Developing and deploying a community healthcare worker-driven, digitally- enabled integrated care system for municipalities in rural Nepal

David Citrin, Poshan Thapa, Isha Nirola, Sachit Pandey, Lal Bahadur Kunwar, Jasmine Tenpa, Bibhav Acharya, Hari Rayamazi, Aradhana Thapa, Sheela Maru, Anant Raut, Sanjaya Poudel, Diwash Timilsina, Santosh Kumar Dhungana, Mukesh Adhikari, Mukti Nath Khanal, Naresh Pratap KC, Bhim Acharya, Khem Bahadur Karki, Dipendra Raman SinghAlex Harsha Bangura, Jeremy Wacksman, Daniel Storisteanu, Scott Halliday, Ryan Schwarz, Dan Schwarz, Nandini Choudhury, Anirudh Kumar, Wan Ju Wu, S. P. Kalaunee, Pushpa Chaudhari, Duncan Maru

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


Integrating care at the home and facility level is a critical yet neglected function of healthcare delivery systems. There are few examples in practice or in the academic literature of affordable, digitally-enabled integrated care approaches embedded within healthcare delivery systems in low- and middle-income countries. Simultaneous advances in affordable digital technologies and community healthcare workers offer an opportunity to address this challenge. We describe the development of an integrated care system involving community healthcare worker networks that utilize a home-to-facility electronic health record platform for rural municipalities in Nepal. Key aspects of our approach of relevance to a global audience include: community healthcare workers continuously engaging with populations through household visits every three months; community healthcare workers using digital tools during the routine course of clinical care; individual and population-level data generated routinely being utilized for program improvement; and being responsive to privacy, security, and human rights concerns. We discuss implementation, lessons learned, challenges, and opportunities for future directions in integrated care delivery systems.

Original languageEnglish
Pages (from-to)197-204
Number of pages8
Issue number3
StatePublished - Sep 2018
Externally publishedYes


  • Biometric identification
  • Community health workers
  • Delivery of healthcare, integrated
  • Electronic health records
  • Health information systems
  • Nepal


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