From paper to digital: Reinventing Zambia’s community health care efficiency

During her first training session, Agness felt uncertain. “At first, I was unsure if I could transition from paper to digital reporting. But after seeing how easy it was to register households, record health visits, and track services, I knew this was the future of health care.”

The results were clear. Reports that once took days or weeks to compile now appeared in seconds. Data that once sat in paper files, inaccessible to decision-makers, became instantly available across the health care system. Children who had missed vaccines could now be quickly identified and reached—something impossible with paper registers, which often remained unprocessed in facility offices.

“Now, I can instantly see which children have missed their vaccines and follow up with their parents,” Agness explains. “This means fewer children falling through the cracks.”

Under the relentless Zambian sun, Agness Kahale treks along dusty and sandy paths that wind through Siakasipa Village in Kazungula District. With purpose in her stride and a smartphone in hand, she registers families, records vaccinations, and tracks maternal health visits in real time. Yet, the device she holds signifies more than technological progress—it embodies a health care revolution in one of Zambia’s most challenging regions.

As a community health assistant in Southern Province’s largest district—spanning 18,056 square kilometers of scattered settlements and difficult terrain—Agness’s current toolkit stands in stark contrast to her past. Just months ago, these same journeys looked dramatically different.

With CHIP, the difference is immediate access to information for decision-making. When a mother brings her child to a clinic, health workers can view her vaccination history on the spot. When planning outreach campaigns, community health workers can immediately identify which communities have the lowest coverage rates. And when vaccines run low, the system alerts health officials before stockouts occur, preventing the disappointing moments when families walk miles only to find no vaccines available.

Moreover, with CHIP, health workers can track not just vaccines, but also HIV services, TB treatment follow-ups, COVID-19 responses, and even cases of violence against women—creating a complete safety net where before there were dangerous gaps.

The success stories echo throughout the district. Lewanika Melissa, an environmental health technician at Agness’s facility, no longer drowns in paperwork: “Before CHIP, I had to manually count and verify reports. Now, I can generate head counts with a click of a button. It has saved me so much time and effort.”

For Kwibisa Ruth, a community based volunteer working with Agness, the platform has rekindled her passion for community health work: “CHIP makes data collection easy, reliable, and accessible. It has motivated us to be more engaged in community health care.”

Digital literacy has grown among community health volunteers. Mirriam Moonga, a community-based volunteer from Agness’s facility, shares her journey: “Prior to CHIP, I had no idea how to use a smartphone. I was afraid to even touch one. But through CHIP training, I have learned how to navigate digital forms, enter data, and access real-time information. Now, I feel more confident in my role and see the power of technology in improving health care.”

What began as a targeted intervention has grown into a nationwide effort with remarkable reach. Through strategic partnerships between PATH and global agencies like UNICEF, CHIP has expanded beyond initial project sites to an additional 25 health facilities. More importantly, over 700 community health workers, facility staff, and government officials have been trained across districts, from provincial to national level.

These partnerships exemplify PATH’s approach—bringing together government leadership, international expertise, and community engagement to build systems that thrive independently. This aligns with multiple Sustainable Development Goals (SDGs): advancing universal health coverage (SDG 3), strengthening digital infrastructure (SDG 9), and fostering global partnerships (SDG 17).

Plans are now in place to connect CHIP with national health systems like SmartCare and the DHIS2 health information management system, creating a seamless flow of health data from communities to facilities and eventually the national level—showcasing how CHIP was built from the start to be interoperable with other digital health systems.

The implications of these integrations could be profound. When fully implemented, policymakers will be able to allocate resources based on real-time needs rather than outdated surveys. Disease outbreaks can be detected and contained faster. And most importantly, children like those in Agness’s community won’t miss lifesaving vaccines simply because of paperwork failures.

If the system were to fail today, the consequences would ripple through communities across Zambia. Health workers like Agness would be thrust back into the world of missing papers and guesswork. Vaccination rates would likely decline as follow-up visits fall through the cracks. The trust that’s been built—when families see health workers arrive at their doorstep knowing exactly which services their children need—would erode. Most critically, the data collected thus far represent not just numbers but a map of community health needs that would suddenly go dark, leaving health care workers again operating with blinders on.

Yet despite the evidence of successful digital technology, thousands of health workers across Zambia still use paper-based community health systems. Every day without digital tools means more missed vaccines, more mothers without prenatal care, and more preventable health problems.

Organizations like PATH show how strategic investments in digital health create meaningful returns—not just in better health outcomes but also in building health care systems that can respond to emerging challenges.

For Agness, the change is real. As she walks through Siakasipa Village with her smartphone, she carries more than just a digital tool—she carries the promise of health care that reaches everyone.

And under that same relentless Zambian sun where she once trudged with tattered paper registers, she now moves with purpose, ready to register families, record vaccinations, and track health progress in real-time—knowing that each tap on her screen bridges the gap between what health care in rural Zambia was and what it can become.