Women Supporting Women’s Access to Primary Health with Expanded Digitization and Data Use 

“I felt as though I would start every client visit asking the same question. And clients had to repeat their information, making up for the misplaced data,” says Sead Ismael, a health extension worker (HEW)at Bishanbe Health Post in Biyo Awale Woreda, Ethiopia.

Photo: Sead attends administrative business at the Bishanbe Health Post.

Health extension workers are an all-female cadre that ensure the health and safety of people—particularly women—in communities. In her role, Sead checks on pregnant and postpartum women and newborns and children. She counsels and treats patients, records their  health information, and offers follow-up and referral visits for those with more complex health issues.

The paper-based system that Ismail and other HEWs  across the country relied upon for years accumulated a lot of content that was hard to organize and recall, and few health extension workers could use data  in subsequent encounters. Some data were lost completely, limiting the ability of the Health Extension Program (HEP), which oversees community-based primary health care, to provide community- and patient-centric care.

Through JSI’s USAID-funded Digital Health Activity (DHA) and the Children’s Investment Fund Foundation (CIFF)-supported Ethiopia’s electronic community health information system (eCHIS)Scale-up for HEP Improvement Project, Ismael and many HEWs across the country received tablets and phased trainings on the  use of eCHIS. JSI also supportseCHIS scale-up by developing components of the applications’ modules and providing infrastructure and technical support.

Photo: Rural health post in Ethiopia.

It has been more than a year since Ismael started using eCHIS. “When we have a new client, we load information on the tablet. When we return to the office, there is no need for paperwork. We just sync our collected data in tablets to the server. It is also easy to report aggregated data. And when we go back to that same client, we can easily retrieve their medical history, onsite, and provide informed health counseling,” explains Ismael.

The eCHIS has strengthened data quality and use in health program decision-making. It has, notably,  facilitated technical exchanges across sites and districts, allowing users to adapt each other’s solutions to common challenges. “We now have correct household information in each kebele. eCHIS alleviates reporting burdens on health extension workers while ensuring no information is overlooked during client counseling and registration processes,” says Kidist Tekle Giyorgis, the health management information case team coordinator in Dire Dawa Administration Health Bureau.  

And when support from DHA ends, “we will continue using eCHIS in our health post. I cannot imagine going back to that old system,” says Ismael. “We are simply better serving women and children. ”

Similarly, JSI/DHA supports over 2500 health posts nationally and around 50 health posts currently provide fully paperless services using the eCHIS.

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