How a public health inspector in Zanzibar supervises community health workers with different needs and what changed when she stopped planning meetings alone.
Rehema Chananta works as a public health inspector at the Magogoni Dispensary, a government health facility in Zanzibar that serves a few thousand people and is often the first place people go to when they’re sick. In the job, she’s responsible for sanitation, clean water and disease prevention in her district. She has had this job for six years and for the past two years she’s also been supervising community health workers. Currently, she is responsible for a large number of community health workers across seven shehias (neighbourhoods in Zanzibar).
Most of her work takes place outside the facility and in the communities it serves. This used to be a challenge because people in those communities didn’t know her.
“Before I supervised community health workers, it was hard for me to go into the community and explain myself and share information and knowledge,” she shares.
She had the title, the training and the mandate — but none of that got her the community’s attention when she needed it. That changed when she started supervising community health workers. Because community health workers come from the same communities they serve, people already trust them. They open the door for Rehema, vouch for her, and prime the community before she arrives. She doesn’t have to start from zero every time.
What the job asks
But her work doesn’t come without challenges. There are often incidents in the community she has to manage. She gives the example of a house in her district with a leak in its drainage system. Raw water from the septic tank was spreading across the ground — the kind of contamination that carries the bacteria behind diarrhoea, cholera and typhoid. It seeps into the soil and the water people drink, cook and wash with, and the standing pools it leaves behind are where malaria mosquitoes breed. This one leak threatened the health of everyone nearby.
“I went to the area to make an assessment, and according to the procedure, we had to close the house. We contacted the owner — the landlord — because the people living there were renting. And so they had to leave, and we made arrangements to drain the septic tank and make sure the area was safe and not until then could the family move back in again”
And on top of this, she needs to manage the community health workers and give them the information and support they need so they can do their jobs well. For Rehema, one of the biggest challenges is providing consistent supervision and support across a large network of community health workers. Managing them individually can be difficult, particularly across the different communities she serves.
“I used to call all of my CHWs to the facility and conduct one meeting per month. But I realised that was too complicated. The focus isn’t there with a larger group. So now, I’m dividing them into groups depending on their needs.”
Since she started using the CHW Supervisor Companion, an AI-powered chatbot for supervisors in Zanzibar, her supervision responsibilities have become easier. The Companion provides continuous and contextual support to the supervisors and helps them better understand what’s happening in the communities by delivering monthly health trends reports – all based on data from the national community health program, Jamii ni Afya.
Rehema confidently explains how she uses the CHW Supervisor Companion. She opens WhatsApp on her phone and types Habari (meaning hello in Kiswahili) and from there she asks different questions depending on what she needs at the time.
Click on the screenshots to see how the chatbot works in practice
Supervisors like Rehema play an important role in making sure that how community health workers serve their communities is based on what is actually happening in the community. They look at the data and share the health issues their communities are experiencing at the moment and then prepare them to hold health awareness sessions, for example, about how they can prevent malaria, diarrhea or what family planning can look like. For example, if a shehia has had many malaria cases recently, the community health worker will share information on how to prevent this – all according to the national guidelines.
Before the CHW Supervisor Companion, Rehema had to ask the community health workers about what issues or trends they had noticed and review data manually, but this took a lot of time and she couldn’t be sure it really reflected the needs in a shehia.
“It saves me time and reduces my workload. I also find it useful for my role as a public health inspector. If I’m unsure of something, I try to ask the chatbot and often get good answers”
The CHW Supervisor Companion was co-designed with users like Rehema and in partnership with Dalberg and the Ministry of Health in Zanzibar. The early results have been promising. Supervisors cut meeting preparation time by 90%. Eight in ten community health workers reported receiving clearer, more actionable guidance. And 97% want their supervisors to keep using the tool. At D-tree, we are actively working with AI. We are designing, testing and in some cases deploying, but we approach each step with clear questions, honest about the uncertainties, and a commitment to sharing learnings and impact from the journey.
Thanks to Stephen Africa for translation support and to Abbas Wandella for coordinating this story.
