Providing first mile healthcare in Diapé, Adzopé District- Côte d’Ivoire

Technological stewardship has been key in advancing different areas of our lives; from improving access to information, resources, and most importantly health. As we celebrate the gains made, we also recognize the need to continuously ensure that even the hardest to reach communities are equipped with the necessary skills that will improve their health and well-being. 

At Medic, we collaborate with many public and private partners, local governments and communities, and Ministries of Health to work toward nationally adopted electronic community health information systems (eCHIS) that increase efficiency for Community Health Workers (CHWs) providing doorstep care. In Mali, Medic has worked in deep collaboration with Muso since 2014 to support integrated community care workflows and health worker performance management. Medic and Muso partner on key innovation projects focused on equity and precision care such as app features to motivate CHWs towards achieving universal health coverage, supportive health worker supervision, and care coordination for malaria rapid diagnostic testing. 

Over the last year, we have expanded the footprint of our longstanding partnership as Muso extends its support to the Government in Côte d’Ivoire to transform its national health system and better serve the population of 26 million. In late 2019, Muso launched a technical assistance partnership with the Ministry of Health, embedding Muso human resources within the Department of Community Health to directly support the development and adoption of a national approach to dedicated CHW supervision.

Medic supported this initiative, in collaboration with Muso, by building and customizing an app to meet the needs of the Côte d’Ivoire context. The app provided dedicated instance support in operational sites while ensuring continuous support to all stakeholders through the capacity building phases. With this engagement, Muso assumed all technical custodianship of the app, led the deployment, and continued to iterate on the tools – emphasizing the pathway toward equitable and quality care for all.

Since the initial deployment in Diapé, Adzopé District, CHWs were up-trained on using the application and received training to bolster efficiency and equip them with the critical set of skills to easen their workload, but ensure that they reach more households. 

We are thrilled to highlight reactions and comments from CHWs below.

The application is very easy to use and serves as a guide on how to treat patients during home visits. When it is time to go on home visits, the application orients me to which household I should go to based on the last time I visited a household or on a patient that may need to be monitored more frequently due to their illness.

Brigitte – CHW (Diapé, Adzopé District)

The application makes my work very straightforward because it allows me to schedule my visits and sort through documents related to supervision. The questionnaire and protocol are already laid out and easy to navigate. The training I completed on the use of the app was also extremely useful – everything is detailed and this allows for efficient supervision.

Rostand – CHW Supervisor (Diapé, Adzopé District)

The application is very easy to use and serves as a guide on how to treat patients during home visits. As soon as I walk into a household, when I enter the information of the patient, the application walks me through the protocol. I take the patient’s temperature, if they are showing signs of malaria, the application automatically tells me to do the malaria test. If the test is positive, the application indicates the treatment and the doses, basically the course to follow.

Giselle – CHW (Diapé, Adzopé District)

The application facilitates my work because it shows me how to conduct treatment, which tools to use and which treatment to provide in which doses. Also, with home visits, I only have to input the households I visit once and it is saved automatically. From then on, the app can tell me how long it has been since I have visited a specific household and this helps track the amount of visits I make to a particular household during the month.

Claudia – CHW (Diapé, Adzopé District)

Upon the launch of this partnership, we were working with a team of 150 CHWs, with 10 currently active. We are looking to scale up in the next year and a half to reach a total of 424 CHWs in Mali and 351 Côte d’Ivoire. 

Medic and Muso are committed to expanding the reach of the CHT as a global public good, enabling governments to adopt low-cost, sustainable digital health solutions.. We celebrate our many years of close collaboration and this landmark achievement in Côte d’Ivoire. We remain committed to human- and user-centered design, sharing learnings and experiences with the wider community of practice, and advancing a vision of universal health coverage.

About Muso

To end the child and maternal mortality crises and deliver universal health coverage at scale, Muso collaborates with governments to design, test, and deploy community-based health systems that deliver care with speed: to all patients who need it, when they need it. Muso has partnered with the Malian government for more than a decade, developing a Rapid Care model based on Proactive Community Case Management (ProCCM) designed to cut across the key barriers that lead to delayed access to care. ProCCM is based on a simple premise: early access to already-proven tools can avert nearly all under-five child deaths. The model’s theory of change: rapid care = early care = lives saved.

Muso now cares for 415,000 patients across ten sites in peri-urban and rural Mali, and 7,000 patients in one test site in Côte d’IvoireIn Mali, Muso recently completed one of the world’s largest Randomized Controlled Trials (RCTs) in community health to rigorously assess our impact, and is supporting the government’s national strategy to deliver on access to care for the country’s 18 million citizens. The communities where Muso works in Mali have achieved a 10x increase in health care utilization and documented child mortality rates lower than any country in sub-Saharan Africa. On the basis of the impact documented, Muso is now working to drive forward a global transformation in universal health coverage, maternal health, and child survival.