In just three months, over 1,000 community health workers have started using Togo’s new digital health app. In this Q&A, those closest to its creation reveal the app’s real-world impact on healthcare access and delivery.
Last year, Togo’s government selected Medic to design SanteComTogo, a national electronic Community Health Information System. What has happened since?
Louis: As a Service Designer, I was responsible for studying user needs, to design a user journey that exactly meets their expectations.
During deployment, I collected users’ first impressions and feedback to improve the application. They all expressed their joy at having an application that makes their work easier. Before, they had big ledgers to record all of their activities that they couldn’t take everywhere, but now with a single smartphone they can quickly go and do their interventions and help the community.
Mouhamadou: The app was launched in March 2024, with a pilot phase in the Maritime Region. It was a significant step towards improving access to healthcare in Togo. Currently, the application is used by over 1,000 community health workers across six districts in the pilot region. My role as the Project Manager involves coordinating all stages of the project, from the design to the deployment of the application, ensuring the quality of deliverables through testing and iterations.
What are the main health challenges that Togo’s Ministry of Health is trying to address with SanteComTogo?
Mouhamadou: Through this tool, Togo aims to tackle the challenge of universal access to healthcare and to digitalize community health. Previously, community health workers relied on paper for patient management, but with this technology, they can optimize their time while caring for communities.
The data collected through SanteComTogo is more reliable and can assist public health officials in Togo with decision-making.
In September, you went to Lomé to meet with the community health workers, or CHWs, who use SanteComTogo. What prompted this?
Mouhamadou: Typically, about four weeks after launching an application, we conduct acceptance tests with users to collect their feedback and make improvements. This is crucial for several reasons: it means we can evaluate the application’s adoption and use, measure its impact in the field, identify unmet needs, and strengthen our relationship with users.
Louis: We are constantly striving for improvement. We saw that three months after the deployment, the community health workers had enough time to familiarize themselves with the application and give us their feedback.
How did you approach it?
Louis: We had three objectives:
- Directly observe community health workers in the field, using the application
- Hold group discussions to give everyone the opportunity to express themselves
- Hold individual interviews with some CHWs to compare with the data we received and better understand their habits.
Why is it important to meet with the people who use the technology?
Mouhamadou: Meeting the end users of the application is a critical step in product design and improvement. It helps us to understand the actual needs of users, as they may struggle to express them. Their feedback was invaluable, allowing us to identify the application’s strengths and weaknesses, improve user experience, and build trust with them.
Louis: They are the only ones who can really tell us if the product meets their expectations. They are the ones who can confirm all our hypotheses.
So the big question: What did they say?
Mouhamadou: The community health workers reported that the application assists them in several ways, such as reminding them of households to visit through scheduled tasks triggered by their daily activities. The application has also improved care activities by ensuring that no steps are skipped, meaning the data collected is of a higher quality.
Kwami Assilete Abel Atossou, the regional health supervisor we met in the Vo district, shared valuable insights about SanteComTogo, stating that the application helps in patient care and referral to health centers for those requiring follow-up.
Louis: I can say that the biggest change is in how it streamlines their work. Their tasks have now become simpler, faster, and more reliable. Sonia Anago, a community health worker, told us ‘Today the work is so simplified that I can register over 100 households a month.’ Her words proved to us the power of digitalization and the impact of the CHT on community health workers.
And what happens now?
Louis: The next step is to take into account the comments and feedback from the community health workers to improve the application, and also to provide new features to meet new needs.
Mouhamadou: We will also finalize additional packages requested by the Ministry of Health, such as community-based epidemiological surveillance and HIV, as well as expand the application’s use nationally, and conduct follow-up and evaluation.
What was your takeaway from this trip?
Mouhamadou: We felt a sense of satisfaction, as the feedback collected indicated that users are engaged and that the application has a real impact on communities in Togo.
It allowed us to validate certain hypotheses, identify the real needs of users in the field, and resolve issues. Many CHWs faced challenges with data syncing, but after the trip, we noticed a significant increase in data on the dashboards. We also valued the meaningful exchanges with community health workers, which highlighted how instrumental they are to the project’s success.
Louis: What I liked most was seeing the CHWs’ rapid mastery of the application in such a short space of time. It showed us that the application is user-friendly.
I felt both reassured and responsible. Reassured, because I saw the positive result of our work for these people. I am excited by the fact that the CHT is an accessible solution that solves real health problems. Responsible, because I am also aware that there are many things to do to bring health to everyone in all the villages. The road remains long but the results show that it is possible.
Manchallah bro excellent job