Introduction
From partnering with innovative non-profits and technical experts, to championing interoperability across health systems, to convening Ministry of Health Kenya, D-Tree International, Intellisoft Consulting, and community health promoter Mary Najoli on stage at the Global Digital Health Forum, Medic closed 2023 with landmark achievements in the breadth and reach of the Community Health Toolkit (CHT).
We continue to innovate and optimize the CHT for the people who rely on the platform to deliver quality care in their communities. Our ‘human-centered everything’ approach saw v4.5 of the CHT Core Framework introduce a more intuitive user interface, while our UX research experts met with community health workers and supervisors across East Africa to better understand their experiences, challenges and needs.
As we reflect on our past quarter successes, we’re incredibly optimistic about the new year ahead – with national programs launching or scaling in Mali, Togo, Uganda, Kenya and Nepal. In 2024, together, we will take significant steps forward in achieving universal health coverage by 2030, with a sharp focus on providing professionalized community health workers the tools they need to deliver equitable care that reaches everyone.
Impact
In Q4 2023, 8.7 million caring activities were facilitated through the Community Health Toolkit - the largest number ever recorded in a single quarter, bringing the total number of caring activities to 117.5 million all-time.
We also welcomed 12,360 new users. The CHT now supports 75,241 health workers and their supervisors across 18 countries. That's a remarkable 85% increase in total users supported since January 1, 2023!
In addition to exponential growth in users and moments of care, in Q4, 1.46 million new households were registered - nearly 700% more than all of 2022. This is largely attributed to the launch and scale of Kenya's new national electronic community health information system (eCHIS). Household coverage in Kenya and across all projects is an important step toward achieving universal health coverage (UHC).
117.5M
All-time caring activities supported
75,241
Total CHT users
18
Countries with active CHT implementations
8.7M
Caring activities in Q4 2023
Product Highlights
New Release: CHT Core 4.5
v4.5 of the CHT Core Framework is now available! This release continues an ongoing journey to bring a more modern and intuitive design throughout the user interface, as well as an improvement to trigger outbound push (exchanging data between CHT applications and other tools) events to run on a schedule.
Medic’s Product Development team also visited Kenya and Uganda to support those Ministries of Health to successfully run the CHT at scale. We are pleased to report that those nationally-owned systems are now able to scale instances to record numbers of active users – over 50,000 on eCHIS Kenya and over 6,000 on eCHIS Uganda.
Community Spotlight
Medic continuously strives to improve the experience of CHT app development. To this aim, we periodically collect direct feedback from CHT application developers via surveys and interviews.
Through the most recent survey, we received feedback from 10 developers across 12 unique organizations. Over 80% of respondents noted that the CHT met their project requirements. For the complete survey results, check out a recent blog from Niraj, Medic’s Developer Advocate.
To expand local capacity in Nepal, we also signed two new partnerships with digital healthcare non-profit Smart Health Global and IT solutions provider Tuki Logic, increasing our total number of technical partners in the country to three.
We continued to build out the resources available through our CHT Academy, launching an interoperability course for developers interested in building interoperable, scalable and sustainable health information systems.
Program Updates
Spotlight on... 🇰🇪 Kenya
The Ministry of Health Kenya is making incredible strides in the rollout of Kenya’s national electronic community health system (eCHIS) collaboratively designed, developed and deployed by the Ministry, Medic, Living Goods, Lwala Communtiy Alliance and the CHU4UHC platform of partners.
In October, Kericho County became the first to integrate the CHT into the Smart Primary Care Network (PCN). This will make it easier for care providers to refer communities to local services or larger facilities, share information and resources and even identify potential disease outbreaks.
Implementation is progressing smoothly, with…
0
out of 47 counties rolled out
0
K
out of 95K CHPs enrolled
0
M
households registered
0
M
registrations and other health services delivered by CHPs
Around the world...
🇳🇵In Nepal, we have been collaborating with six districts to roll out the mHealth program to 2,004 female community health volunteers (FCHVs). For the first time since the program launched in 2012, we partnered with a provincial – rather than district – government. Gandaki Province, and its 11 districts, has adopted and is set to scale a dual SMS-based and Android-based program that will support 1,000 health facility staff and more than 5,000 FCHVs to register and monitor pregnant women.
🇺🇬 We played a critical role in the conceptualization and organization of the Ministry of Health Uganda‘s inaugural Digital Health Conference. Medic has been a long-standing partner to the MoH as the lead developer of their eCHIS, and the conference was an important opportunity to come together in conversation as we revolutionize healthcare delivery together.
🇹🇬 With matching funds from The Global Fund to Fight AIDS, Tuberculosis and Malaria, Togo‘s Ministry of Health has selected the CHT as the platform of choice to build an electronic community health information system – Digitalisation de la Santé Communautaire (DISC-Togo). This is a critical step in improving community-based services and moving closer to achieving universal health coverage in Togo. Medic celebrates the Ministry’s leadership, strategic vision and collaborative partnership.
Medic Labs Initiatives
Digital payments: In support of salaried health workers
Only 14% of community health workers across 24 sub-Saharan African countries are paid. With women making up 70% of this workforce, this has a significant impact on gender equality, and women’s economic empowerment. Making the payment process as straightforward as possible can break down these barriers and make sure that community health workers receive the proper compensation they deserve.
We partnered with non-profit D-Tree in Zanzibar to develop a digital payment workflow addressing challenges such as late or inaccurate payments, lack of information updates and verification problems.
Users found it intuitive and easy to navigate, with one supervisor saying that it “will introduce accountability, automate the process, and build trust between program stakeholders and users”.
Malawi CARES: Optimizing care for HIV patients
Antiretroviral therapy (ART) increases survival and quality of life for people living with HIV. But, with 20 million people receiving the treatment globally as of 2022, this also leads to higher healthcare costs, crowded facilities and longer waiting times.
We partnered with I-TECH and Lighthouse Trust to prototype a Community-based ART REtention and Suppression (CARES) app, powered by the Community Health Toolkit, among more than 35,000 clinic patients in Malawi. CARES aims to improve follow-up processes, viral load monitoring and rapid identification of risks such as low-level viremia. This means optimizing health delivery, without adding to the workloads of healthcare workers.
Recent Publications and Blogs
Climate change has been declared the biggest global health threat of the 21st century. This digital tool could help those on the frontline be ready.
Medic is always looking to improve the experience of CHT application development. Here’s what developers had to say.
The Community Health Toolkit is already enabling different health systems and applications in Kenya to communicate with each other. Medic’s Philip Mwago explains why this is the future of digital health.
It took a decade, but the launch of Kenya’s national electronic community health information system has already seen 50,000 frontline workers equipped with world-class technology.
Internal Updates
In Q4, our teammates represented Medic in various in-person events and at our partners’ milestone celebrations, demonstrating the global reach of the CHT and the enormous impact the platform is having on digitized community health programs around the world…
Spotlight on...Global Digital Health Forum
10 teammates flew to Washington, D.C. to attend the Global Digital Health Forum (GDHF) and present 8 accepted abstracts, superbly representing Medic and our global work, while also demonstrating our five core values: humanity, solidarity, initiative, creativity, and openness.
Medic also hosted a main stage plenary, broadcasting a live satellite feed and co-located discussion from Washington D.C. and Nairobi about the importance of locally owned community health information systems and how we can sustainably achieve them through open source software and local capacity building.
Co-moderated by Medic’s CEO Dr. Krishna Jafa and board member Wambui Kinya (General Manager, Google Search Africa) we were joined on stage by:
- Steven Wanyee Macharia – Founder & Chief Executive Officer, IntelliSOFT Consulting Limited
- Riccardo Lampariello – Chief Executive Officer, D-tree International
- John Wanyungu – Deputy Head, Division of Community Health Services, Ministry of Health Kenya
- Mary Najoli – Community Health Promoter based in Nairobi County.
Smart PCN Launch
16 teammates attended the Smart Primary Care Network launch of eCHIS Kenya in October in Kericho County.
'A scalable model that works'
‘A scalable model that works’ – that was the consensus on Medic’s work from organizations, big and small, attending the Africa Health Tech Summit in Kigali, Rwanda.
There, our Senior Project Manager Joviah, Acting Director of External Affairs Jeff, and App Developer Manager Marina shared our approach to working collaboratively to build digital tools that community health workers want and need, alongside both new and established partners such as the Ministry of Health Uganda, Living Goods, Dimagi, Simprints, and Audere.
New Team Members
Andrew Wabwire
Senior Project Manager
Mary Nasige
Finance Analyst
Paul Alognon-Anani
App Developer
Sarah Graham
Communications Manager
Meet…Andrew Wabwire, Senior Project Manager
“Medic is helping to bring healthcare to the last mile”
Andrew has over 13 years’ experience in program management and health systems strengthening.
He joins Medic to support our mission to achieve universal health coverage in Uganda through its electronic community health information system, based on the CHT.
What have you been working on in the last quarter?
I have been working on building an eCHIS roadmap for the next five years. This will be a reference tool for all digital health/technical partners in their pursuit to scale up eCHIS. It spells out what will be required from human capital, to infrastructural design specifications, architectural design specifications and costs to run them.
What are you most excited about?
I am excited that the discussions about interoperability are beginning to take. With different online applications interlinked, it will be easy to make data-driven decisions at the national level through data analytics and also avoid siloed digital applications at the national and implementation level.