Over 15 years ago, Sarah became a CHW in a peri-urban community in Kampala, Uganda. Her role included registering households, delivering health education, and treating and referring sick children, while also providing care for pregnant women and facilitating referrals to health facilities for safe deliveries.

However, keeping medical records was challenging with paper tools. “We had to write notes during training but would sometimes forget the dosages for the different age groups. Retrieving information from those papers was not easy,” she said. In Kenya’s Kisumu County, for instance, frequent shortages of the paper-based tools for their 3,000 CHWs and 119 community health assistants caused problems during data collection.

“By month-end, we would be in cat and mouse games. The supervisors would be looking for reports and the CHWs would not have them,” explained Maureen Opiyo, Kisumu County’s Community Health Services Coordinator.

“In case of shortages, CHWs would often resort to recording patient data on random papers or books, which would be misplaced or mishandled,” she added. More so, CHWs would often forget their tasks.

To address these challenges, governments— including Kenya, Uganda, and Burkina Faso— are investing in digitizing their community health systems.

Living Goods, partnering with these governments, bridges the gap between community health programs, digital systems, and CHWs, significantly improving the delivery of quality health services at the last mile.

“With timely data, we are better placed to make informed decisions. We can tell the areas that need our immediate attention, including health outreaches, and identify indigents and the interventions to provide,” said Ruth Ojuka, the Nyando Sub-County (Kisumu) Community

Health Focal person. Since Living Goods began operations in Kisumu, most key performance indicators have improved by 30%.

Living Goods has strong in-house digital capabilities, being one of the first organizations to provide smartphones at scale to CHWs on the African continent in 2014. We collaborated with Medic, the steward of the Community Health Toolkit (CHT), to design the first mobile app on the open-source platform.

Living Goods can independently design, develop, and implement digital solutions at scale in low-resource settings working alongside platform providers like Dimagi, Medic, and Ona.

Our vast experience built up over the decade in deploying digital tools at scale and using data to optimize CHW performance, improve quality of care, and strengthen health systems is unique and has proven impact.

Preliminary results from an external randomized controlled trial of our work in Uganda found at least a 28% reduction in under-5 child mortality. In 2021 when the Kenyan Government embarked on its digitization of community health following the successful pilot in Kisumu which Living Goods partnered with the County to implement, it based on Living Goods’ app to design its national eCHIS, which is now being scaled to all 107,000 CHWs nationally.

We worked with Medic on the prototype and together with the CHU4UHC coalition are supporting the MoH to implement their community health strategy. In Uganda, the MoH selected Living Goods to lead the rollout of eCHIS in select districts in 2023, and we continue to provide technical support as the country scales these efforts.

We also believe that different technology is best suited for different contexts and can identify the right product for a user’s needs and support them to develop customized solutions. For example, whilst our app in Uganda and Kenya is built on the CHT platform, we supported Burkina Faso’s government in adopting CommCare as their digital platform in partnership with Dimagi.

“Our expertise extends beyond technology; we advocate for CHWs to receive full support, including supervision, training, supplies, and fair pay,” says Emilie Chambert, Living Goods’ Chief Programme Officer.

Living Goods also advocates for CHW inclusion in national policies and budgets and supports governments in the analysis of their digital landscapes, strategy development and costing, and implementation planning and evaluation of programs.

“We are thrilled to see the progress governments in all three countries we work in are making toward digitizing their community health systems,” emphasizes Liz Jarman, Living Goods’ CEO. “We will continue to partner with them to co-finance and co-implement digitized and professionalized community health programs that include all DESC elements because we know what a difference this makes in the lives of the CHWs and the communities they serve.”

In the case of Sarah, digitization has transformed her work. “So much changed when we started using the phones. We are always sure of the dosages we give to children, and even the communities we serve appreciate the standardization of care.”