Imagine you’re a CHP (community health promoter) in rural Kenya, where trust isn’t always easy to come by. You’ve just finished a malaria rapid diagnostic test (RDT) for a patient, but they’re looking at you with doubt. "Is the test accurate?" they ask. In a setting where resources are limited, and skepticism can reduce patient treatment adherence, building trust is crucial. This is where the HealthPulse app comes into play, and as insights from a recent study conducted in Busia County show, this simple tool could change how CHPs get the job done.

The app, which guided CHPs through malaria testing practices, was seen to have influenced workflow efficiency, helped build trust with patients, and provided accountability within the health system. These findings have far-reaching implications for the future of healthcare in low-resource settings.

Seeing Is Believing: Trust Built Through Visual Proof

For many CHPs, one of the biggest challenges has been convincing patients that the test results are reliable. This is where HealthPulse really shines. The app allows CHPs to take a photo of the RDT result and show it directly to the patient. It’s a simple feature, but one that makes a huge difference. Being able to provide visual proof immediately reassures patients that the test was done correctly, and the result is accurate. Collecting a digital record of the result at the point of care provided a deeper signal to the patient that their results matter, as one CHP noted:

“Yeah they would like it because the results will come out on the spot since sometimes the clients tend to ask when the results will be out. So now when they do it that way and show the client that the results are already out then they will benefit since they trust the system applications.”

In the study, CHPs noted that this visual confirmation made their jobs easier and helped build trust with patients who might otherwise be skeptical. One supervisor shared how the app made all the difference:

"Some of them [community members] say CHPs are not accurate; CHPs are not doing a good job. But when they see these photos, they see this is positive, this is this—I think they will be satisfied. It will eliminate that element of doubting CHPs."

This added a layer of transparency which helped turn hesitant patients into more trusting ones. The app helped patients see that the CHPs were working diligently and following the correct protocols, which, in turn, boosted the CHPs’ credibility in their communities. One CHP remarked:

"It has made me get more respect in the community."

For CHPs, gaining that respect has always been a crucial part of motivating and driving their work, and the HealthPulse app has proven to be a key tool in strengthening that bond with their communities.

“When you take a picture, it gives an assurance that work was done and in progress, this motivated us to work hard and also enables us to use the kits that we were originally given.”

Efficiency Meets Accountability: Streamlining Workflow

The benefits of HealthPulse go beyond building trust with patients—it could also help CHPs manage their day-to-day work. In a system that traditionally relies on paper records, previously CHPs often found themselves bogged down with paperwork, which leads to errors, delays, or even lost data. But with HealthPulse, CHPs were able to record test results digitally, speeding up the process and reducing the risk of mistakes.

One CHP highlighted how the app has simplified their workflow:

"When using the app everything is there, but when it comes to paperwork, you can forget something. The app gives you some guidance…. It will reduce paperwork because I will just be filling in the details on the phone because the papers can get lost, but through the phone, the information is saved."

Another CHP indicated the app helped them get better results: 

“My experience was marvelous because I tried comparing the quality of the results with the traditional way that we used to do [testing]; the app guided us well to get better results.”

By eliminating the need for manual paper logs, the app allowed CHPs to focus more on patient care and less on administrative tasks. This shift made their work not only more efficient but also more reliable, as the risk of lost or inaccurate records was reduced.

Accountability: Strengthening Trust Within the System

While the HealthPulse app has improved interactions between CHPs and patients, it has also strengthened the accountability chain between CHPs and their supervisors. In the past, supervisors had limited ways to verify that CHPs were following the correct procedures, as much of their work was undocumented or dependent on manual records. With the app’s digital tracking and photo capture features, supervisors had a clear view of what was happening in the field.

One supervisor shared how the app ensured accountability: 

"What you do reflects… I would say it is for evidence of doing the job as well as using the right procedure, including the mRDT that you are supposed to use."

Whilst another said:

 “...compared to them doing it manually, there is no evidence, no picture, no nothing, she will just give you any number she wants. But with the app it will tell you this is what she captured; the app is good.”

This system of accountability benefits both CHPs and their supervisors. CHPs felt supported, knowing that their work was being accurately tracked and recognised, while supervisors were able to ensure that proper protocols were being followed without needing to rely solely on paper records.

What We’ve Learned and What’s Next

The insights from this study demonstrate how digital tools like the HealthPulse app are transforming the work of CHPs in rural Kenya. By building trust with patients through visual proof, improving efficiency by streamlining workflows, and enhancing accountability within the healthcare system, the app is setting a new standard for healthcare delivery in low-resource settings.

As we look ahead, these lessons provide valuable guidance for scaling up and improving healthcare systems globally. This study is just the first step in understanding the broader impact of digital tools on CHPs and the communities they serve. 

Look out for the next blog in this series where we’ll dive into “The Hidden Heroes: Mental Health and Well-being of Community Health Workers”