In Kwale, health choices are made in the space between a hopeful message and a shaky signal. Over the past months in Msambweni and Lunga-Lunga, we sat with families, young “sickle cell warriors,” Community Health Promoters and Advocates, and health workers. We heard about long clinic days, empty pharmacy shelves, confusing referrals and the steady courage it takes to try again tomorrow.

At DPE, we build like learners: listen deeply, test small, improve fast. Our job is to turn frontline realities into tools people can actually use. That’s why we’re shaping InfoAFYA™, a simple household health assistant, around what Kwale told us. We’re guided by a practical lens adapted from an article in ICTworks’ named “Three Eyes of Digital Transformation” framing – infrastructure, infomediaries, and actionable information – which keeps us focused on what helps a family take the next right step today. ICTworks

This work is made possible with support from the SFA Foundation and the Gates Foundation. Their backing helps us keep the focus where it belongs: on solutions that fit everyday life, in the language people speak, through the channels they already use.

What We Heard in Kwale

From interviews and focus groups with Health Care Workers, Persons Living with Sickle Cell Disease (PLSCDs), caregivers, and community leaders, a clear picture emerged:

• Awareness gaps and stigma. Some people don’t know their SCD status; others suspect but don’t seek care. Misconceptions lead to fear, isolation, and silence – “Some call it bones disease (ugonjwa wa mifupa).”
• Trust and tradition. For many, a traditional healer is the first stop. As one clinician put it: “You try to explain A, B, C, D, but they believe the traditional healer more than you.”
• Money and medicines. Stockouts at public facilities are common; private care is available but costly. “You’ve paid for cover, you arrive, there is no medicine.”
• Referrals that stall. Initial tests happen locally, but confirmatory tests are often out of county. Families hand-carry results between facilities; some never complete the loop.
• Records that don’t follow people. Without simple tracking, it’s hard to know who was referred, who started treatment, and who fell through the cracks.
• School struggles. Students fear being doubted or punished when pain strikes. One young person told us, “You miss classes. Topics move on without you.”
• A missing spotlight. SCD sits outside many county priorities. Unlike HIV or TB, there are few dedicated clinics, few IEC materials, and little routine outreach – despite real need for plain-language guidance in Swahili.

These aren’t abstract “barriers.” They’re daily decisions: Do I spend fare on a trip that may end with “no drugs today”? Do I tell my boss? Will the teacher understand?

The Three Eyes, Through Kwale’s Experience

We found the Three Eyes helpful because they describe the chain that turns a message into action. ICTworks

1) Digital Citizen Infrastructure

Make the basics work, even on a bad day. When signal drops and transport is expensive, small hurdles become big delays.

• Keep communication light and phone-friendly.
• Send timely reminders that still make sense if they arrive late.
• Reduce extra trips – combine steps when you can, and be crystal clear about where to go next.
• Capture the bare minimum of data needed to know if a referral happened and if medicines were received.

Infrastructure is not towers and apps to families, it’s whether today’s advice reaches them and saves a trip.

2) Infomediaries Rooted in Communities

Trust travels faster than fiber. Community Health Promoters, Advocates, teachers, and faith leaders are the bridge between services and homes. The ICTworks article calls them “soochnapreneurs” – community entrepreneurs of information. Kwale already has them. ICTworks

• Give CHPs short myth-busting scripts and simple checklists.
• Bring schools into the conversation early – provide shade, water, rest, and a plan to overcome punishment and ridicule.
• Offer clear escalation paths so trusted messengers can connect families to the right clinician fast.

When trusted voices carry accurate, kind guidance, families move sooner—and with less fear.

3) Actionable Information

Say what to do, by when, and where. People asked for steps, not speeches.

• “Bring your child to the clinic this month; ask for the SCD register.”
• “Carry water today and take folic acid daily.”
• “If severe pain lasts over two hours, call or go to the nearest facility.”
• “If referred, return with results; if cost is a barrier, tell your CHP.”

Use Swahili and local terms that make sense at home. Keep it short. Reduce anxiety. Point to a door someone can actually walk through.

A Few Voices We’re Carrying With Us

• Hope in good care: “In a private hospital, you get hope… You feel you’ll see tomorrow.” – Adult living with SCD
• The pull of belief: “They believe the traditional healer more than you.” – Health worker
• The classroom gap: “If you miss a topic that week, you miss. It’s not repeated.” – Student with SCD

These aren’t outliers. They’re signposts. They show where a small change – one message, one conversation, one accommodation – could make a big difference.

From Findings to Focus (and Where InfoAFYA™ Fits)

InfoAFYA™ is our everyday companion for households: a simple, conversational way to get reliable tips, reminders, and next steps, especially when energy, data, and time are short. In Kwale, that means:

• Infrastructure: keep messages light and resilient.
• Infomediaries: share the same clear guidance with CHPs, teachers, and local leaders.
• Actionable information: always end with a doable step and the place to take it.

With support from the SFA Foundation and the Gates Foundation, we’re turning field insights into friendly, repeatable nudges that help families act sooner and with more confidence.

A Shared To-Do List for Kwale

1. Name SCD out loud. Put it alongside malaria and HIV in county health promotion.
2. Meet schools where they are. A 10-minute briefing can change a child’s year.
3. Lower the paperwork burden. Track referrals and results with simple tools and clear hand-offs.
4. Make costs transparent. Help families plan for confirmatory tests and medicines.
5. Keep language simple. Swahili first, with local terms that lower fear, not raise it.

Closing: Building Like Learners

Kwale reminded us that “digital” only matters if it helps a caregiver or parent make one good decision today. The path is clear:

• Keep the rails simple and reliable: messages that load on basic phones and survive weak signal.
• Stand with local messengers: CHPs, teachers, and community leaders who carry trust into homes and classrooms.
• Speak plainly: short, timely steps in Swahili and local terms that reduce worry and spark action.

As DPE, we’ll keep learning in the open, shipping small improvements, measuring what counts (completed referrals, kept appointments, controlled pain), and redesigning with the people who use our tools. InfoAFYA will stay humble and helpful, no jargon, no hoops, just practical support when it’s needed most.

If you work in county health, in a school, in a community group, or you’re a caregiver who wants to shape the next round of messages, let’s talk. ICTworks