Redefining what it means to support care

This post is co-authored by Helen Olsen, Senior Research Program Manager, and Isaac Holeman, Co-founder and Chief Research Officer at Medic

As software developers, researchers, project managers, designers, and global health practitioners, our work at Medic is about supporting care in communities. This is true whether we’re building tools for community health workers to better organize their daily tasks, or enabling patients to message providers for diagnostic screening and swift referral. The Community Health Toolkit (CHT) is increasingly adaptable to support a wide range of digital health interventions, which illustrates the power and potential of open source tools to further the reach of care for all. We’re on the path to proving that a global public good for community health can scale and positively impact millions of people’s lives.

Measuring care work – inclusively 

This trend has us thinking about how we might better measure the growth of the CHT community. We know that this growth is only possible because our community is becoming increasingly diverse – encompassing new geographic regions, new skill sets, and expanding needs. More organizations are building CHT apps, they’re prioritizing new kinds of healthcare services and identifying new ways to support care.

Our current cornerstone metric, ‘number of health workers supported’, is an important measure of our community’s size. Yet it doesn’t convey the remarkable growth we’ve observed in the total volume of caring activity as community health systems layer on new service areas and make new investments in supervision and support. While Medic continues to track a range of detailed benchmarks such as ‘facility-based delivery’ and ‘child health assessments,’ we’re recognizing that our community needs a more inclusive metric.

Since January 2014, the Medic team and the CHT have supported more than 50 million moments of care across the globe.

This evolution has made a single metric – caring activities – a better measure of all of the ways the CHT supports care today, and how we might support care in our next decade of work. From household screenings to individual child assessments to providing women with family planning services, caring activities encompass a diverse range of relationships of care supported and facilitated by the CHT.  

A health worker from Barefoot College provides care to a young patient at a PNC camp in India.

The work of care and caring is defined by relationships of mutual support and respect. Care, or a lack of it, is often a central facet of people’s lived experiences. At Medic, our expansive view of care takes inspiration from the work of feminist scholars, such as Professor Joan Tronto, who writes that an ethic of care “is an approach to personal, social, moral, and political life that starts from the reality that all human beings need and receive care and give care to others…We are always interdependent beings.” Providing care at the last mile would be impossible but for the deep, caring relationships that community health workers (CHWs) often establish with people in their communities. 

Over the last decade, we’ve contributed to a growing evidence base that speaks to how digital tools can support care in community health systems. We also believe that technology and data can help make care work visible, and that making care visible is essential to the process of advocating for care providers to be supported, protected with necessary equipment, and fairly compensated for their vital contributions.

Supporting care with a growing open source community

It’s equally important to recognize that software has its limits. Our technology could never capture or contain all of the myriad moments of care and expressions of humanity that happen day to day in community health systems. Perhaps this is as it should be. Our goal is more humble: to measure in a meaningful way whether and where our open source community is growing. When someone uses a CHT app to support a moment of care, we add the event to our global count of caring activities – a touchstone metric for understanding our organizational impact. In addition to health systems directly supported by Medic, we also gather data from health systems that have implemented their own CHT apps and that choose to share this important information with the global open source community. 

Joyanne, product owner at Medic, hosts a design feedback session with users at the Living Goods Innovation Network site in Kenya.

The introduction of caring activities as our new principal metric comes as we are celebrating a milestone: Since January 2014, the Medic team and the CHT have supported more than 50 million moments of care across the world. This milestone has been a valuable opportunity to reflect and challenge ourselves to redefine what it means to support care as members of an open source community.

Building tools for people who care means that we are part of the tech community, and part of a movement for healthcare for all. We couldn’t be more excited to see where this work takes Medic and the CHT community in the years ahead.