Strengthening Maternal and Child Health through Digital Integration: Field Reflections from the Afya-Tek Project in Kibaha, Tanzania

Abstract (English)

This presentation draws on field experiences from the Afya-Tek project in Kibaha District,
Tanzania a public-private initiative aimed at improving reproductive, maternal, newborn, and
child health (RMNCH) through digital health integration. As a graduate student of Anthropology
and intern with the Afya-Tek project, I offer grounded reflections on how digital innovations are
being localized and adapted within community health systems.
Afya-Tek seeks to create a connected continuum of care by integrating Community Health
Workers (CHWs), Accredited Drug Dispensing Outlets (ADDOs), and public health facilities
through a shared digital platform. This platform supports real time referrals, household
registration, and coordinated service delivery. While the project builds on existing government
and community structures, it introduces a digital backbone designed to improve continuity,
efficiency, and data visibility across the health system.
I observed how this technological infrastructure is reshaping the dynamics of care at both the
household and facility level. CHWs report feeling more empowered and accountable in their
work, with digital tools helping them track clients and follow up more effectively. Caregivers
and families in the community are also beginning to place greater trust in CHWs’ guidance,
especially when referrals are supported by the digital system. Meanwhile, private sector
dispensers at ADDOs are taking on a more integrated role in local health care delivery.
However, these promising developments exist alongside important challenges. Limited digital
literacy, infrastructure gaps such as poor connectivity, and questions around long term
sustainability continue to shape the implementation landscape. Furthermore, some community
members remain hesitant to fully engage with digital referrals, preferring face-to-face
explanations and analog practices.

This presentation uses anthropological insights to reflect on how care, trust, and health seeking
behaviors intersect with technological change. Rather than viewing digital health as a purely
technical solution, I highlight how its success depends on social relationships, training,
institutional support, and the daily realities of frontline health workers. Afya-Tek illustrates how
health system strengthening can be both community rooted and digitally enhanced but only when
technology is sensitive to local context and cultural practices.
These reflections contribute to broader discussions on digital health governance, public-private
collaboration, and the politics of care. They may resonate with scholars and practitioners
interested in how infrastructure and innovation shape health delivery in African settings, and
how anthropology can help illuminate the lived experience of system transformation on the
ground.