Supporting localization to digitize Kenya’s community-based surveillance

June 13, 2023 by Tara Newton

Kenya-based Brink Innovation is creating tools for early detection of potential outbreaks, such as COVID-19, Ebola, and polio.

Brink Innovation holds a co-creation workshop in Mombasa, Kenya. Photo: Brink Innovation.

Brink Innovation holds a co-creation workshop in Mombasa, Kenya. Photo: Brink Innovation.

PATH’s Digital Health Ecosystem project awarded four Africa-based digital health organizations with funding to expand and adapt their offerings to benefit community health and explore sustainable business models. This is the first article in a series that highlights the different phases of the project, including the application process, assessments, Community Health Toolkit (CHT) onboarding, and business outcomes.

Digital health innovations are often most effective and sustainable when they center country leadership, sovereignty, and choice. PATH seeks to advance localized digital health innovations like these by supporting local digital health entrepreneurs, establishing country and regional hubs, expanding the ecosystem of choice, and supporting sustainable digital health markets.

PATH’s Digital Health Ecosystem (DHE) project, funded by Bayer Foundation and in partnership with Medic, puts this concept into action.

A unique opportunity for innovation

Kenya’s integrated disease surveillance and response system is largely facility based. These systems often don’t capture data and information at the community level, missing many opportunities to improve disease surveillance and reporting. Community health workers have access to a wealth of community-level information that, if reported to health care facilities at the primary level, could be used for immediate action. However, right now, many lack the digital tools to do it.

Brink Innovation, one of four DHE project grantees, is a Nairobi-based design and consulting firm. During the COVID-19 pandemic, Brink Innovation recognized that manual surveillance systems could not keep pace with the spread of disease. To address this, they developed RADA (a local saying meaning “what’s happening”), a digital COVID-19 community surveillance system in Kenya.

RADA is designed to support community health workers and disease surveillance officers and to quickly detect clinical symptoms to signal COVID-19 outbreaks or emerging clusters in their communities. Brink Innovation designed the system to be augmented by analysis of chatter or other unstructured data, such as texts from the public, media reports, stories, social media, and websites.

However, the RADA system was never deployed because the Ministry of Health ended up moving forward with a community event-based surveillance system, which will be actualized through a unified national Electronic Community Health Information System (eCHIS).

The eCHIS will integrate community health into the broader health information system while addressing challenges related to information availability, quality, acceptability, utilization, cost, and accountability (including for the disease surveillance program).

This grant under the DHE project offered a compelling chance for Brink Innovation to leverage Medic’s Community Health Toolkit (CHT) to expand the scope and functionality of community event-based surveillance to all priority disease areas.

As Kenyans, we have a good understanding of the landscape, including the gaps, and how digital tools can help. Any chance to be part of the team that builds the tools that helps our health system is compelling.
— Michael Owigar, Brink Innovation

For Brink Innovation, this is their first capacity-building grant and not typical for their work, which mostly includes designing products, services, campaigns, environments, and digital experiences. However, the localization aspect resonated with them, and they approached the application process by highlighting their strengths and displaying their passion to build an appropriate, sustainable, and scalable solution that will be used at the community level.

The Brink Innovation team is looking forward to applying their expertise as they align with a national program and contribute to the development of the community event-based surveillance system thanks to this grant.

To implement the project, Brink Innovation will design and build community-based surveillance workflows using the CHT Framework. The tool will be designed to support community health workers to collect and report unusual health risks and diseases at the community level. The Brink Innovation team will integrate the CHT surveillance tool with DHIS2 to ensure timely transmission and availability of quality surveillance data for better disease prevention and to support health care workers to make informed decisions.

As a potential next step, the team would like to explore if machine learning and natural language processing could be integrated into the surveillance tool, to offer a precision health model that would be able to identify potential outbreaks early, including emerging diseases.

“We see the opportunity that digital tools can provide for health in Africa. The spirit of this grant is bigger than our vision. It is going to improve and impact the way health can be scaled and the government can make decisions.”
— Beatrice Wango, Brink Innovation

Looking ahead

As Brink Innovation gets started by onboarding onto the CHT, they are piloting a novel approach to work with developers to ensure they maintain a healthy pipeline of talent, since developer retention is a concern in the global health technology space.

“We are keen to see continuous availability of talent and are looking to train junior developers who expressed interest in building on the CHT as partners who we can deploy as needed.”
— Michael Owigar, Brink Innovation

Through this model, Brink Innovation has been able to increase the number of developers currently finalizing CHT technical onboarding from 3 to15. Brink Innovation plans to document the learnings from this model and reiterate that innovation is not just part of their name, but at the heart of what they do.

Stay tuned for the next article in this series, where we will highlight other entrepreneurs and the next phase of the Digital Health Ecosystem project.