Partnering for Innovation: Reaching Communities in Mali Through Digital Health Initiatives

11 February 2022

Monitoring the spread of COVID-19 in communities can be challenging. Lockdowns and restrictions mean that fewer people can access health facilities, and fear of contagion can discourage people from seeking out health care even if they have symptoms. In this context, the only way to ensure access to health care is for health workers to go into the communities themselves – to provide health information, and to identify patients showing symptoms of COVID-19 and other diseases and refer them for testing and treatment.

Collaborative engagement with the private sector has produced innovative tools to support health workers to detect and trace cases of COVID-19 and prevent the virus from spreading. In Mali, a digital app called MaliKaKeneya is supporting community health workers to find patients who may have COVID-19 and refer them to get tested and treated. The app is powered by the Community Health Toolkit platform developed by Medic, a nonprofit organization that creates open-source digital tools to help community health workers provide timely, equitable and accessible care.

In September 2020, under the leadership of Mali’s Department of Health and Social Development, a partnership between the Global Fund, the Clinton Health Access Initiative (CHAI), and implementing health partner Muso launched a project to respond to COVID-19 using the MaliKaKeneya app across six communes of Bamako. As a principal partner, the Global Fund supported the recruitment and training of community health workers in Bamako, and provided them with personal protective equipment (PPE) and mobile phones to use the app.

The app works on mobile phones and tablets and can be updated offline when there is limited cellular service. The app provides a protocol for identifying COVID-19 symptoms, guiding community health workers to screen for the virus. As symptoms such as fever and cough can also be a sign of malaria or TB, community health workers can also screen for these diseases at the same time. Using the app, community health workers can log in and see the list of households in their community and follow the screening protocol to refer potential patients for testing. In this way, community health workers can provide the first line of care at people’s doorsteps and break the chain of local disease transmission. The app also provides training for community health workers, which is particularly important during a pandemic where face-to-face interaction is restricted. 

During the project, a total of 564 community health workers, also known as the ASC Sentinelles, were equipped with the MaliKaKeneya app to not only screen for suspected cases of COVID-19, but also for malaria, pneumonia, and tuberculosis. They also referred patients for testing and delivered basic care and health promotion messages.

“It was a good initiative,” says Adama Konate, a community health worker who was part of the project. “This app helped us in our daily activities, and we could work easily in the context of the pandemic.”

The project was a success and had a positive impact: By the end of 2020, the community health workers deployed with the app had visited more than 500,000 households in all the communes of Bamako and identified more than 30,000 sick people, of which 980 were suspected of having COVID-19. When the community health workers followed up, 347 of these suspected cases reported having tested for COVID-19, with 187 people testing positive.

As the app is used for multiple diseases, community health workers integrated health services and were able to refer more than 8,000 people with symptoms of pneumonia and more than 800 with symptoms of tuberculosis to the nearest health centers.

There are many different digital tools used in Mali today, so the government decided to develop a roadmap for the digitization of community health using a holistic approach. The first step was an in-depth analysis of the digital health situation at the community level and of the tools used in the field, placing the patient at the heart of these activities. To this end, several participatory workshops were organized with relevant stakeholders to establish priority needs and a list of all digital tools available in the country. The results of these workshops, comparing the functional needs and technical constraints identified by the stakeholders and the functional and technical coverage of the tools, helped to determine the best option.

This in-depth analysis of the situation objectively determined that the Community Health Toolkit platform managed by Medic was the best option, based on the functional needs and technical criteria defined and validated by all. This decision was further supported by the success of the project. Based on this experience, the Mali Ministry of Health has now selected the Community Health Toolkit as the official national digital tool for community health workers.

Through innovative partnerships, Mali is committed to investing in community health and further ensuring community health workers are equipped with digital tools to improve the speed, quality, and equity of care provided. These digital solutions will help to ensure that no one is left behind, and they will support communities to effectively prepare for and respond to existing and future health crises.

The Global Fund engages the private sector to contribute to our mission, including through the delivery of innovative tools and digital initiatives, to drive impact and save more lives. Private and nongovernmental partners help Global Fund-supported programs work better by sharing their knowledge, skills and technologies. Our partners tackle critical and complex challenges in program implementation, operations and delivery.