Poor quality of care within the Tanzanian primary health system contributes to more than 600,000 preventable deaths for under-five year olds, 1.2 million unintended pregnancies (including 26% of adolescent girls aged 15 -19), and 9,000 preventable maternal deaths each year (Tanzania DHS 2015). In order to save lives and improve well - being, it is critical to bring preventive and curative care closer to communities and explore private - sector solutions to reduce the workload of health facility staff and strengthen the overall health system. Community health workers (CHWs) and private drug shop dispensers are two resources that already support individuals at the community level in Tanzania. However, they lack formal linkages to facilities and one-another and often have limited health training and opportunities to exchange critical learning and knowledge. This results in
valuable information being siloed and lost, creating additional barriers to timely access to care for children and adolescents.

There is an urgent need to establish linkages among health facilities, community health workers and drug shops to (1) improve provider decision - making in care provision and patient referrals and (2) ensure high quality, respectful, and people - centered care throughout health system touch points. Digitally -enabled approach To address these challenges, the Afya-Tek program is applying a human centered design process to develop and deploy an integrated digital system among three health system actors (community health workers, drug shop dispensers, and primary care facilities) to support client care and patient tracking from initial screening and diagnosis, through treatment and follow - up.

The system will incorporate decision - support and biometric identification, which will allow health workers at each level to provide personalized care and identify, refer, and track patients. By improving the quality and continuity of care, the digital system will help ensure prompt access to care and increase appropriate referrals. Real-time data and analytics will enable decision makers to monitor that care is consistent with international standards and implement evidence - based quality improvement measures as needed.