Utilising a Community Health Toolkit (powered app) to enable HIV Testing in Kenya: The Case of AfyaStat

In March 2020, when COVID-19 had not fully established itself in Kenya, an opportunity emerged for Medic and Palladium Kenya to co-develop an integrated COVID-19 surveillance system with the Ministry of Health (MoH) and other stakeholders, and exchange knowledge on respective technologies they partnered to design and develop a Community Health Toolkit (CHT-based mobile app) for the project – named AfyaSTAT – that centres on HIV testing and screening (HTS) as an entry point to HIV care and treatment. Interoperable with KenyaEMR and supportive of both facility-based HTS workflows and outreach services to key populations, AfyaSTAT’s offline and online modes enable the delivery of integrated HIV preventive and treatment services at the community level.

AfyaSTAT Pilot and Adoption in Siaya County

In March 2021, the AfyaSTAT app was piloted in two CHS supported facilities in Siaya County at Kogelo Dispensary, and Bar Olengo Dispensary. The AfyaSTAT pilot provided an opportunity to test and enhance both the application and its deployment approach.

Following the successful pilot, CHS  adopted and scaled AfyaSTAT to 40 additional facilities with approximately 120 Service Providers trained on AfyaSTAT. These 42 facilities have fully transitioned from the legacy system, mUzima. This adoption has led to 100% coverage of CHS  (Siaya Mechanism) eHTS sites.

The Kenya HMIS project continues to work with the Regional Strategic Information (SI) Officers. The SI Officers support user training, provide technical and data validation support. This support has been the engine driving the successful implementation

Since the Service Providers at Kogelo Dispensary started using the AfyaSTAT app, the following has been observed:

• 100% daily linkage of all clients has been achieved at the facility, per Antony Ambogo (a Health Records Information Officer at Kogelo Dispensary).
• Ability to detect previously-identified Known Positives who come to the facility to test by flagging their records through the error queue. For instance, the facility identified a client who had dropped out of care from the facility in 2016 when he sought testing in April 2021, per Evelyn Ayuma, HTS provider at Kogelo Dispensary.

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With support from the U.S President’s Emergency Plan for AIDS Relief (PEPFAR) through Centers for Disease Control and Prevention (CDC), CHS has been working collaboratively with the Siaya County Government since October 2016, to deliver quality and sustainable HIV Prevention, Treatment and Care services.