Introduction
Every so often an opportunity presents itself to stop and take stock of the progress we have made after more than a decade of digital innovation.
One such moment was our return to the Clinton Global Initiative stage. When we were last there in 2012, we made a commitment to develop a model for digital maternal and child health services.
In the last three months, in addition to seven governments who have already selected the Community Health Toolkit (CHT) as a tool of choice, we have seen how the ripples of our commitment are cascading across West Africa.
Côte d’Ivoire became the third country in the region to launch a national electronic Community Health Information System (eCHIS) powered by the CHT, Togo’s pilot program welcomed over 1,000 active users, and Mali’s community health workers shared the life-changing interventions they have made with the support of their digital health app.
Technology is having a real-life impact in the hands of professional community health workers.
As we reflect on all the achievements in the last quarter, we want to thank our partners for working with us in solidarity to make this a reality.
Twelve years after our first commitment, the power of partnership and community ownership is transforming health for all in the digital age.
Impact
In Q3 2024, the CHT supported:
18.1 M
caring activities
(172M all-time)
1.9 K
new CHT users
(165 K all-time)
1 M
households registered
(11 M all-time)
Advancing health for all - universal health coverage services in Q3 2024:
98.2 K
family planning sessions
22.8 K
pregnancies registered
87.2 %
facility-based deliveries
47.2 K
postnatal care visits
42 K
immunization screenings
70.8 K
malnutrition screenings
346.2 K
under-5 assessments
Product Highlights
In Q3, we enhanced the CHT with new and improved features, including:
Users can view data for the previous reporting period
Users assigned multiple places can see Aggregate Targets
Flexible ways to validate phone numbers
Guaranteed continuous access to data across major updates
Number validation to detect common mistakes like typos
In Q3 2024, we were delighted to see Kenya’s Ministry of Health to deploy many of the latest innovations in the CHT, including:
Telemetry
The Ministry enabled us to access and analyze application performance data from 12 million records and 13,000 health workers. Telemetry enables us to identify slow and seldom-used pages to improve the performance of the tools for CHWs, as well as use data from real-world application usage to drive feature decisions that will generate the most impact for our users.
CHT Sync
CHT Sync solution combines several technologies to synchronize data collected at community level in near real-time for processing and analysis. This provides projects with up-to-date, reliable data dashboards. This feature is now production-ready and has been deployed on a national scale.
Kubernetes
Technical staff trained on Kubernetes, or ‘k8s’. This industry standard is designed to manage the complexity of large-scale systems like Kenya’s. It enables the Ministry to keep track of moving parts and improve their application’s uptime, easing the demands of significant scale running multiple instances of the CHT.
Find out more about Kubernetes and CHT-Sync from teammates Ashley and Phil below:
Community Spotlight
Brink Innovation, one of our CHT Entrepreneurship Accelerator (CHTEA) grantees, has made remarkable strides since participating in the program, significantly increasing their capacity to leverage the CHT.
Brink Innovation has now set its sights on growing a community of developers to build and innovate on the CHT platform.
Lessons on scale and sustainability from the CHTEA are bearing fruit, as they explore the long-term viability of the CHT and the importance of skilled human resources to support its growth. Recently, they hosted the first in a series of hackathons, offering developers hands-on experience in building solutions on the CHT. This initiative not only strengthens the toolkit’s existing ecosystem but also fosters a new generation of digital health innovators.
Program Updates
Spotlight on... 🇹🇬 Togo
0
accounts created
0
active users
0
people registered
0
households registered
In April 2024, the Ministry of Health’s Division of Community and Elderly Health launched SanteComTogo, the national eCHIS we designed in partnership with the Global Fund, in the country’s Maritime Region. In six short months, the app has welcomed over 1,000 active users, supporting community health workers to provide high-quality care to families, including pregnant women and children under 5.
In September, our West Africa team headed to the three districts of the Maritime Region to meet with the people most critical to the app’s continuous development: the community health workers who use it. This is what they found (French version).
Around the world ...
In 🇺🇬 Uganda, the Ministry of Health officially transitioned from paper-based to eCHIS data reporting, thanks to the support of our in-country partners. In the last quarter, health indicators revealed a 15% increase in antenatal visit attendance, as well as a 93% reporting rate at health facilities.
Through funding from the Global Fund’s BIRCH projects via Living Goods, we are supporting the development of workflows, hierarchies, and analytics to digitize the recently commissioned Community Health Extension Workers (CHEW), a cadre which supervises Village Health Teams and links communities to health facilities for further care.
0
out of 50 districts reached
0
CHWs digitized
0
households registered
In 🇳🇵Nepal, we added 800 new users and provided online refresher training to nearly 500 health workers across 21 municipalities, along with programmatic feedback and support.
We are finalizing the integration of the CHT with the electronic Health Information Management System (eHMIS), as well as the deployment plan to scale the CHT application in Lumbini Province, with the support of the Ministry of Health and UNICEF.
The Nursing and Social Security Division also introduced two new workflows in the CHT Android app to support Community Health Nurses in non-communicable disease screening and post-natal care.
In 🇰🇪 Kenya, we added 1,413 new users, trained 25 additional county user managers, and provided continuous mentorship on eCHIS V.3 workflow enhancements. We supported the Ministry of Health in updating the user management Standard Operating Procedures and the eCHIS privacy policy and co-developed the CHW-R System Requirements specification, which provides a primary source of information for health workers.
Medic held a meeting with Nairobi County to share the objectives and anticipated outcomes of our Digital Payments project, which aims to ensure CHWs receive the right payment for their performance. This led to the launch of a project pilot in August for Migori and Nairobi Counties, supporting over 12,000 users.
Innovation
📊 Data Quality Assurance
We developed and piloted a data quality assurance tool with the Kenyan Ministry of Health. The tool supports the Ministry to review data quality based on considerations like system accessibility, completeness, timeliness, and accuracy, as well as how it links to national systems and structures.
The tool already yielded some interesting results, revealing some of the challenges that users face in using the technology including knowledge gaps of some of the terminology, limited access to devices leading some to share their details with other users, and missing or duplicate information.
These findings provide valuable insights for our Design team and can help to inform discussions or re-design considerations.
Recent Publications and Blogs
Standardizing data exchange across healthcare systems has the potential to enhance patient care. That’s what we’re doing in Kenya and Nepal.
Our promise from 12 years ago has reimagined how care is delivered to millions. Now we’re aiming even higher.
What does it take to build a CHT app? Here’s what 28 developers told us.
Hawa Koné has dedicated her life to caring for children and mothers. This responsibility is now that much easier: thanks to technology.
Internal Updates
"Real change-makers don't quit"
The UN General Assembly (UNGA)’s annual meeting is a major moment for global health and development. Our CEO Dykki Settle, Director of Community Nekesa Were, and Director of External Affairs Jeff Jacobs gathered in New York to contribute to the conversation and advocate for health equity through technology at side events and partner gatherings.
We were delighted to find that the impact of community health and the importance of paying, training, supervising, supplying, and digitally strengthening frontline workers were central themes. These were some of our favorite quotes from the people who inspired us most.
A bold commitment at CGI
In parallel with UNGA79, Dykki was invited on stage at the Clinton Global Initiative (CGI) to reaffirm our commitment to advance health for all in the digital age.
Reflecting on Kenya’s extraordinary success rolling out a national electronic community health system, Dykki stated: “We’re aiming higher. By 2030, we will support 500,000 community health workers, expanding access to improved healthcare for 250 million people.”
A year of impact in Nepal
Our Nepal team joined the annual reviews of Gandaki and Lumbini Provinces. In the latter, we have already deployed the CHT across four districts, adding 2,800 users. During the meeting, the Health Minister presented Medic with an award in recognition of our work.
Our Nepal Program Head Nitin Bhandari also joined a panel discussion at the Digital Health Symposium, co-organized by the Ministry of Health and Swasthya Khabar Foundation. Alongside eminent figures in digital health, Nitin emphasized the impact of the CHT in improving healthcare access and coordination, especially in remote and underserved areas.
