Updated: Nov 18, 2021
Today, we celebrate a momentous achievement. In August 2021, the Zanzibar Ministry of Health (MOH), in partnership with D-tree International, celebrated a significant milestone as Jamii ni Afya (“Community is Health”)—the government’s digitally enabled community health program—reached full national scale. Jamii ni Afya leverages government guidelines and global best practices to guide community health volunteers (CHVs) using digital technology to deliver high quality, standardized services in maternal and child health, nutrition, and early childhood development.
By ensuring all of its 1.6 million citizens have access to a digitally equipped CHV at their doorstep, the Zanzibar MOH has brought the country closer to universal health coverage than it has ever been before and has become one of the world’s first examples of a government-led digital community health program achieving full national scale.
As a result of these services being delivered, the digital system captures critical data which is integrated into the government’s health management information system. CHV supervisors, district health managers and MOH officials at the national level now have access to millions of data points, updated daily, providing the clearest picture about the state of community health that Zanzibar has ever seen.
Decisions about budgets, programs and policy are now based on population-level data—enabling the government to optimize resources based on emerging needs and explore ways to leverage the power of data science to further improve health delivery and efficiency at scale.
Throughout Jamii ni Afya’s rollout, the MOH has played a central role, from recruiting and training CHVs and supervisors, raising awareness in communities, and coordinating supportive supervision for health workers. This government leadership reflects the MOH’s long-term commitment to improving health and implementing universal health coverage in Zanzibar.
D-tree has supported the government in training over 2,200 CHVs across 11 districts, achieving full coverage of every household. To date, over 1.2 million Zanzibaris (over 70 percent of the population) have been enrolled in the program with registrations ongoing, and over 130,000 pregnant women and children under 5 have been enrolled and have received health visits. The program has also been written into national policy and has strong commitment from the government to institutionalize and sustain it as a critical part of the broader health system.
Most importantly, the program is having a positive impact on the lives of everyday Zanzibaris like Aisha, a mother of five children living in the Kidazini community, who are connecting with dedicated CHVs in their communities to better understand their health risks and the options available to them to access essential, potentially life-saving health services.
We at D-tree are very proud of these accomplishments and value our partnership with the Zanzibar government. They have shown bold leadership to leverage innovation and technology to bring health services to all Zanzibaris. This achievement is also the result of meaningful collaboration across government, partners and funders.
While this milestone represents a significant achievement, this is only the beginning. As partners to the government, we will continue to support the institutionalization of Jamii ni Afya within Zanzibar’s health system—fully transitioning financial and operational management to the government, while retaining high-quality service delivery and sustained health improvements.
We will work with the government to develop a roadmap to incorporate additional service delivery modules to support health areas such as HIV, malaria, adolescent health, family planning and disease surveillance. And, we will continue to support efforts to strengthen the program content—especially for early childhood development—and strengthen linkages between the community and primary health facilities to ensure a continuum of client-centered care wherever people receive health services.
In the last few years, digital health has been recognized as a critical component of health systems strengthening and governments globally are developing digital health strategies and tools for frontline health workers. Yet very few examples exist of a government-led digital community health program being integrated into the health system and scaling nationally. Jamii ni Afya represents a model for how governments—in partnership with long-term committed partners and donors—can design, scale and sustain national digital health programs, leading to a strengthened health system and improved health for all.
Over the next three weeks, we will be publishing stories and insights from Jamii ni Afya, culminating during Digital Health Week to highlight Zanzibar government leaders, funders and partners who have been part of the journey along the way. We hope you will join us as we reflect on lessons of how national-scale digital health programs are critical to achieving universal health coverage.
This is the first post in a series highlighting Jamii ni Afya, one of the world’s first digital community health programs to reach full national scale. Learn more about Jamii ni Afya’s journey to connect every community in Zanzibar to essential health services.