The Story
In Uganda, community health depends on Village Health Teams (VHTs); volunteers who diagnose, treat, and refer to common illnesses like malaria and pneumonia. Yet their critical work was hampered by paper-based registers and fragmented systems. Hours spent filling forms often produced delayed or lost data, leaving supervisors blind to ground realities. The consequences were devastating: high child mortality, frequent stock-outs, and frustrated caregivers walking long distances for care that often wasn’t available. Uganda’s health system needed transformation, not mere digitization.
The Challenge
To address this, the Ministry of Health, supported by BRAC and UNCDF, sought to design an electronic Community Health Information System (eCHIS). But earlier digital initiatives had failed, tools built far from the field ignored the realities of poor connectivity, heavy workloads, and limited digital literacy. The challenge was to create a solution usable by over 200,000 VHTs while producing reliable data for decision-makers at all levels.
The Turning Point
The turning point came when the team reframed its mission from “building an app” to “building a human-centered ecosystem of trust.” Immersing themselves in villages, they listened to VHTs’ frustrations and aspirations, realizing that empowerment and respect were as vital as technology. By mapping real workflows and designing around VHTs’ lived experiences, the team created a shared vision where national scalability met local usability. This alignment between system goals and human dignity set the foundation for adoption and a more responsive, data-driven community health system.
The Execution
The project unfolded through a full Human-Centered Design cycle. Over four months, a baseline assessment in four West Nile districts engaged 40 VHTs, 8 focus groups, 20 district officers, 16 facility staff, and 8 caregivers revealing key challenges namely: stock shortages, double reporting, limited supervision visibility, and caregiver mistrust when services were delayed.
From these insights, personas including Village Health Teams (VHTs), supervisor, district officer, and caregiver were developed, with user stories mapping pain points and desired improvements. Co-design workshops generated ideas such as automated task lists, stock reporting modules, and hierarchical dashboards, ensuring alignment with national indicators.
A prototype built on the Community Health Toolkit integrated maternal, child health, and stock management features with role-based access. Testing with VHTs and supervisors highlighted navigation issues, leading to streamlined workflows and offline capability. Iterative learning refined the tool ensuring that reminders matched local disease peaks, and supervisors gained concise exception reports for faster decision-making.
The Evidence
Adoption rates were high because VHTs felt ownership. Supervisors reported faster, cleaner data flow. The Ministry recognized that eCHIS not only improved reporting but also built frontline accountability.
The Result
Human impact: VHTs reported reduced paperwork and increased motivation. “Now my work is seen,” one VHT shared, noting that supervisors acknowledged their contributions more frequently. Caregivers trusted services more as children received timely immunizations and mothers delivered safely at facilities.
Systemic transformation: eCHIS transitioned Uganda’s community health data from paper silos to a national digital platform. Its modularity means new health priorities (such as malnutrition) can be integrated seamlessly. The project shifted Uganda’s health system from reactive reporting to proactive, data-driven care, setting a precedent for national digital health strategies.