Astana Declaration (18) Digitizing Primary Health Care Delivery

8 November, 2018

By: Caroline Mbindyo, Director Digital Health Partnerships, Living Goods

Read online here:


'At the Global Conference on Primary Health Care that took place in Astana, Kazakhstan, October 25–26th, participants discussed Universal Health Coverage (UHC), as primary health care (PHC) is essential to achieving UHC. Living Goods contributes to expanding PHC by improving service delivery at the community level and referrals to facilities through support of community health workers (CHWs), in part by giving them the tools they need to be successful.

Equipped with an Android phone loaded with a powerful mHealth application which supports care coordination and diagnostics, and a supply of key medications and health-related products, Living Goods-supported CHWs go door to door in their communities. We support governments to recruit and train the CHWs to manage the most easily treatable yet potentially deadly health issues for mothers and children — including malaria, diarrhea, pneumonia, pregnancy and newborn care, family planning and under-nutrition. These networks of CHWs currently reach more than 6 million people across our programs in Kenya and Uganda.

Technology can support governments to improve the quantity and quality of data collected, improve the consistency and accuracy of diagnostics and treatments, drive results and accountability through performance management, increase retention and motivation through financial and non-financial incentives and supportive supervision, and enable managers to monitor the performance of CHWs and their supervisors each day through near real-time dashboards.

CHWs help expand PHC through the following ways:

- Reach the last mile: Across the developing world, CHWs with basic health training are the first, and often the only, link to health care for hundreds of millions of people.

- Work effectively: They are trusted frontline health personnel with basic health training who can bridge cultural, geographical, information, and linguistic barriers to expand basic demand for and access to care.

- Support health education, prevention and curative care: CHWs have proven effective in providing health education to prevent under-five deaths, promote care, and can provide basic treatments to cure common illnesses such as malaria, diarrhea and pneumonia.

- Provide services at low cost: The provision of PHC by CHWs is less expensive than facility-based care.

- Drive equity: The ability of people to access health facilities in low-income settings is highly inequitable. Therefore, community-based approaches are vital to achieving equity and universal coverage.

Technology in the hands of CHWs alone is not enough to expand PHC; it is also necessary to have the systems and processes in place to ensure that the technology is adopted by the CHWs, supervisors, managers and district and national governments, as well as be supported and maintained by governments.

Living Goods deploys mHealth solutions at scale, identifying the right solution, managing the hardware, including in low-resource environments, and building the systems and processes needed to drive adoption and use of the technology. Because of our technology, we are able to explore innovative financing and help governments to finance high-impact programs. Further, we explore the potential of nascent technologies, including artificial intelligence, to impact global health where these trade-offs of cost, access and quality are felt most acutely.

The use of technology creates accountability in terms of results achieved that donors and governments want to see, hence attracting more funding into the space and allowing governments and donors to have more oversight on how their funding is spent.

At the Global Conference on PHC, we discussed our use of mobile technology and heard from others about their experiences as we all work toward expanding PHC. It is only by expanding PHC that we can achieve UHC, and we must focus on communities to get there. Please visit the Communities at the Heart of UHC campaign website for more information.'


Best wishes, Neil

Coordinator, mHIFA Project (Mobile Healthcare Information For All)

Coordinator, HIFA Project on Community Health Workers

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HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - ), a global community with more than 18,000 members in 177 countries, interacting on five global forums in three languages. He also currently chairs the Dgroups Foundation (, which supports 800 communities of practice on international development, health and social justice. Twitter: @hifa_org FB: /