The Journey of Zanzibar’s Digitally Enabled Community Health Program to National Scale: Implementation Report
BackgroundWhile high-quality primary health care services can meet 80%-90% of health needs over a person’s lifetime, this potential is severely hindered in many low-resource countries by a constrained health care system. There is a growing consensus that effectively designed,...
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| Format: | Article |
| Language: | English |
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JMIR Publications
2023-10-01
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| Series: | JMIR Medical Informatics |
| Online Access: | https://medinform.jmir.org/2023/1/e48097 |
| _version_ | 1797663150978367488 |
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| author | Erica Layer Salim Slim Issa Mussa Abdul-Wahid Al-Mafazy Giulia V R Besana Mwinyi Msellem Isabel Fulcher Heiko Hornung Riccardo Lampariello |
| author_facet | Erica Layer Salim Slim Issa Mussa Abdul-Wahid Al-Mafazy Giulia V R Besana Mwinyi Msellem Isabel Fulcher Heiko Hornung Riccardo Lampariello |
| author_sort | Erica Layer |
| collection | DOAJ |
| description |
BackgroundWhile high-quality primary health care services can meet 80%-90% of health needs over a person’s lifetime, this potential is severely hindered in many low-resource countries by a constrained health care system. There is a growing consensus that effectively designed, resourced, and managed community health worker programs are a critical component of a well-functioning primary health system, and digital technology is recognized as an important enabler of health systems transformation.
ObjectiveIn this implementation report, we describe the design and rollout of Zanzibar’s national, digitally enabled community health program–Jamii ni Afya.
MethodsSince 2010, D-tree International has partnered with the Ministry of Health Zanzibar to pilot and generate evidence for a digitally enabled community health program, which was formally adopted and scaled nationally by the government in 2018. Community health workers use a mobile app that guides service delivery and data collection for home-based health services, resulting in comprehensive service delivery, access to real-time data, efficient management of resources, and continuous quality improvement.
ResultsThe Zanzibar government has documented increases in the delivery of health facilities among pregnant women and reductions in stunting among children younger than 5 years since the community health program has scaled. Key success factors included starting with the health challenge and local context rather than the technology, usage of data for decision-making, and extensive collaboration with local and global partners and funders. Lessons learned include the significant time it takes to scale and institutionalize a digital health systems innovation due to the time to generate evidence, change opinions, and build capacity.
ConclusionsJamii ni Afya represents one of the world’s first examples of a nationally scaled digitally enabled community health program. This implementation report outlines key successes and lessons learned, which may have applicability to other governments and partners working to sustainably strengthen primary health systems. |
| first_indexed | 2024-03-11T19:10:28Z |
| format | Article |
| id | doaj.art-acc298eaa08d4afbb0d78b6d00debff6 |
| institution | Directory Open Access Journal |
| issn | 2291-9694 |
| language | English |
| last_indexed | 2024-03-11T19:10:28Z |
| publishDate | 2023-10-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Medical Informatics |
| spelling | doaj.art-acc298eaa08d4afbb0d78b6d00debff62023-10-09T20:09:04ZengJMIR PublicationsJMIR Medical Informatics2291-96942023-10-0111e4809710.2196/48097The Journey of Zanzibar’s Digitally Enabled Community Health Program to National Scale: Implementation ReportErica Layerhttps://orcid.org/0000-0001-6582-1959Salim Slimhttps://orcid.org/0009-0001-5068-8419Issa Mussahttps://orcid.org/0009-0002-6337-3915Abdul-Wahid Al-Mafazyhttps://orcid.org/0000-0002-1251-4741Giulia V R Besanahttps://orcid.org/0009-0005-0443-9875Mwinyi Msellemhttps://orcid.org/0000-0002-1600-5733Isabel Fulcherhttps://orcid.org/0000-0002-1209-824XHeiko Hornunghttps://orcid.org/0000-0002-4248-2744Riccardo Lampariellohttps://orcid.org/0000-0002-3765-0213 BackgroundWhile high-quality primary health care services can meet 80%-90% of health needs over a person’s lifetime, this potential is severely hindered in many low-resource countries by a constrained health care system. There is a growing consensus that effectively designed, resourced, and managed community health worker programs are a critical component of a well-functioning primary health system, and digital technology is recognized as an important enabler of health systems transformation. ObjectiveIn this implementation report, we describe the design and rollout of Zanzibar’s national, digitally enabled community health program–Jamii ni Afya. MethodsSince 2010, D-tree International has partnered with the Ministry of Health Zanzibar to pilot and generate evidence for a digitally enabled community health program, which was formally adopted and scaled nationally by the government in 2018. Community health workers use a mobile app that guides service delivery and data collection for home-based health services, resulting in comprehensive service delivery, access to real-time data, efficient management of resources, and continuous quality improvement. ResultsThe Zanzibar government has documented increases in the delivery of health facilities among pregnant women and reductions in stunting among children younger than 5 years since the community health program has scaled. Key success factors included starting with the health challenge and local context rather than the technology, usage of data for decision-making, and extensive collaboration with local and global partners and funders. Lessons learned include the significant time it takes to scale and institutionalize a digital health systems innovation due to the time to generate evidence, change opinions, and build capacity. ConclusionsJamii ni Afya represents one of the world’s first examples of a nationally scaled digitally enabled community health program. This implementation report outlines key successes and lessons learned, which may have applicability to other governments and partners working to sustainably strengthen primary health systems.https://medinform.jmir.org/2023/1/e48097 |
| spellingShingle | Erica Layer Salim Slim Issa Mussa Abdul-Wahid Al-Mafazy Giulia V R Besana Mwinyi Msellem Isabel Fulcher Heiko Hornung Riccardo Lampariello The Journey of Zanzibar’s Digitally Enabled Community Health Program to National Scale: Implementation Report JMIR Medical Informatics |
| title | The Journey of Zanzibar’s Digitally Enabled Community Health Program to National Scale: Implementation Report |
| title_full | The Journey of Zanzibar’s Digitally Enabled Community Health Program to National Scale: Implementation Report |
| title_fullStr | The Journey of Zanzibar’s Digitally Enabled Community Health Program to National Scale: Implementation Report |
| title_full_unstemmed | The Journey of Zanzibar’s Digitally Enabled Community Health Program to National Scale: Implementation Report |
| title_short | The Journey of Zanzibar’s Digitally Enabled Community Health Program to National Scale: Implementation Report |
| title_sort | journey of zanzibar s digitally enabled community health program to national scale implementation report |
| url | https://medinform.jmir.org/2023/1/e48097 |
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