Introduction
It is exhilarating to see technological innovation advance the promise of health for all.
In Q2 2024, that’s what happened in Kenya. The national electronic community health information system (eCHIS) – built in partnership with CHU4UHC, a fantastic group of organizations – is now reaching community health workers (CHWS) across all 47 counties nationwide.
This is a remarkable achievement for the country. It is a testament to national and county government leadership and the steadfast commitment of the Ministry of Health to paying, training, and equipping CHWs with kits, smartphones, and medicines.
It was made all the more poignant when one eCHIS user shared with us her motivation for becoming a CHW in Migori County, saying:
“We don’t want our community to be left behind.”
Maureen Akomo Wauda
Lead Community Health Promoter, Lwala
The eCHIS will support more than 107,000 CHWs across Kenya, ensuring they can reach everyone in need of care and no one is forgotten on the path to universal health coverage.
It is a joy to reflect on the achievements that Medic and our partners are advancing, not just in Kenya but across our five other national programs and the global CHT community.
Impact
In Q2 2024, the CHT supported:
15.5 M
caring activities
(153.6M all-time)
9 K
new CHT users
(140.7 K all-time)
27 K
households registered
(9.3 M all-time)
Advancing health for all - universal health coverage services in Q2 2024:
100.7 K
family planning sessions
24.8 K
pregnancies registered
85.9 %
facility-based deliveries
51 K
postnatal care visits
69.2 K
immunization screenings
132.5 K
malnutrition screenings
405 K
under-5 assessments
Product Highlights
In Q2, we enhanced the Community Health Toolkit (CHT) with new and improved features, including:
CHW supervision across multiple areas through one login
Massive performance gains on the Contacts Page
Hand-drawn signatures from patients
Mandatory countdown widgets to guide better breathing assessments
Additional Spanish, French, and Swahili translations, making the CHT more inclusive
Multiple security enhancements and bug fixes
We all know that slow apps are frustrating. In v4.7 of the CHT, we released features that make it easier to understand where CHWs are experiencing slowness while using their apps.
Recognizing it takes time for projects to upgrade, and for new data to become available, we ran several simulations using devices, configurations, and data typical of a CHW working offline in rural communities. We discovered a few key focus areas and worked on performance improvements. As a result, all CHWs using v4.8 (released May ’24) will have a speedier experience on the Contacts Page.
We also know that supportive CHW supervision leads to more engaged health workers – a pathway to achieving better health outcomes for patients.
While the CHT has long supported supervisor workflows, in many instances supervisors need to oversee CHWs across multiple catchment areas – a geographically-bound area that a CHW serves. To handle this, supervisors either needed several user accounts, or else significant changes to the configuration had to be made.
In v4.9 (June ‘24) we released a feature that enables supervisors to access all the data they need from one login, without requiring major configuration changes. This is a critical – and highly celebrated – change to improve how supervisors can serve the needs of CHWs in their scope.
Check out a preview in the video below…
Community Spotlight
As the technical steward of the Community Health Toolkit (CHT), we provide community members with hands-on support, resources, and training to learn and apply their skills to create digital tools. In turn, members contribute back to the CHT community and its documentation – and ultimately improve users’ experiences across the world.
In Q2 2024, community partners and developers made significant contributions to the CHT. These features and improvements are publicly available in the v4.7.1 release and documentation site, meaning all CHT projects can benefit from them:
- Living Goods updated the configuration of the countdown timer widget to improve the accuracy of data captured by users.
- Cape Town Systematic Healthcare Systematic Action Research Project (C-SHARP) built and documented a fix to ensure secure communication between different CHT services to support end-to-end testing and troubleshooting.
- The C-SHARP team also supported a configuration to calculate the difference between two dates in various time formats.
- An individual contributor updated the CHT documentation site navigation so mobile users can now access the hamburger navigation menu.
- Datharm developed comprehensive RapidProCHT gateway installation documentation to guide community members on installing gateways to support two-way texting between health workers and households.
- Medic worked with Kenya’s Ministry of Health to co-create, test, and publish training resources for end users.
- We also grouped together all app hosting resources on the documentation site to make it easier for users to find and add information.
Program Updates
Spotlight on... 🇰🇪 Kenya
0
out of 47 counties reached
0
K
new CHPs enrolled
0
K
new households registered
0
M
health services delivered
Kenya made major milestones in its digitization journey in Q2, as the scale-up of the country’s national eCHIS reached all 47 counties.
eCHIS Kenya underwent a major upgrade from v4.2 to 4.8 across all three training instances and four counties, with more upgrades planned in Q3.
The upgrade brought a wealth of enhancements – solving bugs, strengthening cybersecurity protection, and significantly improving app load times to provide a better experience for CHWs.
What difference is eCHIS making for community health workers? Maureen in Migori County explains below…
Around the world ...
In 🇳🇵Nepal we ushered in significant achievements, adding 6,729 new users – 35% growth! – by completing training with all Female Community Health Volunteers (FCHVs) in Gandaki Province. This is the first time Medic has supported rapid scaling across an entire province, having traditionally supported individual districts. Medic now supports deployments across all seven provinces and 40 of 77 districts.
We were delighted when The Family Welfare Division (FWD) of the Ministry’s Department of Health Services recognized our success in Nepal. A major decision-making body, the FWD plays a critical role in shaping policies, strategies, and guidelines for provincial and local governments, particularly with regard to maternal and child health, immunization, nutrition, and family planning.
It selected the CHT for designing and implementing an immunization tracking workflow, with support from UNICEF’s Nepal office. This initiative will enable FCHVs to closely monitor the immunization status of pregnant mothers and children, supporting critical vaccination uptake and marking another significant step in advancing universal health coverage.
We celebrated the 100% digitization of CHWs in the Ntungamo District of 🇺🇬 Western Uganda, alongside our partners Malaria Consortium, Living Goods, Amref Health Africa, BRAC, and UNICEF.
The team also produced a view enabling supervisors to complete CHW tasks, provide consistent support, and promote quality care at the household level.
Alongside Muso and Save the Children, we helped launch a new workflow within 🇨🇮 Côte d’Ivoire‘s CHT-powered app across six regions, supporting CHWs and supervisors to improve the quality, provision, and use of community health services.
In 2023, the Ministry of Health invited Medic to join as a member of a technical committee to support the customization and implementation of its national eCHIS, alongside our partners Muso and Save the Children. CHWs will use this new app to monitor pregnant women and children under five and treat illnesses such as diarrhea, pneumonia, malnutrition, and malaria.
In Q2, in advance of further deployment activities next quarter, we also launched Training of Trainers workshops, building the knowledge of trainers identified by the Ministry to guide others on using the eCHIS.
Innovation
⚠️ Flood crisis response
In April and May, unprecedented rainfall devastated Kenya and parts of East Africa, leading to flooding that demolished households, wiped out infrastructure, and took lives.
In response, we rapidly designed and developed a digital flood status reporting form within eCHIS Kenya. The form, created in collaboration with the Ministry of Health and the CHU4UHC platform of partners, collected data that supported the Ministry and counties to measure the impact of flooding on communities, and how it had affected their access to health services. This data was critical to their planning and response.
🦠 Digital campaigns to eliminate tropical diseases
In Kenya, we also designed and developed integrated digital awareness campaigns to support the Ministry of Health in controlling or eliminating neglected tropical diseases.
Together with the Clinton Health Access Initiative and World Health Organization, we ran testing in two sub-countries of Kakamega County, targeting 50 community health workers and six advisors. Once deployed, these digitization elements will boost campaigns with active screening, client follow-up, logistics, and supply chain management.
📈 Data Quality Assessment Toolkit
We collaborated with Kenya’s Ministry of Health to digitize their Data Quality Assessment (DQA) system using open-source technology and human-centered design. The DQA tool provides key information including data availability, completion, timeliness, and accuracy to help healthcare providers make fast and informed decisions to improve patient care, disease surveillance, and resource allocation.
We piloted the system in two counties and made iterations before scaling it to eight others. The electronic DQA system revealed reasonable data completeness and accessibility of the CHT, as well as focus areas to work on for the future.
Recent Publications and Blogs
Designing a health service is always special. Service Designer Louis shares why.
Andra had questions when she arrived at Medic. She set up Technology Radars to answer them.
Dykki has 30 years of experience in digital technology and data systems. He shares the defining moments that led him to Medic.
Director of External Affairs Jeff Jacobs reflects on key takeaways from the 77th World Health Assembly.
Medic is bridging the gap between digital healthcare systems to improve patient care. Technical Product Owner Phil Mwago explains how.
Internal Updates
Global health forums
In Q2, we brought our work to the global stage!
In parallel with the Skoll World Forum, we debuted a film produced with Maureen, a lead CHW with an exceptional story, and our partner organization Lwala, who supports her.
We were also joined for a panel discussion by the heads of Living Goods, Lwala, and Muso, who shared how our collaborative and CHW-focused approach is revolutionizing care delivery across Africa and Asia.
This was later echoed at the World Health Assembly in Geneva, where Maureen opened a second film screening at a WHO Foundation event, giving a powerful speech on the difference that Kenya eCHIS is making for CHWs like her as they work to advance health for all.
CHU4UHC co-creation workshop
Our Kenya team joined fellow CHU4UHC partners for a co-creation workshop in Siaya County. We reflected on our shared achievements in the scale-up of Kenya’s national eCHIS and used this momentum to create a vision for the years to come.
Medic was recognized for our efforts in advancing the CHT, and our Chief Program Officer Robert Mutai received an award for his resilience in the face of rapid scale-up.
Bayer Innovation Days
Bayer Foundation invited our Chief Technology Officer Gareth Bowen to speak at their Social Innovation Days on Medic’s approach to AI and the role it plays in human-centered, community-based care.
New Team Members
Dykki Settle
Interim Chief Executive Officer
Sara Komaiha
Product Manager, Digital Payments