Three years ago, CHT Community member Guild Digital made a decision that would fundamentally change how they think about refugees, technology, and healthcare.
In recognition of World Refugee Week 2025, Guild’s Brian Ssennoga shares their journey.
In the early morning light of Uganda’s Kyaka II refugee settlement, Sarah, a Village Health Team member, opens her smartphone and begins her rounds. She visits families, checks on pregnant mothers, follows up on children’s vaccinations, and updates health records—all through the rCHMIS app.
Sarah is one of over 2,000 refugee community health workers (CHWs) who have become the backbone of healthcare delivery for more than 800,000 fellow refugees across 13 settlements.
Three years ago, Guild Digital made a bold decision: we chose to bet on refugees as agents of change, not just beneficiaries. We adapted a proven digital public good—the Community Health Toolkit (CHT)—and placed it in the hands of volunteer CHWs. What began with 27 users has grown into a movement that reaches over 151,000 households and is now part of Uganda’s national health system.
This is the story of that journey.
Why We Chose Open-source Tools to Power Refugee-led Healthcare
As a small digital health company, we faced a choice: build from scratch, or upon existing foundations. We embraced the CHT, an open-source platform created by a group of leading organizations, including Medic, and used globally to support frontline health workers.
It’s been tested and refined across multiple countries and contexts, supporting health workers to improve health outcomes while reducing costs.
But this wasn’t just a strategic decision—it was philosophical. Digital public goods represent a belief that healthcare technology should be accessible, adaptable, and community-owned. Rather than creating solutions that kept refugees dependent, we wanted to build something they could ultimately own, manage, and improve themselves.
Our philosophy: what if refugees weren’t just recipients of healthcare but providers of it?
What if technology could harness their skills, languages, and cultural understanding to create a more effective and trusted healthcare system?
The Human Impact: Meet the Refugee Health Heroes
Behind our growth are human stories that remind us why technology must always serve humanity, not the other way around.
Amina, a former nurse in Nakivale settlement, was among the first volunteers. “In my country, I served my community through healthcare,” she explains. “Here, I can continue that service, but now I have tools that make me more effective than I ever was before.”
Amina now serves over 200 families, tracking everything from maternal health to childhood immunizations through her smartphone.
David, a young father in Kiryandongo, had no medical background but a deep desire to help his community. He trained through rCHMIS to identify danger signs in children and pregnant women, and how to use digital tools to coordinate care.
“The phone is like having a doctor with me,” he says. “It guides me through each visit, reminds me what to check, and helps me know when someone needs to go to the clinic immediately.”
What stands out is not their vulnerability, but their capability. They’re multilingual, culturally aware, and trusted in their community. They know what it means to flee, start over, and navigate complex systems with dignity and hope.
This is the power of representation in healthcare. The technology doesn’t replace this—it amplifies it. When Amina visits a pregnant woman, the app allows her to document concerns in the woman’s native language, schedule follow-up visits that respect cultural practices, and connect with other health workers with similar experiences.
The Technology Journey: Adapting Global Tools to Local Needs
Refugee settlements present unique technical constraints: limited connectivity, varying digital literacy, diverse linguistic needs, and complex health protocols.
We adapted the CHT to meet these challenges head-on.
We prioritized offline functionality so CHWs could continue their duties uninterrupted, regardless of network status, and sync data later. We developed a multilingual system allowing health workers to serve patients speaking dozens of different languages.
We also tailored clinical protocols to reflect the health needs of refugees—higher trauma rates, specific vaccination requirements, and the psychological impacts of displacement.
Our most significant achievement? Successfully integrating the entire rCHMIS platform with Uganda’s national electronic Community Health Information System (eCHIS). Refugee health workers now contribute data directly to national health planning and surveillance, ensuring their communities are represented in statistics and resource allocation.
Scale and Impact: The Numbers Tell a Story
The growth from 27 pilot users tells a story of trust, capability, and systematic change.
Across 13 refugee settlements, health workers serve more than 800,000 refugees from over 150,000 households. The health outcomes of refugee-led care, supported by digital tools, speak volumes:
- Childhood immunization rates rose by 34% over three years
- Full antenatal care coverage rose from 52% to 89%
- Emergency response times dropped by an average of 45 minutes—a potentially life-saving change
- Unnecessary visits to overcrowded health facilities decreased by 28%, refocusing limited resources on those most in need and improving care quality for everyone.
Lessons Learned: What Refugees Taught Us About Resilience and Innovation
We’ve learned powerful lessons from three years of building with refugee communities about the role of technology in addressing complex humanitarian challenges:
- Refugees are natural innovators. Forced to adapt and problem-solve, they’re exceptional at seeing opportunities for improvements that our technical team missed.
- The power of community ownership. Refugees developed training programs, created peer support networks, and even contributed to technical documentation—driving sustainability and dignity.
- Integration, not isolation, is key. When refugee health data flows into national systems, it drives genuine inclusion.
- The best technology is invisible. It supports and enhances what refugees already do well as healthcare providers, community, leaders, and solutions-creators. The best compliment our platform can receive is when people stop noticing it and start seeing the improved health outcomes it enables.
Looking Forward: The Promise of Refugee-Led Innovation
As we mark World Refugee Week 2025, the successful integration of rCHMIS into Uganda’s national health system demonstrates that with the right support and tools, refugees can become net contributors to host communities rather than burdens on existing systems.
The model we’ve developed is already attracting attention from other refugee-hosting countries. With discussions underway in Kenya, Tanzania, and Lebanon, we believe this approach—digital public goods, refugee-led implementation, and national integration can be replicated to transform refugee health systems globally.
In a time of increasing displacement, the lessons learned from refugee health workers in Uganda offer hope that technology can be a force for inclusion, dignity, and shared prosperity.
This is just the beginning. The next chapter is about scaling from 2,000 to 20,000, from one country to many, and from refugee health to refugee-led innovation across multiple sectors.
Because when we bet on refugees, everyone wins.