Nairobi – After five days of walking door-to-door, visiting churches and attending community gatherings, Margaret Khasiala finally gets to rest in her home in Chekalani, Western Kenya. She is one of 4,250 community health promoters who worked to ensure up to 13 million children across Kenya received medicines to combat neglected tropical diseases. 

Margaret was also one of 110 community health promoters piloting a new digital system. Using her phone, she recorded the details of every child she gave medicines to. The data could be seen immediately at national level, making the data collecting process faster than traditional handwritten records.

This marks the first time Kenya has used a digital system for a mass public health campaign, a bold step forward in a country where health initiatives of this scale have long relied on manual data collection.

THE BURDEN OF NEGLECTED TROPICAL DISEASES

While Kenya successfully eradicated Guinea Worm Disease in 2018 and is on track to eliminate Lymphatic Filariasis by 2027, at least 25 million Kenyans remain at risk from neglected tropical diseases. For children, these diseases often hinder school attendance and academic performance, while adults experience reduced work productivity and social stigma.

To curb the prevalence of these diseases, on the 13th of December 2024, Kenya launched a 5-day mass drug administration campaign targeting 13 million children aged 1 to 15 years in the Western, Nyanza, and Coastal regions of Kenya — areas with the highest neglected tropical disease prevalence. 

“Addressing neglected tropical diseases not only saves lives but also unlocks economic opportunities” said Cabinet Secretary for Health, Dr. Deborah Barasa during the launch of the campaign. 

WHO supported the Ministry of Health to train over 800 healthcare workers across 20 counties, donating $1.6 million worth of medicines, provided support supervision, and advocated for government ownership and investment in neglected tropical disease elimination.

“We believe investing in neglected tropical disease elimination will give us the best returns because it reduces poverty, while allowing people to live dignified and productive lives,” said Georgina Bonet Arroyo of WHO.

CHALLENGES OF HAND-WRITTEN RECORDS

While mass drug administrations are an effective strategy for combating neglected tropical diseases in Kenya, their large-scale implementation presents a major challenge—efficient data collection.

To track the number of children reached during these campaigns, community health promoters like Margaret traditionally record household visits by hand, noting details such as children’s names, ages, administered medicines, and any refusals.

With each promoter visiting up to 800 children daily, these handwritten records are then submitted to local health facilities, where the data is compiled and forwarded up the chain—from the sub-county to the county, and eventually to the national level. This labour-intensive process requires manually counting millions of records to assess the campaign’s overall impact.

This system slows down data collection and often takes weeks before information reaches decision-makers. The process is not only time-consuming but also prone to errors. Without real-time visibility, organizers struggle to address challenges as they arise. For instance, if certain areas experience low coverage or high refusal rates, these issues may go unnoticed until it is too late to take corrective action. Additionally, accessing handwritten records for follow-ups or long-term evaluations remains cumbersome, making it difficult to measure the true impact of the campaign.

THE DIGITAL PILOT: A STEP FORWARD

Recognizing the limitations of manual data collection, Kenya’s Ministry of Health, with support from WHO, Clinton Health Access Initiative, and funding from the Gates Foundation, piloted a new digital data collection system.

The pilot took place during the recent mass drug administration campaign and involved 110 community health promoters from two areas in Kakamega County—Chekalani and Bunyala Central.

Using their mobile phones, these health workers logged every child they administered medicine to, as well as any refusals or adverse reactions. 

“The ability to see live results from these two areas was a game-changer,” said Eric Maira from WHO. “It allowed us to monitor progress during the campaign and respond immediately to challenges.”

For the individuals who took part in the pilot, this data was instantly uploaded to a centralized database, allowing health officials — both locally and nationally — to access live campaign updates.

For participants like Margaret, the app simplified their work. Without the burden of carrying registers or worrying about errors in transcription, they could focus on reaching more children.

The WHO supported the Ministry of Health in the design, development, testing, and piloting of the new system, as well as conducting trainings with the 110 community health promoters on how to use it. 

Since the digital tool was designed as a new feature within the Electronic Community Health Information System (eCHIS)—an app they already used—health promoters had some familiarity with it, making it easier to adopt. 

With 90% coverage achieved, the recent mass drug administration campaign met WHO’s target for effectiveness, pushing Kenya closer toward its goal of eliminating neglected tropical diseases by 2030. Additionally, the 110 community health promoters using the digital tool expressed optimism about incorporating it into other large-scale health campaigns, such as polio vaccination campaigns.

By improving efficiency, accuracy, and real-time monitoring, Kenya is setting a new standard for public health campaigns in Africa.

As for Margaret and thousands of other health promoters, the campaign may be over, but its impact has just begun.