ArticleJMIR medical informatics2023
The Journey of Zanzibar's Digitally Enabled Community Health Program to National Scale: Implementation Report.
Article in JMIR medical informatics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The mHealth clinical decision-making tools for maternal and perinatal health care in Sub-Saharan Africa: A systematic review.PloS one · 2025Pooled it
- Enhancing Efficiency and User Experience of Digital Community Health Worker Payments in Zanzibar: Implementation Report.JMIR medical informatics · 2025Article
- Sustainability of health system strengthening interventions implemented at primary healthcare level: a scoping review.BMJ open · 2025Article
- Implementation of WHO SMART Guidelines-Digital Adaptation Kits in Pathfinder Countries in Africa: Processes and Early Lessons Learned.JMIR medical informatics · 2025Article
- Perceived effectiveness and recommendations from a childbirth quality assurance and improvement programme in India's private sector: a qualitative evaluation using the RE-AIM framework.BMJ public health · 2025Article
- iCHECK-DH: Guidelines and Checklist for the Reporting on Digital Health Implementations.Journal of medical Internet research · 2023Article
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9 authors.
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Abstract
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.
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