Introduction
In Q1 2023, we celebrated a milestone moment toward achieving universal health coverage:
The Ministry of Health and Public Hygiene (Ministère de la Santé et de l’Hygiène Publique) in Mali officially launched the Digitalisation de la Santé Communautaire (DISC-MALI) – a Community Health Toolkit (CHT)–based electronic community health information system (eCHIS) which aims to reach full national scale by 2025, equipping over 25,000 health workers with digital health tools.
Last quarter, we also launched the Community Health Toolkit Entrepreneurship Accelerator (CHTEA), through the Bayer Foundation-funded Digital Health Ecosystem project, in partnership with PATH. The first phase of the project involves accompanying four local entrepreneurs and software developers who will benefit from Medic’s expertise in community health systems, human-centered design, app building, product development, and the digital health ecosystem. Medic will lead curriculum development and all capacity building training sessions and associated activities.
In February, our global team reunited for an annual retreat (our first full-team gathering since 2020). We stepped away from our standard day-to-day work to meet, connect, and strengthen our team relationships.
Join us in celebrating the progress we made in Q1!
Impact Metrics
In Q1 2023, 41,206 health workers provided 4.59 million caring activities with CHT-based tools, bringing the total number of caring activities provided to 96.74 million (since monitoring began in 2014).
41,026
Total CHT users
16
Countries with active CHT implementations
96.74M
All-time caring activities supported
4.59M
Caring activities in Q1 2023
45,602
Pregnancies registered
93.06%
of deliveries in a facility
681,550
Under-5 assessments
83.90%
% of under-5 assessments conducted within 72 hours.
Product Highlights
Care updates
In Q1, the Product team continued work on the CHT user interface to more closely align with the Android UX and material design patterns. This move will support improved learnability for new and existing users and also improve scalability by ensuring our mobile-first framework has room to support more use cases and functionality.
Several stages of this evolution are already complete and have been deployed in live projects. We are closely monitoring user engagement on the new interface to ensure health workers are able to easily discover and engage with updated features like filters, search, and bulk delete.
In Q1 2023, we made significant progress on moving actions to a “Floating Action Button”, and completed a “More Options” menu for additional actions. We also completed work on in-app Training Cards so that health workers can learn about changes to their apps on their own, reducing the need for in-person training.
Monitoring and Alerting with CHT Watchdog
As Medic supports ministries of health (MoHs) to self host the CHT, it is important for them to do so autonomously and with a high up time. To facilitate this, Medic has released the CHT Watchdog, a tool to help monitoring CHT instances, and alert administrators when systems might be failing.
With just a few lines of code, and zero changes to their existing CHT deployment, MoHs gain powerful insight into the health of their instance. Most importantly MoHs get push alerts that detect anomalies which might interfere with CHWs ability to deliver care:
CHT Watchdog is based on both open source and existing best in class solutions. This means they are free for all to run, no matter their budget, and also integrate into existing solutions. MoHs we surveyed were already familiar with the underlying tools used in CHT Watchdog, which means adoption of this tool will be easier for administrators. The tool is available to install and run today. The documentation covers high level monitoring and alerting information and specific install steps while the code repository ensures the open source code is accessible.
COMMUNITY SPOTLIGHT
Throughout the past three years, Medic has dedicated extensive time and resources to creating and maintaining tutorials, technical guides, training guides and presentations, practical exercises, and sample code to guide Technical Partners and enable them to rapidly build expertise on the Community Health Toolkit (CHT).
In Q1, 2023 we launched the Community Health Toolkit (CHT) Academy, a free, open, online learning platform for learning about CHT. The CHT Academy is being modeled after similar solutions in the global health ecosystem, such as DHIS2 Academy and Community Health Academy, with which many Technical Partners and governments are already very familiar.
Currently, the Academy provides two courses; the first course “Introduction to the Community Health Toolkit ” gives a non-technical high-level overview of CHT highlighting key CHT features. The second course, “Introduction to Building CHT Applications,” dives into the technical details needed to develop CHT applications. The CHT Academy follows a modular format where each module covers different topics and contains video tutorials. Modules also contain quizzes and exercises to give hands-on experience to the learners. As of now, 54 learners have enrolled in our course that is focused on developing skills to build CHT applications.
In order to understand the effectiveness and helpfulness of the CHT Academy, we have started conducting surveys. Initial results show that the course was very helpful in the initial setup of the CHT for a large majority of learners. We will continue to monitor progress and impact of CHT Academy in the CHT community and strengthen our existing resources.
CHT Approved as Global Good via Digital Square's Notice G
In Q1, Digital Square announced the updated list of Global Goods, which once again included the Community Health Toolkit (CHT)! With this recognition, the CHT will be included in Digital Square’s upcoming fourth version of the Global Goods Guidebook, presenting the CHT as a strong option for governments and funders interested in strengthening health systems.
To continue ensuring that we are providing the right resources and systems for our growing community, our team launched the contributor handbook which will centralize all documentation and bring more visibility to the product development processes we use at Medic e.g. continuous discovery, product trio, and quality assistance.
Program Updates
Spotlight on Nepal
We are delighted to share updates on the CHT Android App pilot in Nepal, led by the Nursing and Social Security Division (NSSD). This is a pilot project supporting Community Health Nurses (CHNs) with a CHT-based digital health app to support high-quality, equitable doorstep care.
In March, fifteen CHNs, one Community Health Officer, and other personnel received orientation and training on the new app. This achievement comes as an addition to already established working systems in the districts of Bardibas and Bhaktapur Municipalities, which launched in 2022.
NSSD, the Department of Health Services (DoHS), and the Ministry of Health and Population (MoHP) chose to scale the program to Chandragiri based on high demand for digital tools and reported success from the initial launch communities.
It is really exciting to share how the personnel from Chandragiri municipality, CHNs and CHO observed the CHT android app as useful and are excited to use and implement CHT app in their municipality.
Dr. Niraj Kumar Nakarmi
Project Manager, Nepal
Spotlight on Mali
In Mali, we celebrated a landmark achievement after years of in-country collaboration alongside our partner, Muso Health. We joined a committed coalition of stakeholders – led by the Government of Mali – including UNICEF Mali, USAID Mali, World Bank, Global Fund, Muso, Centre de Recherche et d’Expertise pour le Développement Local (CREDEL), and dozens of additional NGOs working in Mali to address the needs of community-based health systems.
Ministère de la Santé et de l’Hygiène Publique (Ministry of Health and Public Hygiene) officially launched the Digitalisation de la Santé Communautaire (DISC-MALI) – a Community Health Toolkit-based electronic community health information system which aims to reach full national scale by 2025, equipping over 25,000 health workers with digital health tools.
The launch was coupled with the delivery of 2,000 tablets, contributing to 26,000 tablets provided by various partners, which will be used for the coordination of community care, collection and reporting data via the DISC-MALI platform.
Research Initiatives
Uganda MoH Capacity Building and Deployment of Data Observation Toolkit
On the road to precision health, there’s a need for actors to build and maintain confidence in data collected by community health workers (CHWs). In Q3 last year, we developed a data observation toolkit (DOT) in collaboration with DataKind (Figure 1) to automate the process of identifying inconsistent or problematic data. DOT is designed such that it can sit as close as possible to the point at which CHW-gathered data syncs with the server.
In Q1, 2023 the research team provided four Training of Trainers (ToT) sessions to build the capacity for six Uganda Ministry of Health (MOH) staff on the use of the DOT. We collaborate with MOH to document their server infrastructure, develop deployment scripts, and subsequently deploy and configure the DOT with the leadership of the MOH ToTs.
Hot off the press
Digital tools make it easier to collect data about patients and the care they receive, and health workers can use these data to improve the cover- age, speed, and quality of health services. In this research article, read more on how data can be used to increase public trust.
When care provision and the needs of a community remain invisible, communities do not receive just and equitable health services. A gap between needs, supportive interventions, and ethical data use to inform policy making persists. Read more on how Interoperability in Digital Health is important.
Internal news
In Q1 2023, 86 of us came together from 18 different countries to connect and strengthen our team relationships as we doubled our efforts towards advancing our work that will enable a thriving global community of practice deploying and sustaining digital health apps.
Our team was represented in the 3rd Community Health Worker Symposium held in Monrovia, Liberia. This was an opportunity to widen our collaboration with new and existing partners through sharing more on our work. During this Symposium, MoH Uganda presented a joint publication with Medic on the Data Observation Toolkit, a research initiative launched in collaboration with DataKind.
As a proud founding member of Unlock Aid, we celebrated the appointment of our Chief Executive Officer, Krishna Jaffa as a Deputy Board chair for Unlock Aid. Unlock Aid is an advocacy coalition calling on aid agencies like USAID to become more accessible to potential tech partners, attract the world’s best innovators + meet the challenges of the 21st century.
New Teammates
Phil Mwago
Technical Product Owner
Falmata Hassane Awada
App Developer
Victoria Reyes
People, Culture and Business Operations Director