In Côte d’Ivoire, the new SanteComCIV digital system is transforming community health, improving data quality, and helping to reduce child mortality.
Meet CHWs on the frontlines of care
Since 2018, Simon Pierre Gabo Gohou has cycled through the Kabehoa district of Gagnoa, south-central Côte d’Ivoire, caring for 60 households as a community health worker (CHW).
He describes his work as “very important because it helps improve the health of my community. What I love most is caring for the health of children and pregnant women.”
The job presents challenges—especially during planting season when families are harder to reach. But since August 2024, it has become easier to provide care to everyone thanks to a mobile app called SanteComCIV.
SanteComCIV: A digital companion for health workers
Built on the open-source Community Health Toolkit (CHT), the system helps CHWs monitor diseases, deliver the right medicines to sick children, track vaccinations, and follow up with patients.
“It’s a tool that allows us to keep track of everything we do,” Simon Pierre explains. “The application helps us collect and transfer all the data from our work. Everything is quicker with the application.”
Speed doesn’t just save time—it saves lives, too.
“Thanks to the application, the CHW can finally have a clear summary of everything that they did during the day: household visits, group meetings, and all health care activities related to malaria, pneumonia, diarrhea, and more,” continues Adou Alain Claude Ayorokon, a data analyst at the Ivorian Ministry of Health. They can also know exactly the correct dosage of medicines to give, which is very reassuring.”
For Amani Firmin Kouadio, a CHW in Bayota, the app changed his work and his home life. “It’s not just a regular phone—[the app] helps me perform my duties and provide better care,” he says.
“Before, my children used to get sick frequently, and we would go to the hospital almost every month. But since I started this work, it’s been two years, and I’ve only had to take them to the hospital once. It’s a huge improvement.”
Tackling child mortality with skilled care
Since October 2024, nearly 600,000 household members have been registered, including 103,980 children under five. Over 90,000 children were registered with up-to-date vaccinations, protecting them at a critical age.
“Ultimately, this system can help reduce child mortality, because it optimizes the intervention of CHWs,” explains Olivier Gnissan, Muso’s Digital Product Implementation Manager.
“Whether a child is suffering from malnutrition or severe malaria, the app provides clear treatment advice: ‘Don’t waste time, refer them,'” explains Elvis Paha, a computer systems and network engineer at the Ministry of Health. “This referral follows the official protocol, which specifies when a community health worker should direct someone to a healthcare facility.”
He was stunned by a conversation he had with a CHW, which brought home to him the impact of SanteComCIV. “For 17 years, he had never referred a patient. After two months of using [the app], he had referred two or three children. That really touched me, actually.”
“One experience that stands out is when parents thank me for helping their children recover,” says Amani Firmin. “It gives me great satisfaction. It’s challenging, but when you’re willing to do the work, nothing is impossible.”
Digitalizing community health in Côte d'Ivoire: How did we get here?
Muso, a global health organization dedicated to ending child and maternal mortality crises, has worked with Côte d’Ivoire’s government since 2019. Four years ago, they saw an opportunity for the Ministry of Health to digitalize their community health system.
“The most important thing was putting the Ministry at the center of the project,” explains Olivier. “Our aim was for the partners to play a supportive role, but the leadership remained with the government. That was one important factor.
“The second was the co-development process with Medic: genuine co-definition and co-design of workflows, spreadsheets, everything. From the beginning, when we set up committees and technical working groups, Muso relied on Medic as its technical partner and invited them to the Ministry’s table.”
Building together: Government, Muso, Save the Children and Medic
Sustaining open source systems like the CHT requires genuine partnership and collaboration was key for SanteComCIV’s development. Muso brought experience from previous implementations in Mali, the Ministry provided vision and authority, Save the Children brought material and logistical support, and Medic contributed technical expertise from our work in Kenya, Uganda, and Nepal.
“Together, this allowed us to create an application that is now being used effectively,” Olivier states, with Elvis agreeing: “This collaboration works very well.”
“Diversity is a great asset in collaborative work,” follows Seydou Traoré, Government Partnership Coordinator at Muso. “Expertise is varied, discussions are enriching, solutions are found quickly, and savings are achieved in terms of working time and human and financial resources.”
The Community Health Toolkit: The right choice for Cote d’Ivoire
When Muso introduced the Ministry to the Community Health Toolkit, the choice was clear.
“We needed a tool that responded to health workers’ needs, that would reduce errors and the use of paper, and that would guide community actors in their daily work,” Elvis explains. “And that’s exactly what SanteComCIV provides here in Côte d’Ivoire.”
“The Community Health Toolkit was presented to us and we saw it was the tool that best responded to our expectations, because instead of being just a collection tool, it was really a tool that guides the CHW in their work, with tests, with images, and with prompts that show more clearly what must be done.”
As an open-source system with no licence fees, the CHT also enables the Ministry to focus resources on training and capacity-building.
“With such a system, we can allow CHWs, who voluntarily want to help their community, to be much more empowered and up-to-date with various health protocols and programs,” says Olivier.
Why better data means better decisions
Paper-based reporting once limited the quality and timeliness of community health data.
“Since the data that was transmitted [before] didn’t match reality, often the response was delayed,” Elvis explains. “For example, when an epidemic was reported, by the time the Ministry was able to decide to take action, often the outbreak had already spread.”
“I think this application will really help bring out the gaps and show the real health needs of the people and that if we invest in this or that domain of health, it will reduce mortality.”
“What drove the state to want to digitize community health tools was really to optimize data quality,” Olivier continues. “With a tool like the CHT, it guides the CHW in using different protocols, which ensures high-quality data. And with optimized data quality, you can easily have dashboards for decision-making.”
Amani Firmin agrees: “I feel much more comfortable using the smartphone than paper. I often made mistakes in my reports, which made me uncomfortable. But with the phone, my work is easier and more accurate.”
Supervisors also benefit. Mamissiri Konaté, who started supervising CHWs in September 2024, says: “When you go into the community with the CHT, it allows you to see everything. If the CHW is correctly carrying out their activities, if they behave well in the community, the CHT allows you to see all of that which is something we didn’t really have the possibility to see before. I really like this application.”
Professional recognition for CHWs
Today, SanteComCIV is deployed in 53 out of 113 districts, with impact felt at every level of the health system. Over 7,700 CHWs are now supported and report feeling more respected and professional—a vital aspect in ensuring they can achieve their full potential as critical frontline health workers.
One CHW told Olivier: “Now I’m recognized in the village. Now when I go in front of patients and take out my phone with the app, people think ‘wow, what this man is doing now is so professional.’”
“What makes me proud is being the community health representative in my village,” Simon Pierre agrees.
It’s something Adou has also detected. “Today, the CHW is so enthusiastic. I am really proud of the work we have accomplished with this project. The application is efficient and makes the daily work as a community health worker much easier.”
“For me as a field worker who has been involved since the beginning in this initiative, it has been really, really valuable,” Elvis says. “When I see an opportunity that can benefit my country, I seize it. And, from experience, I saw the opportunity that SanteComCIV offered.”
For Olivier, the feedback makes all the hard work worth it: “For me, as someone who has been there since the start of the process, who often spent sleepless nights with Medic to produce the design of the application, when you hear such things, it goes straight to your heart.”