Empowering Digitized Community Health in Kenya: Medic’s Journey of Impact and Growth

In celebration of Kenya’s upcoming national launch of the CHT-based electronic community health information system (eCHIS), we’re reflecting on the breadth of Medic’s more than decade-long commitment of collaboration and impact in-country.

In part one below, we highlight Medic’s journey supporting community health in Kenya. In part two, we highlight our collaboration with Living Goods – a partnership that led to the development of a powerful set of mobile and web tools to support their community health model. The mobile app, eventually named SmartHealth, became the early foundation for Kenya’s Ministry of Health-led eCHIS product, which will be scaled to nearly 100,000 community health workers. In part three, we detail Medic’s role in supporting the Ministry of Health and the national consortium of partners making eCHIS a reality.

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It’s been more than a decade since Medic piloted our first digital health program in Kenya – establishing new relationships with implementing partners, and collectively learning how to iterate upon and bring digital health innovations to scale. Today, we are on the precipice of an historic moment – the Presidential launch of the national electronic community health information system (eCHIS) for Kenya, built with the Community Health Toolkit (CHT), and slated to support over 95,000 Community Health Workers.

It is with resolute determination to improve community-based health care delivery and to empower Community Health Workers (known as Community Health Promoters -CHPs in Kenya) that Medic and our partners have reached this transformative milestone. As we approach the official launch celebration, we’re looking back on the path that led to this moment – awe-inspiring and iterative development; lasting, collaborative partnerships; and a steadfast focus on the needs of community health workers and the communities they support. We invite you to join us as we reflect on our journey of impact in Kenya, commemorating the critical junctures that inspired this landmark occasion.  

Where it started

Our journey began in 2011, with an inaugural project in Kilifi County. This project, in partnership with Kilifi Kids, introduced SMS-based technology that empowered nurses in remote areas to use digital tools to inform weekly Integrated Disease Surveillance and Response reporting. Overcoming unreliable mobile connectivity and phone procurement challenges, we focused on promoting maternal and child health, prioritizing early antenatal care access, fostering adherence to antenatal care recommendations, remotely monitoring coldtrace temperature for viable vaccines, and ensuring immunization services for children. This early endeavor highlighted that community health workers are not just data collectors, but rather providers of care, agents of change, and responsible stewards of data to inform optimal household-level care delivery. Our first project with Kilifi Kids laid the foundation for the digital investment that was soon to follow. 

Expansion and Innovation

Starting in 2013, our program scope expanded to Makueni County, where we introduced SIM apps – simple, menu-based applications that operated on basic, feature phones and were cost-effective to implement. This technology revolutionized how evidence-based tools could quickly reach health workers as they provided quality antenatal care, postnatal care, immunization delivery, and referrals to health facilities.

To further enhance community health reporting and data visualization, we harnessed the power of Klipfolio dashboards, which enhanced supportive supervision and performance monitoring of health workers. This advancement showcased our commitment to continuously pushing the boundaries of what was possible in the early days of digital health, while simultaneously focusing on the needs of marginalized communities. 

We later expanded our project scope to Machakos, Kiambu, Narok, and Elgeyo Marakwet counties through our partnership with Christian Aid. In these regions, we introduced additional SMS-based apps, focusing on maternal and child health.

The First Android-Based Apps

As SMS-based apps flourished, Medic began to focus on creating Android-based apps for Smartphones, the future of digitized community health. It was then that we formed a partnership with Living Goods to create a powerful set of mobile and web tools to support their community health model. The mobile app, eventually named SmartHealth, provided a long-term, flexible tool for integrated, high-quality, community-based care and resources for CHPs and their managers. Medic’s analytics platform also provided critical management tools for Living Goods’ staff. Today, over 10,000 health workers supported by Living Goods are using CHT-based apps.

The First MOH Partnership

In 2017, we established our first MOH deployment, led by Siaya County. This groundbreaking initiative aimed to provide CHPs with digital tools to support quality service delivery and proper supervision, a critical link to ensure well-supported, effective health workers. 

This initiative served as a proof of concept that digital tools could effectively support quality and sustainable delivery of comprehensive health services for an MOH. It led to our inclusion in county- and national-level technical working groups around community health. 

In turn, the Siaya County effort informed our ongoing work with Living Goods and was further adapted by CMMB for Kitui County and Safari Doctors in Lamu County, leveraging synergies and connections along the way.

The Pandemic and Birth of eCHIS 

In late 2019, Medic began attending meetings with MOH, discussing digital harmonization and operationalization of an evidence-based community health digitization strategy. The vision was grand – a singular platform for community health delivery across Kenya. This shift would require extensive collaboration between the public and private sectors to ensure the right tools were chosen, adopted, designed, implemented, and scaled.

Fortunately, the Living Goods and MOH Siaya programs served as strong demonstrations of what comprehensive digital community health information systems could look like. They provided blueprints for what was possible, celebrating Medic’s open everything ethos and the CHT’s innovative Core Framework that makes it easier and faster to build reliable, interoperable, customizable, and secure digital health apps rather than coding from scratch.

The involvement of partners, especially the Ministry of Health, has been instrumental in the success and sustainability of our projects. We are proud to witness their increasing engagement, co-designing and co-developing workflows, which has fostered a sense of ownership and long-term sustainability.

Jennifer Muli, Service Designer

Building upon Medic’s technical leadership and the CHT’s selection as the foundational platform for the Ministry-led eCHIS, Medic collaborated with MOH-Kenya and key implementing partners to co-create features and functionalities, a roadmap for eCHIS implementation, architectural documentation for the technology, and a transition plan for the respective community-based digital health programs to migrate to the eCHIS app. After months of piloting, iterating, hackathons, and training, roll out of eCHIS 2.0 began in November 2022 and in 2023 was formally approved to scale to over 95,000 CHPs nationally.

It was never a question of if, but when the technology would reach rapid adoption. We have created quality, scalable technology that partners can quickly take and deploy.

Simon Mbae, Programme Head, East Africa

Continued Focus On People as We Look Forward

Relying on Medic’s foundation of human-centered design, we have been able to create innovative and scalable digital tools that are meeting this moment in Kenya. eCHIS is intuitive and easy to use, effectively supporting quality home-based care and also facilitating near-real-time data that supervisors and health system managers can rely on for critical decision making. 

The theme for the launch, Afya Bora Mashinani: Accelerating universal health coverage through digitally empowered compensated Community Health Promoters, is well-aligned with Medic’s decade-long vision: a more just world in which health workers are supported as they provide care for their communities, where universal health coverage is a reality, and health is a secured human right – for everyone, everywhere, always.

As we approach the formal launch ceremony, we will be sharing additional stories celebrating our partnerships and progress that led to this milestone.