Q3 2021 Report

introduction

Q3 2021 was guided by community and collaboration.

In Q3 2021, community and partner collaborations propelled us towards new areas of focus, celebration, and impact:

Accelerated product collaborations for community-level COVID-19 response.
A courageous new advocacy campaign and coalition calling for global aid reform.
Multiple district-level trainings to onboard new frontline health workers and facility staff to tools built on the Community Health Toolkit (CHT).
2022 Zayed Sustainability Prize finalist in the health category.

In this report, we dig deeper into new CHT Core Framework releases 3.12 and 3.13, our latest research initiatives, highlights from our ongoing, promising partnerships in Kenya, and much more. Below, learn what our global team and community have been working on during a quarter filled with innovative pandemic response efforts and resiliency in the face of continued change.

our impact

In Q3, the CHT supported 5.76 million caring activities, with over 17.3 million caring activities supported in this year to-date.

By the end of September 2021, there were more than 39,500 frontline health workers using the CHT to provide care in their communities – working towards improved speed, coverage, and quality of care – with nearly 1,800 new CHT users trained by partners across multiple sites in Africa and Asia this quarter alone. At Medic, we believe that these digitally-enabled health workers are on the frontline of the efforts to not only respond to the unrelenting COVID-19 pandemic but also play a critical role in achieving global health equity.

39,564

Total CHT users

1,750

New CHT users

63.6M

All-time caring activities supported

5.76M

Caring activities this quarter

In the health systems leveraging the CHT, an average of 31% of households received one or more visits from a CHT-equipped health worker each month in Q3, with nearly 2.2 million households receiving at least one visit from a CHW during the quarter.

METRIC SPOTLIGHT

Celebrating 50 active CHT deployments across 15 countries!

81,344

Pregnancies registered

93.3

% of deliveries in a facility

978,673

Under-5 assessments

86

% of under-5 assessments conducted within 72 hours

Additionally, more than 81,000 pregnancies were registered via the CHT in Q3 enabling health workers to provide more timely antenatal care (ANC) care for pregnant women and encourage in-facility deliveries. Of all pregnancies with a delivery registered via the CHT, over 93% occurred within a facility in Q3. This benchmark for in-facility delivery has been maintained across all three quarters of 2021 – a key marker of quality care.

product highlights

New releases of the CHT Core Framework: 3.12 and 3.13

The July release of 3.12 came with a collection of features that CHT app developers have been asking for: finer grain telemetry, improved monitoring, and a new API endpoint to retrieve patient information.

In September, version 3.13 of the CHT Core Framework was released, including key features requested by both app developers and health workers who use CHT-powered apps every day:

Household Tasks Landing Page

When health workers complete a task in an app, they now see a list of other tasks for the household. This improvement was completed after consultation with partners and users seeking a more streamlined way to ensure health workers see and complete all possible tasks for a household in order to maintain an efficient, organized schedule while delivering care to their neighbors.

Launch External Android Apps

Actions in CHT apps now support launching other Android apps to complete workflows, and saving the result within the CHT app. This feature can be seen in our newly launched COVID-19 RDT Reference app, which demonstrates the use of a rapid diagnostic test (RDT) reader.

Configuration for Task Due Date Display

After consultation with CHT community members, we enabled app developers to have additional options for how to display overdue tasks. By default, an overdue task is simply displayed as “due today”. Alternatively, the configuration allows for displaying the number of days passed since the task’s due date, allowing health workers and supervisors to have increased visibility into task prioritization. This is critical to ensure households are receiving the follow-up and care they need.

PRODUCT EXPERIMENTS

App Distribution. Exploring the use of F-Droid for app distribution when Google Play Store is not a viable option.

Scalability Proof of Concept. Experiment completed to help decide on next generation infrastructure that can more easily scale nationally, reducing the common bottleneck when implementing partners add or train many new users simultaneously.

COVID-19 RESPONSE

With support from FIND, Medic developed a reference app for administering COVID-19 antigen RDTs using open-source technologies already deployed in LMICs at the community-level.

The app features ready-to-use COVID-19 RDT workflows and allows customizations to fulfill future needs of communities where deployed. Learn more in a new blog post by Jennifer Quesada, Software Developer at Medic.

program updates

AfyaSTAT, a CHT-powered app, enables HIV testing within facility and community settings in Kenya

In March 2020, when COVID-19 had not fully established itself in Kenya, an opportunity emerged for Medic and Palladium Kenya to not only co-develop an integrated COVID-19 surveillance system with the Ministry of Health (MoH) and other stakeholders, but also to exchange knowledge between the two organizations on respective technologies. The partnership was premised on the principles of digital development with an aim of mutually advancing and extending capabilities of the two technologies – OpenMRS (released under the name KenyaEMR) and the CHT – for a seamless data exchange and closed-loop client journey from the community to the health facility.

Implemented by Palladium Kenya, the Kenya Health Management Information System (KeHMIS) project is a PEPFAR-funded initiative with the goal of supporting the MoH, county health management teams, and service delivery partners to develop and maintain health information systems (HIS) innovations in Kenya. Palladium Kenya partnered with MoH and other stakeholders to design and develop a CHT-based mobile app for the project – named AfyaSTAT – that centers on HIV testing and screening (HTS) as an entry point to HIV care and treatment. Interoperable with KenyaEMR and supportive of both facility-based HTS workflows and outreach services to key populations, AfyaSTAT’s offline and online modes enable delivery of integrated HIV preventive and treatment services at the community-level.

In a collaboratively authored case study with Palladium Kenya and Centre for Health Solutions (CHS) Kenya, learn more about the project details and how AfyaSTAT will play a significant role in achieving a more connected, interoperable, people-centered health system in Kenya.

COMMUNITY SPOTLIGHT

Announcing an official partnership between OpenHIE and Medic

In September, we launched an official partnership with OpenHIE: a community of people building an open framework to support implementation teams as they develop health information exchanges (HIEs) in their regions. We’re thrilled to serve as an exemplar of OpenHIE’s mission, vision, and values through the adoption of its standards and workflows outlined in their Architecture Specification – while also sharing learnings within the CHT community.

Involving health workers in collecting geospatial health data for better precision public health

As technical stewards of the CHT, Medic works with our partners to integrate the use of geospatial data to inform care delivery. Previous CHT deployments collected geolocation passively (in the app’s background) with no health worker involvement in the process. Now, with an effort to promote openness and improve geolocation data accuracy, our research team is working alongside our partners to actively involve health workers in geolocation data capture.

In a new blog post, Mourice Barasa, Research Officer for Monitoring & Data Systems at Medic, explores our ongoing work to improve accuracy and reliability of collected geospatial data, and in the long term, contribute to improved precision public health.