impact

Introducing "caring activities": Medic's new principal metric

The first quarter of 2021 gave us space to reflect on the role of the CHT in supporting care with and in communities. Now more than ever, the CHT can support a wide range of digital health interventions, illustrating the power and potential of open-source tools to further the reach of care for all. We’re on the path to proving that a global public good for community health can scale and positively impact millions of people’s lives.

As the CHT grows, so does the need to measure and understand it’s true impact. Our current cornerstone metric, “number of health workers supported”, which you’ll see below, is an important measure of our community’s size. But it doesn’t convey the remarkable growth we’ve observed in the total volume of caring activity as community health systems layer on new service areas and make new investments in supervision and support. It’s time for our community to have a more inclusive metric.

To achieve this, we’ve introduced “caring activities” – a better and more comprehensive measure of all of the ways the CHT supports care today, and how we might support care in our next decade of work. Informed by feminist scholarship, care ethics, and central to Medic’s mission of supporting care at scale, learn more about our new key metric and see it in action below!

impact metrics

Medic and the CHT community celebrate supporting 37,161 total users across multiple health systems in 16 different countries.

In Q1 we added over 3,000 new users to our community in South Africa, Kenya, Nepal, and more. Now more than ever, we are proud to support the delivery of care to communities around the world.

Our work also reached a new and exciting milestone surpassing 50 million caring activities supported by the CHT since our inception — 52.1 million at the end of Q1 2021 — with 5.7 million caring activities supported in Q1 alone.

37,161

Total CHT users

3,080

New CHT users

52M+

All-time caring activities supported

5.7M

Caring activities this quarter

The role of the CHT and our partners in supporting care is also evident in aggregate metrics on household coverage of care with over 33% of households receiving at least one visit from a CHW per month during the quarter, the highest proportion of households ever reported since we began tracking this metric in 2019.

While the impact of the COVID-19 pandemic remains evident in a number of our priority use case impact metrics across Antenatal Care (ANC), Postnatal Care (PNC), Integrated Community Case Management (iCCM) and Acute Malnutrition, we have observed critical increases in maternal and child health metrics.

For example, nearly 80,000 pregnancies were registered via the CHT in Q1 2021, which represents an increase of over 5,000 from the previous quarter and nearly double the number reported in Q3 2020. The rate of women delivering in facilities also increased with over 93% of deliveries confirmed via the CHT occurring within a facility.

79,947

Pregnancies registered

93

% of deliveries in a facility

1.2M+

Under-5 assessments

81.1

% of under-5 assessments conducted within 72 hours.

In the face of reported disruptions to essential health services during the pandemic, the increased coverage of care for women and children signals the power of community health systems. Of the 1.2 million child assessments conducted with the support of the CHT in Q1, over 81% occurred within 72 hours of symptoms being reported – illustrating the importance of speed of care to improve child health at the last mile.

Our impact metrics and routine monitoring of the coverage, speed, and quality of care provided to communities supported by the CHT illustrate the vital importance of CHWs, particularly in maintaining continuity of care during the pandemic.

Our observations align with, and contributed to, new research from the Community Health Impact Coalition which demonstrates that CHWs who were equipped and prepared for the pandemic were able to maintain speed and coverage of community-delivered care during COVID-19. To learn more about the role of CHWs in maintaining coverage and continuity of essential services, please read the study here.

product highlights

New release of the CHT Core Framework: 3.11.0

The latest release of the CHT marks a significant Q1 undertaking and includes major back-end improvements, exciting new features, and updates that ensure the Core Framework is more reliable than ever. With this release, you can now use RapidPro directly as a messaging gateway for CHT apps. Also, deploying CHT apps can be automated more easily using our new GitHub Action as a building block. The release includes a lot of other improvements beneath the hood to improve performance and make it easier to build on the CHT.

product successes

In addition to core development, we also supported capacity building, external grants, and partnership expansion throughout Q1. Product-related highlights include:

A prototype integration with Cloudworks and the Rapid Diagnostic Toolkit, through a collaboration with Dimagi.
In collaboration with Dimagi and ONA, we set up an interoperability proof of concept for Community Health Information Systems using FHIR and OpenHIE.
We supported the Palladium Group with prototypes and new documentation in their efforts to deploy CHT servers completely offline in clinics throughout Kenya.
With the support of partners, we completed field sessions with users about improving the user experience of CHT apps. The feedback will help us update components of CHT apps to make them easier to use for existing and new users.
A new “how to” guide for building and publishing Android Applications.

program updates

Spotlight on Nepal: Strategic collaboration and a shared vision for sustainable health systems

In Q1, we continued our deep commitment to accompany our partners in creating, owning, and sustaining systems independently. Our long-term goal in Nepal includes complete ownership of the mHealth program by the Ministry of Health and Population (MoHP) and sub-national governments, with the program predominantly funded by the government budget and supported by national technical solution providers. With that vision, we developed a three-year program strategy in Nepal, shining light on a promising, collaborative path towards health equity across Nepal.

As part of the mHealth scale-up, 1,059 new users completed training and began actively using tools built from the CHT in Q1, spanning Sindhuli, Sunsari, Morang, Dankuta, and Panchthar.

For health facilities and municipality teams, we developed a user reference manual and tutorial videos to facilitate easy learning and adoption of data visualization dashboards. These analytics dashboards provide supervisors and local governments with real-time data for more effective decision-making and program planning, supportive supervision, and ultimately enhance program ownership and accountability. These training materials are freely available and do not require an in-person component.

As we look to the remainder of 2021, Medic will conduct review meetings in districts where mHealth deployments were completed before 2020. This one-time event at the local level will invite FCHV supervisors and the health team from the local government (95 municipalities and 688 health facilities) to: review program progress, create an opportunity to strengthen and reinforce our relationship with local governments, and provide a quick refresher on SMS-based tools as well as an on-site orientation on the health facility and municipality-level dashboards.

internal updates

Celebrating women at Medic

On March 10, in honor of International Women’s Day, our team hosted a fireside chat featuring a panel of ten geographically and culturally diverse women on teams across the organization. We spoke with panelists about their experience as women in the workplace, stereotypes they’ve faced and barriers they’ve overcome, as well as the people and the moments that inspire them. We remain inspired by the incredible women at our organization, and we're committed to improving gender equity in both our organization’s impact and in how our team operates in pursuit of our mission.