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 pooling 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. This is in line with Kenya’s National Neglected Tropical Diseases Master Plan (2023–2027), and WHO’s 2030 Roadmap on Neglected Tropical Diseases.
During the launch, Cabinet Secretary for Health, Dr. Deborah Barasa emphasised “addressing neglected tropical diseases not only saves lives but also unlocks economic opportunities”.
Medicines included Mebendazole, Praziquantel, Diethylcarbamazine Citrate, and Albendazole, donated through the WHO NTD Global Donation, to treat and prevent diseases including Schistosomiasis and Soil-Transmitted Helminths.
WHO supported the Ministry of Health to train over 800 healthcare workers across 20 counties, advocate for government ownership and investment in neglected tropical disease elimination and supported supervision of the mass campaign.
“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 during the campaign launch in Kakamega county.
CHALLENGES OF HAND-WRITTEN RECORDS
While mass drug administration campaigns have proven to be a cost-effective and impactful strategy towards eliminating neglected tropical diseases in Kenya, their large scale has highlighted a significant challenge — the reliance on handwritten records.
Community health promoters like Margaret manually document each household they visit, recording details such as children’s names, ages, administered medicines, and refusals. At the end of each day, after reaching up to 800 children, community health promoters must submit their handwritten records to their local health facility, where data from all promoters in the area is compiled. These paper records are then counted and forwarded to the sub-county, county, and finally, the national level. This labour-intensive process means that millions of written records must be manually counted to assess the campaign’s impact.
This manual 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 this limitation, Kenya’s Ministry of Health, with support from the WHO in collaboration with Clinton Health Access Initiative and funded by Gates Foundation, piloted a digital data collecting system during Kenya’s latest mass drug administration.
110 community health promoters were selected to use the new digital system in two wards of Kakamega County — Chekalani and Bunyala Central.
Using their mobile phones, the community health promoters logged each child they treated in real time, recording key details such as the medicines administered, refusals, and adverse reactions.
This new digital module, integrated into the mobile app that community health promoters already use instantly uploaded the data to a central database, making it accessible to health officials at all levels, including the national team overseeing the campaign.
WHO provided technical supported in the design, development, testing and piloting of the new health campaign module as well as conduct a series of trainings for the 110 community health promoters on how to effectively use it.
“The ability to see live results from these two areas was a game-changer,” said Eric Maira from the WHO. “It allowed us to monitor progress during the campaign and respond immediately to challenges.”
For community health promoters like Margaret, the app made their work easier. Without the burden of carrying registers or worrying about errors in transcription, they could focus on reaching as many children as possible.
NEXT STEPS
With 90% coverage achieved, the recent mass drug administration campaign met WHO’s target for effectiveness. Additionally, the 110 community health promoters using the new digital data seemed optimistic about saving time and reaching more children in the future.
Building on this success, Kenya’s Ministry of Health plans to expand the digital system to three additional counties in the next mass drug administration campaign planned for March 2025, with further plans to integrate it into other large-scale health initiatives including 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 began.
