Several days a week, Isabelle Marie Kouame, a community health worker (CHW) in rural Dimbokro, Côte d’Ivoire, makes home visits to clients in her small town. She checks on those who have recently visited the health center, ensuring that they’re still in good health, and is always on the lookout for new clients.
When she arrived at the door of Aka, a 40-year-old mechanic, Isabelle pulled out her phone and tapped the CommCare application. This mobile technology helps CHWs to identify and track next steps for their clients. The CommCare platform stores much-needed information and delivers it instantly, allowing for efficient referrals and timely follow-up by health care providers. It was piloted last year. Not only does the patient benefit, but so do health care providers.
“Before, home visits and referrals required a lot of paperwork and were very tiring,” said Isabelle. “But with CommCare, the work is much easier and quicker.”
Aka’s referral and treatment reflect a commitment by the government of Côte d’Ivoire, in partnership with Jhpiego, to bring basic health services closer to people where they live and to change the approach for treating chronic conditions ranging from hypertension and diabetes to tuberculosis and HIV.
Key to this community health initiative is the government’s decision to provide nurses and midwives with the training and authority to prescribe HIV medication—a task previously reserved for doctors based in larger cities.
Funded by the U.S. Centers for Disease Control and Prevention, and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), the program is being implemented by Jhpiego in close collaboration with the Elizabeth Glaser Pediatric AIDS Foundation and Foundation Ariel Glaser, PEPFAR’s partners.
To help ensure the success of this new chronic care model, Jhpiego has worked to strengthen the capacity of 145 nurses and CHWs. CHWs have logged more than 635 home visits.
A case in point: Loukou Kouame, a yam farmer who had all but given up before a CHW using the CommCare app showed up at his home.
“I was suffering from lower back pain, and I had lost a lot of weight,” Loukou recalled. “When the CHW weighed me, I was hardly 37 kg (82 pounds). He was visiting patients living with chronic diseases, and he advised me to go visit the nurse at the health center in the village. At first, I didn’t want to go because I didn’t think I could get better.”
At the local health center, he received a diagnosis of HIV, learned how to manage his condition and began antiretroviral treatment.
“Loukou respects all of his appointments and takes all of his medications properly,” said nurse N’da Ble Avi Gilles Edgard. “He welcomes the CHWs into his home and participates regularly in health club meetings.”
No longer a reluctant patient, the farmer has gained a lot since Isabelle first knocked on his door and tapped on the CommCare app: not only weight (40 pounds!) but also new hope for a healthier future.
Contributing to this story: Oumar Toure, technical advisor, HIV and reproductive health; and Angeline Dia Lou Balona Anoble, HIV technical assistant, both from Jhpiego’s Cote d’Ivoire Country Office. Also, Nathan Rehr, Jhpiego senior program coordinator for West and Central Africa.
