The invention of computers and internet has revolutionized every aspect of human life, bringing profound changes across various domains. Digital transformation has significantly impacted healthcare delivery worldwide. The health sector has seen significant benefits from advancements in medical research, accurate diagnostics, enhanced medical accountability systems and streamlined patient record-keeping through Electronic Health Records.
Murang’a County, located in the Central region of Kenya with a population of 1,056,640, has historically struggled with deficiencies in its health sector due to reliance on manual systems. These limitations have emerged in several critical areas including; financial leakages, inefficient commodity management, prolonged patient waiting times, poor drug inventory management, inadequate ward monitoring and delayed detection of disease outbreaks. Collectively, these issues have hindered effective healthcare delivery and obstructed timely medical interventions. Recognizing the urgent need for improvement, the County Government of Murang’a initiated a strategic move towards the digitization of its health systems across all public health facilities. The digital transition sought to overcome the challenges posed by manual operations, ensuring better resource management, precise health revenue tracking, reduced waiting time and effective drug inventory oversight.
Implementation of the practice
In September 2022, the County Government of Murang’a, through its Department of ICT, and partnership with Safaricom, began the semi-automation of revenue collection within the health sector. Cash payments were abolished, and a USSD code for M-Pesa payments was developed, streamlining the payment process. Additionally, the County developed a real-time client exit dashboard to monitor client movement and generate patient data promptly. Data was also generated to identify and address shortages in drug stocks that were lacking.
In March 2023, following the need for transition from manual to digital health record system, the County Government of Murang’a through the Health Department conducted benchmarking visits in Kisumu, Nakuru, Vihiga and Kajiado Counties to identify the most suitable model for adoption and enhancement in their health sector.
In May 2023, after a careful evaluation, the County chose to adopt the Afya.KE model, a system developed and provided for free by the Ministry of Health (MoH) to willing Counties. The adoption of the Afya.KE Health Management Information System brought significant financial advantages. Since the system was free, the County could reallocate funds initially intended for system development towards other crucial activities. These included; purchasing electronic equipment, installing reliable internet connections and providing comprehensive training to medical practitioners on how to effectively utilize the digital platform. internet connections and providing comprehensive training to medical practitioners on how to effectively utilize the digital platform.
In June 2023, the County conducted a thorough needs assessment research, to identify existing gaps within the health sector. Based on the findings, they purchased laptops, desktops and tablets to be distributed across all County public health facilities, apart from 6 that are to yet to be equipped. Following this, a pilot program was conducted at the Murang’a County Referral Hospital to assess the effectiveness and integration of the devices into the healthcare system. This aimed to ensure that the technology met the specific needs of the facility before full-scale implementation across the County.
In July 2023, the County began implementing the project at Murang’a County Referral Hospital in three phases over three months, starting with the outpatient department, followed by specialized clinics like eye care and concluding with the implementation in the inpatient department. Approximately Ksh 180 million was allocated to digitize health services in the 151/157 (96%) public health facilities that are now fully digitalized.
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