From the newsletter
Community Health Promoters (CHPs) use digital health tools to streamline data collection and health communication. While digital health tools have improved their work, Dr. Grace Miheso, a public health expert explains in an interview that CHPs are also key to solving two of the biggest challenges to implementing digital health in rural areas, digital literacy and trust.
“A CHP is, in most cases, the first point of contact for many households in rural areas. They are the familiar face people trust. This makes them central to digital health. They bring it to the doorstep and help families understand why it matters. Coupled with digital literacy, which they help with at local levels, they help build trust in the system.” Says Dr. Grace Miheso.
Digital health in many ways holds the key to getting healthcare ready for climate change in Africa. Dr. Miheso explains that CHPs need continuous training and a strong work support system to help implement digital health.
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Dr. Grace Miheso is a Public Health Expert with experience in social behaviour change and health system strengthening. She has trained and worked with CHPs on various health aspects: malaria control, maternal and child health, especially across Western Kenya and the Coast.
How do community health promoters support the implementation of digital health?
A community health promoter (CHP) is, in most cases, the first point of contact for many households, especially in rural areas. They are the familiar face people trust: the one who checks on a child’s vaccination, follows up on illnesses, helps distribute mosquito nets or supports expectant mothers. When families see a CHP using a phone or tablet to record information or check health details, it changes how they see technology. The CHP can easily explain why he or she is using the smartphone instead of the big, fat book as was previously used. It helps the community members to understand that data is what helps improve care. It also makes them more comfortable with digital tools because they are seeing them in use, right in their own homes.
CHPs are central to digital health. They bring it to the doorstep and help families understand why information matters. Coupled with digital literacy, which they help with at local levels, they help build trust in the system. Digital health however, has also made their work easier.
In the past, CHPs carried bulky paper registers filled with handwritten records. Each CHP looks after around 100 households, often spread far apart, and by the time you reached house number 60, you were still lugging that same heavy book around.
Digitisation has really changed that. It began with NGO programmes introducing basic phones and later tablets. Early apps simply copied what was in the books but in a simpler format, and with the right training, CHPs quickly adapted. Digital tools make it easier to collect and act on data. They allow health teams to track progress, spot gaps and respond faster. For example, during malaria mass net campaigns, CHPs could map households and register distributions digitally, giving real-time updates on coverage.
This kind of real-time reporting means decisions don’t have to wait weeks for data. It keeps the system responsive and brings digital health directly into people’s lives. But even with all this progress, the human connection still matters. When taking patient histories using electronic tools, for example, health workers might focus too much on their screens. Without that simple eyeball connection, they miss out on the much needed connection of health worker - patient interaction that builds trust and empathy in care.
What support do community health promoters need to enable digital health programmes?
To support digital health implementation, CHPs need good tools, training, proper remuneration and system support. Many of them work in areas with weak network coverage and long walking distances, so devices must be reliable and easy to charge. Phones often fall or run out of battery midway through their visits, so practical items like power banks and accessible charging solutions are essential. In some households the devices are shared. Without replacement systems, once a device is lost, broken or damaged, their ability to work digitally stops immediately.
Digital tools must also be simple and designed with the user in mind. A large number of CHPs are older, some with only primary education, so complicated apps discourage use. Some openly say the tools are too much for them. Regular training and supportive supervision help build confidence across all age groups and prevent older CHPs from being left behind. At the same time, supervision ensures they stay within their scope and do not become isolated in their work.
Motivation and financial support are equally important. Historically, CHPs relied on external programmes for small stipends, T-shirts, bags and transport reimbursement. The government’s move to provide a monthly stipend is a positive step, but it must be predictable and timely to sustain motivation and retention. Digital work cannot be pushed onto volunteers without corresponding investment in their welfare and supervision, otherwise the quality of services suffers.
Digital health requires long-term planning for maintenance and replacement. Blood pressure machines and phones given out previously are already failing in some areas, and without budgets for service and replacement, the investment is quickly lost. For digital health to succeed at the grassroots, the system must include continuous resourcing, replacement cycles, data and airtime support, and strong policy implementation. Community health workers are willing and capable, but they need sustained tools, simple technology, training, supervision, and consistent government commitment to truly anchor digital health at community level. This support system eventually translates to proper digital health sensitisation in communities and improved trust.
Do you think Africa is ready to integrate CHPs into digital health systems?
Africa is more than ready to integrate CHPs into digital health systems. We have already seen strong examples on the continent, not just in Kenya but also in countries like Ethiopia and Malawi. In fact, years ago while working at UNICEF, we supported the Kenyan government to visit Ethiopia because they were already far ahead. Their community health programme was so well established that they even had a dedicated college for CHPs. So this is not new for Africa, we have models and experience to learn from and many countries have already proven that it works.
What we now need is consistency and commitment. The direction is right. Kenya has rolled out digital tools, CHPs are being trained and digital health is a clear government strategy, but the success of this transition depends on sustained support. Policy exists, but policy alone does not deliver results; we need strong enforcement.
So yes, Africa is ready and we have been ready. The capacity is there and the community health workforce has already demonstrated dedication across challenging terrains and fragile contexts. The key now is to strengthen and sustain the systems around them.