M-Jali - Our Story
Many factors influence health and well-being in a community, and many entities and individuals in the community have a role to play in responding to community health needs. Critical to this process are performance monitoring activities to ensure that appropriate steps are being taken by responsible parties and that those actions are having the intended impact on health in the community. In Kenya, a robust and well-thought out Community Health Strategy (CHS) prescribes an approach to ensure that Kenyan communities have the capacity and motivation to take up their essential role in health care delivery. The overall goal of this strategy is to enhance community access to health care in order to improve productivity and thus reduce poverty, hunger, and child and maternal deaths, as well as improve education performance across all the stages of the life cycle. This is being accomplished by establishing sustainable community level services aimed at promoting dignified livelihoods throughout the country through the decentralization paradigm. This strategy makes use of Community Health Workers (CHWs) on volunteer basis who ideally should be equipped with training, capacity and tools to spearhead health promotion and awareness activities at household level.
As part of the Community Health Strategy, a comprehensive monitoring and evaluation (M&E) approach is outlined as a continuum of observation, information gathering, analysis, documentation, supervision and assessment. The purpose is to keep activities on track towards goals and objectives and to support decision making. Effective M&E is envisioned to contribute to accountability on current activities (reporting and assessing impact) and help improve planning and implementation of future activities. This is collectively operationalized through a formalized Community Health Information System (CHIS), outlining specific indicators that CHWs must collect and observe on regular basis (monthly, quarterly, biannually and annually).
Consistency, accuracy, timeliness and completeness of data from community level has been the key impediment to the delivery of this strategy and the CHIS framework over the years of implementing CHS. The process has been largely manual, with a few disaggregated pilot initiatives to automate the process, most of which have not achieved scale and adoption. In view of this, Amref Health Africa in partnership with county governments in Kenya have developed an automated platform aimed at improving management of community data using mobile technology. Mobile Jamii Afya Link - M-Jali ("Jamii" is the Swahili word for Community and "Afya" is the Swahili word for Health) is an innovative platform that seeks to improve management of community health information incorporating a mobile application for capturing data from the household level and transmitting it online to a web-based database. Through this platform, community units have been able to cut the turn-around time for transmitting data from the point of collection to several points of use from several weeks to a few minutes. CHWs collect data on simple smart mobile devices during their regular household visits and remit this data to the platform, from where health care workers and health managers can view, retrieve, review and draw inferences to support decision making and planning at all levels of the health sector.
Between the years 2013 - 2016, during the implementation of one of the first devolution-aligned programmes by Amref Health Africa, a partnership was developed with the county government of Makueni (one of the 47 counties of Kenya) with the financial support from Comic Relief, UK , under which the M-Jali initiative was invented and piloted. Covering 350 CHWs, and a population of approximately 7,000 households, a successful pilot phase brought forth the adoption of the solution by existing projects in Amref Health Africa. Bungoma county in Kenya's Western region, under a DfID-funded Maternal New-born Improvement programme, Samburu county in Rift Valley through a Safaricom-funded Maternal, New-born and Child Health (MNCH) programme and Nairobi county through a Dutch Postcode Lottery funded programme adopted the solution to scale to 1,800 more CHWs, covering an additional 53,293 households with a population of 204,472. At the same time, demand to grow the solution in functionality and reach beyond CHIS data developed. In 2017, M-jali was positioned as a social enterprise innovation, offering community health data management as a service, envisioned to be adopted by governments and other implementing partners, running independent of grant-based funding.