Sub-Sahara Africa bears the highest disease burden in the world. Mobile health approaches are promising because mobile penetration rates are 80%. The NGO Amref Health Africa has been working on better community health care for over 60 years. Recently, Amref has introduced digital platforms for data recording and learning purposes. Amref, Achmea and TNO are collaborating on professionalization and scaling the mobile health services.
Health care workers using mobile health applications

Kenya has a young population that is growing rapidly. The health care system can’t keep up with this growth. This leads to high morbidity and mortality mainly from HIV, AIDS, malaria, tuberculosis, respiratory infections, diarrhoea and malnutrition. There are wide disparities in health status across the country, closely linked to underlying socioeconomic, gender and geographical disparities. The Kenya Health Policy (2014-2030) targets attaining a 16% improvement in life expectancy; a 50% reduction in annual mortality from all causes; and a 25% reduction in time spent in ill health. A major driver for health improvement is a better organized and equipped primary care and better health behaviour in communities. However, the Kenyan government faces difficulties in reaching all 44 million inhabitants, especially in remote areas. Amref Health Africa helps to fill this gap and is working on the improvement of community and primary health care for the most vulnerable groups. The vision of Amref is that better health results in a higher chance to escape poverty, through education, a better job or a small business.


The application of mobile health technologies, known as ‘mHealth’ is the practice of medical and public health supported by mobile devices, such as mobile phones, patient monitoring devices, personal digital assistants (PDAs), and other wireless devices. mHealth is increasingly seen as a way to provide high quality and easily accessible care at lower costs. Amref is aware of these opportunities and is training the health care workers through their mobile device, also registers health care data and links them to the public health systems. The first pilots are promising and Amref has the ambition to further professionalise her mHealth and to launch these services into the market with a sustainable business model. Amref collaborates with TNO and Achmea on this trajectory. TNO is adding value as innovation partner on interoperability of ICT systems, value creation from data and health content of tools. The insurance company Achmea contributes with knowledge on data warehousing and data management in health care.

Working mission to Kenya

Half November the consortium had a joint working visit to Kenya, with the aim to develop a grand design for the future. Besides sharing ambitions at Amref Head Quarters in Nairobi, we also went to Makueni county and to the Dagoretti slum to see how healthcare and mHealth tools actually work in two different fields. The joint team from Amref, Achmea and TNO learned a lot and distinghuished several opportunities to further improve and implement healthcare through data-driven innovations, with the aim to reduce costs, to enforce capacity building and to safe lives. Find below their personal feedback on this week of co-creation in Kenya.

Danny Dubbeldeman from Amref

Danny Dubbeldeman - Business Development Manager at Amref Flying Doctors in the Netherlands: “Last April I met Mathilde Miedema from TNO for an introduction to see how we could collaborate. It’s amazing to see what has happened since then! In Africa e- and m-Health bring a lot of opportunities. When distance and money are a problem, technology empowers the solution. M-Jali is Amref’s innovative solution for improving efficiency in reporting health information at community level. It incorporates a mobile application for capturing data from the household level and transmitting it online to a web-based database. The goal of this innovation is to improve health indicators by facilitating data for enabling decision making and appropriate action. TNO has a lot of expertise and experience in this field and thus bring a lot of added value to the Amref organisation and the many challenges we face. It is not only their technological expertise, but also their scope of business development. For me, it was impressive to see the team at work in the African landscape and how this accelerated the process. I look forward to bringing MJali together to the next level!

Hanneke Molema from TNO

Hanneke Molema – mHealth expert of TNO stated: “I found it fascinating to see what Amref, community health workers and volunteers accomplish with so little resources. Their motivation and drive, to improve health and healthcare for all, results in simple and effective innovations and was inspiring to me. While in Kenya, I often felt that we, in Western society, are often too wound up in complex systems to simply cooperate and accelerate. A great and simple example I saw during our working visit were the “talking walls” in the health facilities. These walls tell you the treatment protocols, patient education and the facility performance. They list numbers on all patients treated, all children born and vaccinated and all mothers in antenatal care. The walls make everone count, because people take pride in what they reach and how they improve health! It made me wonder why most health providers in the Netherlands are shy to share such information, afraid that it will be used against them. Now Amref has developed a simple, yet effective mHealth tool, to register health and health needs at the household level and to structure decision making. This tool is embraced by professionals and volunteers, who can now easily show what is needed and accomplished. I take pride in working with Amref and Achmea to further improve and implement this tool in Kenyan healthcare.”

Serena Oggero from TNO

Serena Oggero – data science consultant at TNO: The second day we met a group of community health volunteers in Makueni county. Everyone – also we ourselves, was clearly excited to be there! The volunteers were wearing their best clothes, showing the Amref bag and their new smartphones. We sat in a small building under construction by a small local clinic, no window frames, a rain shower outside, and a pretty shy start of the conversation. But when we asked whether they were happy, and why, of contributing to the collection of health data, all shyness went away. All faces started making “yes”, all eyes went wide and smiling, yes, they are really happy to go around their villages every day, discussing topics sometimes delicate or even hard, walking for hours in their free time, and even getting calls in the middle of the night, to help without a pay. They are happy because they keep learning on how to improve their own health and that of their families and friends. They said, ‘we are happy because we help and we save lives’. Their pride was so genuine and tangible. And I felt also a little proud to have the chance to sit there and listen to them. I learned something: these volunteers recognise the value of relevant and quality information, a concept that we have almost completely forgotten. In our continuous rush to the fastest, the latest and the biggest amount of data, we are not used anymore to recognize how a small amount of carefully chosen and personally delivered information can make the difference. This totally unusual type of “data projects” can bring an unexpected new perspective to our usual way of doing innovation. And in this project I can see the famous mission of TNO at her best: “connecting people and knowledge to create innovations that boost the competitive strength of industry and the well-being of society in a sustainable way.”. I think now all elements are finally in place, so I’m looking forward for the boost!

Ignace Konig from Achmea

Ignace Konig - Manager Datawarehouse & Beheer at Zilveren Kruis/Achmea Ltd. “It was my first visit to Kenya. I loved the kindness of the people we met. Concierges, cleaners, directors, waiters, ministers, nurses, health volunteers, ... we met the human kindness – or Ubuntu - everywhere. Amref, the Makueni county government and many health care professionals believe data can be put to great use and will make a difference in the forthcoming years. Next to our initiative there are many initiatives in Kenya aiming at putting data to good use. And I will be lucky to follow one initiative from up close or even will be taking part. What makes it interesting is that the power of data increases with broad use. The strong sense of community and Ubuntu will nourish this even more. Which makes it a very powerful combination. In the short term I’m curious about the speed with which health care in Kenya is truly served and improved using data. In the long term I’m curious if Kenya, and other African countries, will actually turn out to be global leaders in using the power of data for making its citizens happier.”

'Talking walls' in rural health center

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Drs. Mathilde Miedema

  • Developing countries
  • Development Cooperation
  • Africa
  • Bangladesh
  • Inclusive Business