A Community Health Worker’s Dedication, Strengthened Through Innovation

A health extension worker using the electronic community health information system in Ethiopia. Credit: JSI Ethiopia.

About 80% of Ethiopians live in rural communities, with limited accessibility to health services. Ethiopia’s health extension workers (HEWs) play a vital role in delivering essential primary health services to remote communities across the country. In partnership with the Ministry of Health and funded by the Children’s Investment Fund Foundation, JSI is working to transform the way HEWs work, alleviating barriers and enhancing their care offerings through improved data use. The Electronic Community Health Information System (eCHIS) Scale-up for Health Extension Program Improvement project aims to digitize primary health care delivery, enhance service quality, and streamline reporting processes, leading to improved health outcomes for women, children and adolescents.

Barriers to Community Health Care

Almaz Boyno, a HEW in Mirab Abaya Woreda of Ethiopia, crosses hills, forests, and gorges to reach communities with primary care services.

“My first outreach attempt was daunting.” Almaz recalls. “I set out alone, lugging vaccine carriers, supplies, paper family folders. I spent the entire day going door-to-door. By evening, much of the work was unfinished. Exhausted and frustrated, I broke down in tears.”

A Mobile Technology Solution

Through the eCHIS Scale-up for Health Extension Program Improvement project, JSI provided nearly 300 high-spec tablets loaded with 18 health care modules, automated reporting forms, and job aids to health extension workers in nearly 200 health posts. The heavy paper folders Almaz once lugged door-to-door became available on one small portable device. The tablet offered her job aides to counsel each of her patients on a wide array of health services from antenatal care to the prevention and treatment of infectious diseases. The tool also offered her real-time reporting access, sparing her from having to hand-deliver her client paperwork.

I am optimistic about what we can do for our communities now. My movement through my communities is seamless. I feel I am able to have longer, more meaningful interactions with my patients.” –Almaz Boyno, a health extension worker (HEW)

Looking Ahead

Almaz soon saw how this technology tool transformed her daily work: reporting time decreased significantly, the physical burden of carrying materials was removed, and immediate access to counseling tools improved the quality care she provided. Despite technical challenges like unreliable internet and data gaps, Almaz began to feel the benefits of digitization and resolved to learn how to use the tablet. With JSI’s technical support to solve problems as they arose, Almaz’s confidence in the technology grew, and she now mentors other HEWS on using this new, automated approach.

Almaz is hopeful about the future of the country’s Health Extension Program, Ethiopia’s primary health mechanism, and the investment in eCHIS that is facilitating reliable connectivity and system use for better health services.