Community health workers struggling to use digital phones, apps – ministry

Community health practitioners are struggling with the digital technology they should use to collect and post people’s health data.

Nearly all of the 107,831 CHPs commissioned last year received mobile phones or tablets to help them collect and transfer health data from their communities.

The ministry said it distributed 110,000 tablets and smart phones equipped with the electronic Community Health Information System (eCHIS).

However, only 5,000 CHPs have been using the devices regularly to send health information.

“A recent pulse check on the Afya Nyumbani dashboards showed at times that numbers of CHP reporting on a daily basis are 5,000. The question begs why are the other 95,000 not reporting as expected,” Health PS Mary Muthoni said.

Her speech was read by Dr Simon Kibias, the ministry’s director of health standards and quality assurance, at a meeting to accelerate the digitising of CHPs.

The meeting was called by Living Goods, a non-profit that promotes digital tools, among community health workers. 

PS Muthoni said they finding ways are making efforts to close the digital divide gap among CHPs.

Part of that will be improving the numbers and capacity of supervisors. 

“So far, we have just about 34 per cent of the required number of supervisors. Is there room to reimagine our approach to supervision by leveraging digital tools? Our supervisors have not yet been equipped with digital devices,” she said.

The scope of work of a CHP includes basic preventive and promotive health, health education, basic first aid at the household level and referral for facility based healthcare.

Each health promoter is allocated 100 homes within their neighbourhood where they provide community health services.

The national government and 47 county governments pay stipends for the CHPs on a matching basis 50:50 with each worker getting a monthly stipend of Sh5,000.

The national government has allocated Sh3 billion for that this financial year, Muthoni said.

Despite the challenges, the Afya Nyumbani executive dashboard, where the CHPs post data, shows the CHPs have visited more than 2.69 million households, registering slightly above 4.4 million, and referring more than 137,000 diabetic and hypertensives cases for facility-based care.

 Tharaka Nithi Governor Muthomi Njuki, also head of health committee at the Council of Governors, said community health services need to be strengthened.

“This will be achieved through sustainable primary healthcare financing, sufficient human resource for health, improved service delivery, adequate provision of health products and technology, digital revolution through efficient and effective health information systems,” he said.

Muthomi complained they are sometimes unable to pay CHPs on time because of slow disbursement of funds by the National Treasury.

“There’s also slow development of the roll out of the digitisation of the health data systems by the MoH, lack of standards and guidelines for counties to align,” he said.

Living Goods CEO Liz Jarman admitted that scaling digital tools can be challenging.

“But the upside is worth it, and we will work hand in hand to overcome the challenges, share and embrace new learnings,” she said.

“With any digital system, there are always glitches and upgrades needed and we are excited about the improvements being developed and stronger supportive systems being put in place and as I say to my team – it will get messy and you have to feel comfortable with feeling uncomfortable but remember the upside.”

 Liz said the magic bullet is not the phone itself or the app on the phone, nor just access to diagnostics and treatments.

“But in ensuring all aspects of professionalising CHPs - the digital tools, the access to commodities and appropriate training, strong supervision and use of data to drive performance, and being paid adequately and on time,” she said.

Liz said Kisumu health indicators have improved and that the platform is being used to identify indigents as part of their Marwa (meaning 'ours' in Dholuo) health insurance.