TotoAfya Digital
Maternal & Child Health EHR Platform for Rural Clinics & CHWs
Problem Context & Objectives
Rural clinics in East Africa struggle with paper-based maternal healthcare records, leading to lost immunization track records and delayed emergency interventions. TotoAfya provides an offline-first Electronic Health Record (EHR) system designed explicitly for low-resource environments.
Architectural Highlights & Systems Engineering
- Pattern 1
HL7 FHIR Interoperability Architecture: Built standard-compliant FHIR R4 resource mapping (Patient, Immunization, Observation, Encounter) for seamless national health stack integration.
- Pattern 2
Offline-First Sync Protocol: Designed an encrypted SQLite transaction queue operating seamlessly in zero-connectivity rural clinics, auto-resolving conflicts on network reconnection.
- Pattern 3
CHW Worklist Automation: Algorithmic scheduling generating daily follow-up visit rosters for CHWs targeting high-risk maternal patients.
Technology Stack
Compliance Standards
- Kenya Digital Health Act 2023
- Kenya Data Protection Act 2019
- HL7 FHIR R4 Standard
TotoAfya Digital Pipeline Blueprint
HL7 FHIR R4 Stack
Interoperability PipelineStandard-compliant HL7 FHIR R4 mapping layer transforming clinical maternal encounter data into national health registry format.
{
"resourceType": "Observation",
"id": "maternal-vitals-902",
"status": "final",
"code": {
"coding": [{
"system": "http://loinc.org",
"code": "8480-6",
"display": "Systolic Blood Pressure"
}]
},
"valueQuantity": { "value": 124, "unit": "mmHg" }
}Measurable Outcomes & Impact
- Outcome #1Awarded Best Health Innovation at WRICC 2026.
- Outcome #2Successfully piloted across healthcare facilities in western Kenya with 100% CHW adoption rates.
- Outcome #3Reduced maternal follow-up default rates by over 40% in pilot zones.