Q2 2023 Impact Report

Introduction

In Q2 2023, we celebrated a major milestone: reaching 100 million caring activities since monitoring of this metric began in 2014. This represents an awe-inspiring number of moments of care provided by CHWs to families in last mile communities. We equally celebrated the expansion of the reach of the CHT to a global cohort of 48,178 CHWs, an increase of 7000 users as a result of rapid project expansions in Kenya, Mali, Nepal, Nigeria, Uganda, and Togo.

The past quarter also included a wealth of global engagements – moments where our team met with colleagues, celebrated global goods, and advanced Medic’s mission. In addition to our attendance at the Skoll World Forum, Innovations in Healthcare Annual Forum, and OpenHIE Annual Forum, our CEO Krishna Jafa participated on a panel with the Council for Foreign Relations, organized by Resolve to Save Lives. Moderated by Dr. Tom Frieden, former Director of the CDC, and accompanied by Dr. Raj Panjabi, Special Advisor to President Biden, Krishna spoke about community health workers and practical protocols for primary health care.

The momentum achieved in Q2 demonstrates significant progress on our shared commitment to advancing digital health and realizing the promise of a new model of care led by professionalized, paid, supervised, and digitally-enabled CHWs.

In this report, we celebrate remarkable achievements, updates, and milestones — each made possible by the dedication of our global team and partners.

Impact Metrics

In Q2 2023, the CHT supported 5.4 million caring activities, bringing the total number of caring activities supported to 102.4 million all-time, a landmark achievement.

102.4M

All-time caring activities supported

48,178

Total CHT users

16

Countries with active CHT implementations

5.4M

Caring activities in Q2 2023

Product Highlights

New Release: CHT Core 4.2

In November 2022, we celebrated the groundbreaking release of CHT Core v4 – a decade-long culmination of innovation, iteration, and a significant improvement in how the CHT is deployed at scale. In May 2023, we released CHT Core 4.2, upgrading additional features that will increase ease for CHWs as they provide care to their communities. The features include:

Floating action button that provides easy access to menus.
More menu options that align the CHT more closely with Android UX and material design patterns.
Improved offline accessibility of training cards, empowering CHWs to learn about changes to their CHT app remotely and directly in their app.

New Stock Monitoring Workflows for Commodity Management

In Q2, we celebrated releasing version 0.0.2 of a stock monitoring (commodity management) reference workflow, built in collaboration with MoH Mali. The stock monitoring module serves as a versatile and reusable component that plays a crucial role in managing commodities across various CHT applications.

A recent research review released by the Community Health Impact Coalition details a concerning trend of essential medicine stock-outs hampering the efforts of CHWs in low- and middle-income countries. Throughout the study, CHWs experienced stock-outs 28.93% of the time, resulting in delays in care, increased out-of-pocket expenses for patients, and reputational damage to health workers who rely on being a trusted member of their community. Commodity management workflows within the CHT will allow CHWs and their supervisors to better predict and track supply usage to limit or eliminate stock-outs of essential medicines and equipment.

Through the implementation of innovative supply CHW solutions, we have established a standardized approach to commodity management, ensuring consistency and efficiency in our operations. The integration of this module into our digital ecosystem significantly reduces the time and effort required by developers to build their applications. By adopting the best practices and insights from the supply CHW domain, we have been able to address real-world challenges in commodity management effectively.

We are grateful for our government partners and the opportunities that designing for national scale brings to improving access to innovation for the global CHT community. We remain committed to continuing this fruitful collaboration and exploring opportunities to drive innovation in supply chain management for CHWs. By harnessing the collective knowledge and experience of our partners, we can stay at the forefront of advancements in commodity management and better serve the communities that rely on the CHW program’s invaluable support.

Community Spotlights

CHT Entrepreneurship Accelerator (CHTEA)

As over 100 innovators, developers, implementers, and donors gathered for Digital Square at PATH’s first-ever Global Goods Innovators Summit in Dar es Salaam in June, Medic’s first cohort of Community Health Toolkit Entrepreneurship Accelerator (CHTEA) grantees took center stage.

Representatives from Brink Innovation, Guild Digital, IntelliSOFT, and Posh IT joined a panel alongside Medic’s Director of Community, Nekesa Were to talk about sustainability of global goods. The group focused on how global goods, like CHT, can drive local ownership by engaging innovative technical organizations based in-country, and what it takes for these entrepreneurs to find a business case for adopting new global goods.

Speakers shared how the CHTEA has provided them with access to the assistance they need to scale and sustain their tools, whether in the form of funding, product development, or design, and all within a community of people working on similar challenges who are willing to share solutions. With successful graduation from the CHTEA, grantees will be fully equipped to build on the CHT, certified as a CHT technical solution provider, and primed to support new business opportunities as a supplement to their independent business development.

It was exciting to watch our grantees warmly offer partnerships and collaborations, and challenge the Global Goods Community to confidently pitch their own products as best in class. Our grantees provided insight into local markets and no doubt left the community excited to scale their work on the African continent.

Nekesa Were, Director of Community

Program Updates

Advancing an Electronic Community Health Information System (eCHIS) in Uganda

In May, we celebrated a highly successful meeting with MoH Uganda, Malaria Consortium, and UNICEF as we collaboratively build an electronic community health information system (eCHIS). The meeting served as an opportunity to showcase the advancement of the national eCHIS to be used by public sector CHWs – called Village Health Teams (VHTs) – along with the unveiling of the draft concept of the Uganda eCHIS roadmap. Furthermore, all stakeholders were onboarded on MoH systems and interoperability standards and discussed mechanisms to exchange and use data.

Our team traveled to Buikwe District to shadow VHTs as they provided doorstep care to their community members. Medic’s foundational approach to app design follows the Principles of Digital Development, emphasizing human-centered design with the user. To solicit such direct feedback, these shadowing trips are essential. For instance, observing VHTs as they assessed children under-five emphasized the paramount importance of providing comprehensive training to enhance the capacities of VHTs.

Expanding mHealth in Bardiya, Kohalpur, and Humla Districts

In Nepal, we successfully completed a number of training sessions across different regions to support the digital enablement of community health workers. In the district of Bardiya, we held a district orientation of eight municipalities that are now adopting the mHealth program which has resulted in an additional 831 new users. We held a retraining for 50 Female Community Health Volunteer (FCHV) in Kohalpur Municipality and celebrated Ram Kumari Tharu, an outstanding FCHV who was recognized for having the highest reporting entries out of 71 FCHVs in Kohalpur municipality. In Humla District (one of the most remote districts of Nepal), we conducted a FCHV level training at Darma Health Post supporting 8 FCHVs.

Medic Labs Initiatives

We are excited to share new publications which showcase our commitment to exploring evidence-based research and its potential to revolutionize healthcare for the better. We delved into understanding how two-way texting (2wT)–based follow-up can provide a safe and an efficient alternative to scheduled clinic visits for low-risk patients who underwent voluntary medical male circumcision (VMMC). By conducting a comprehensive review and meta-analysis of various interventions, we gained valuable insights into the efficacy and feasibility of these technologies. Our findings have shed light on the potential benefits of digital health tools in improving patient engagement, health behavior, and overall health outcomes.

We focused on the rising trend of telemedicine adoption and its implications for healthcare accessibility. Through a mixed-methods approach, we examined the experiences and perspectives of both patients and healthcare providers in utilizing telemedicine services. The study revealed promising results, indicating high patient satisfaction and increased access to healthcare, particularly for remote and underserved populations. Moreover, we identified key challenges and opportunities for further improvement in telemedicine implementation. By disseminating these insights, we aim to facilitate informed decision-making and foster the expansion of telemedicine initiatives, ultimately making healthcare more accessible and convenient for all.

We also explored the dynamics of infectious disease transmission in densely populated urban areas. Using advanced mathematical modeling and simulation techniques, we studied the impact of various intervention strategies in mitigating disease spread. Our research not only provided crucial insights into the effectiveness of public health measures but also offered a predictive framework to inform response strategies during outbreaks. By collaborating with public health authorities, this publication has the potential to shape proactive measures that can limit the impact of infectious diseases in urban settings and safeguard the health of communities.

Recent Publications and Blogs

Unlocking the Power of Interoperability

Philip Mwago, Medic Technical Product Owner, presents, "Unlocking the Power of Interoperability," sharing insights into the transformative potential of interoperability in the healthcare landscape. Discover how seamless data exchange between systems and applications can revolutionize patient care, improve decision-making processes, and enhance overall healthcare efficiency.

Collaborating for Healthcare

In our ongoing blog series celebrating the launch of a national electronic health information system in Kenya, we are highlighting milestones , challenges, and successes that lead to this moment. Our digitization efforts aim to empower 95,000 CHPs with cutting-edge tools and technology, enabling them to deliver even more effective and targeted healthcare services to their communities. Read more about our journey and history and our multi-year partnership and collaboration with LG.

Internal Updates

In Q2, our team represented Medic at various conferences that provided an opportunity to celebrate the crucial milestones being achieved in the digital healthcare space as well as serve as a catalyst to discuss current challenges in the current impact health systems. We attended the Skoll World Forum, Innovations in Healthcare, OpenHIE Annual Community Meeting, 2023 Digital Square Global Good Innovator Summit, the 3rd Africa Digital Health Summit and the Mozilla Africa Mradi Innovation Week.

CEO Krishna Jafa was also featured on a panel by Resolve to Save Lives and was joined by Dr. Raj Panjabi, special advisor to President Biden, this conversation was moderated by Dr. Tom Frieden, CEO of Resolve to Save Lives. This session was a high level panel with Council for Foreign Relations focusing on the resilience of Primary Health Care (PHC), CHWs and digital tools. Krishna also joined the “Inclusive Healthcare Talks” series convened by Innovations in Healthcare and Bayer Foundation as part of the panel discussion on “Preparing for Impact: The Potential of CHWs through Digital Enablement.”

Chief Development Officer Emily Michael joined conversations hosted by Innovations in Healthcare . Head of App services Derrick Lung’aho Technical Product Owner Phil Mwago, and Software Developer Njuguna Ndung’u were part of the Annual OpenHIE Community meetings that brought together a community to connect and learn from each other. A group of our team attended the 2023 Digital Square Global Good Innovator Summit in May. In June, Mercy Amulele, a service designer, presented on community-based digital communication to support neonatal health (CHV-NEO) at the 3rd Africa Digital Health Summit. Later in the month, our Director of Community facilitated a panel conversation at the Mozilla Africa Mradi Innovation week.