ChanjoTap

Globally, immunization is one of the major contributors to public health, preventing over 20% of childhood mortality annually with the highest fatality rates from vaccine preventable diseases being prevalent among children less than five years old. Despite immunization guidelines put in place by the World Health Organization, globally, 1.5 million children still die annually due to inadequate vaccination coverage [1]

In Kenya ultra-poor settings particularly rural arid and semi-arid areas, the Kenya expanded programmer on immunization (KEPI) a project of Kenya government has intensified child vaccination as a key strategy to improve child survival and reduce morbidity. Though this program has represented the most cost effective and simple intervention to protect against distressing epidemics there are challenge of enormous nature emanating from  religious fanatics' and terrorism in northern Kenya. GAVI has reported that “Health workers in the northern region of Kenya  face misinformation and the threat of Al Shabaab which has affected the strategy to reach zero-dose children [2]“. This has resulted in children from Northern Kenya deprived from mortality and morbidity related benefits that are derived from prevention of infectious diseases through vaccination. 
Since 2019 through our organisation STAMP CLEANTECH we have been supporting the Kenya Government vaccine initiative through our award winning intervention “Royalty rewards to address Barriers to immunization uptake[3]”.This has been in remote and hard to reach areas . As we implement this we have continually observed and faced emergent barriers confronting parents, caretakers, providers, and the health systems that keep hindering childhood immunization which in turn affects public health care and health for all as follows;

1. Parents/ caretakers’ barriers  related to lack of knowledge on immunization schedule/vaccines, long distance to vaccine access points, poor households with financial deprivation, children born in home settings of mothers with no education, migratory communities searching for pastures and livelihoods, limited health facilities, parent’s forgetfulness and inconvenient time , language barrier and limited Mobile and internet infrastructure. We have noted that these areas have lower rates of full child immunization and adherence. Even though there were some initiatives that would send SMS to caregivers on immunization schedule and availability, the SMS normally takes a week or a month to deliver and that only happens if by chance the caregivers will find themselves in an area with mobile network. We have also noted that majority of these caregivers are illiterate and cannot read the reminder SMS resulting in many children missing important vaccines.
2. Barriers at the health system level observed and cited by healthcare providers includes limited human resources and inadequate infrastructures to maintain the cold chain and adequate supply of vaccines in remote areas. In instances where vaccines are available it is hard most of the times to trace unvaccinated children for either they have migrated or in some instances they are not traceable .
3. Where health service providers have mobile clinics there are inadequate home visits, staff lack commitment and have poor counseling skills and they had a caveat of none open multi-dose vials unless a substantial number of children were present. This has resulted in majority of children in far flung villages missing vaccines and having no records to show what vaccines were administered. It has also been hard to map new born and other children present in remote areas.

This has continually contributed to inequities in full child immunization coverage. These under-immunized children, who are already at a socioeconomic disadvantage in early life are more susceptible to an infectious disease which worsens their early childhood development with potential lifelong sequelae or death. 

During our interactions and observation meetings with the providers and caregivers we have noted that the well intentioned interventions have limitations as follows:

• Lacks strategy on tracking child vaccines defaulters, way of sharing information to address vaccines apathy , inconsistency in administration , no specific monitoring systems that could detect anomalies and remedy them in real time with no one wanting to be responsible and a clear sustainability plan.             
• Many reported cases of double immunization of infants as caregivers had  lost the physical Child health card that would show administered vaccines,. There is lack of community based vaccines initiatives monitoring systems and health service provider mostly  depends on the caregiver’s information on child vaccines default or adherence which has resulted in falsified and unreliable records.
• The team also observed gaps and challenges in relation to last mile delivery of vaccines in marginalized areas, paradigm shift in technologies that didn’t lime well with target groups , were inconvenient and unreliable. 
• Available immunization monitoring Apps and technology lacked a human face, were not designed for areas with no network coverage and didn’t adapt to the target beneficiaries ecosystem.

As a result of this public health problem, the missed immunization will translate into high prevalence of preventable diseases, increased morbidity, mortality and disability amongst children in the first 1000 days of life for Kenya’s vulnerable communities. For Kenya as a country to reduce mortality and morbidity from vaccine-preventable diseases, adoption of innovative strategies will result in high coverage and minimize drop-outs and missed opportunities.

In an environment of significant cost restraint and increasing demands for more children to be immunized, a low-cost solution child vaccine tracking in remote and hard to reach areas in Kenya has always been a felt need to.

[1] https://www.researchgate.net/p... 

[2] https://innov.afro.who.int/eme...

ChanjoTap a low tech electronic smart off grid caregiver pendant and child bracelet programmed as per individual child vaccine schedule to flash intermittently, vibrate causing a tingling vibrating sensation on caregiver and child skin. The bracelet and pendant are both water proof, small, light-weight and have non-intrusive amber, green and red lights. For the child it creates a disturbance making the child cry, laugh or make sounds consistently attracting caregiver attention. The vibration and flashing LED lights alerts and reminds them on the upcoming vaccine schedule. For the CHVs the same alert simultaneously happens on their pendant which is programmed as per schedule of each child  immunization schedule. They are able to identify which child is due , adhered or defaulted since the LED  lights are numbered and only brink on specific child number making them pay a visit to remind m check on default of the child. 

ChanjoTap operates as follows

1. Three days prior to vaccine due date an Amber light flashes intermittently on both bracelet and pendant after every six hours simultaneously for a 15 second duration and increases to one hour interval a day before the vaccine is due.
2. On vaccine due date the green light on the child’s bracelet and mothers pendant flashes every 15 minutes to remind them the vaccine is due.
3. If the mother did not take the child for the vaccine a day after the vaccine due date the red light flashes continuously and activates an alarm at intervals of 30 minutes to notify them they have defaulted.
4. Simultaneously the CHVs get an alert of an amber light three days prior for each caregiver, a green light for each caregiver who has taken children for vaccine and red for defaulters and late uptake and a vibration.

Through the machine learning process and an integrated algorithm as  a caregiver taps their pendant or the child bracelet by CHV a request is sent to health clinic that services the area to plan the delivery of vaccines using Geolocation software embedded in the assistive products and CHV phone. This enables the clustering and consolidation of vaccines needed for children in a particular remote area at a certain given timeline , recording of vaccination status and uploading data into the ChanjoTap immunization Information Record System (CIIRS). The information is relayed on  daily updates on children for whom vaccination is overdue and contact details of families available for tracing by CHVs.

ChanjoTap is given to caregivers when they visit a clinic or when they are enrolled by CHVs in their communities. Each bracelet is activated during registration and is programmed to align to individual  child’s immunization schedule as per their child health card. Both have a QR code and the caregiver just tap on caregiver phone or the  community health worker scans the same when they pay visit to the household. At the health facility the caregiver can also tap or the nurse administering the vaccine can scan their smart phone which opens the virtual child health card.

The tapping or scanning opens the ChanjoTap immunization Information Record System (CIIRS) either on web page  or on health service provider gadget  enabling them access the specific child’s dashboard  digitized immunization booklet. By just a click the nurse records the administered vaccine which sync automatically and updates the CHV dashboard. This facilitates generation of customized vaccination schedules, creates a virtual immunization record and syncs with calendar for scheduling. The nurses also key in any treatment offered , development milestones and the CHV records weight of child and other significant changes or issues observed during household visits.

If caregivers lose the Child health booklet, forget it at home, migrate to another area where the CHV or health facility has the platform they just need to scan their pendant’s QR code in a nurse station or CHV phone.  A dash board with the child and mothers information in regards to immunization will pop up and the nurse will quickly click vaccine take rather than the current tedious hand written records. This will sync immediately with our platform, update the CHV platform and change the child bracelet and mother pendant color to green in real time.

The platform also connects caregivers to a health system and importantly, monitored and tracked childhood immunization adherence in real time in the health facility where they attend.

ChanjoTap complements our award winning project “Innovative community-led caregiver reward system by increasing and monitoring vaccines uptake in resource deprived settings.” Every three months depending on royalty rewards the caregivers can redeem their points for doctor’s hour chat, discounts for child related products amongst vendors in their community who have enrolled for the discounted program. 

ChanjoTap is contributing to reducing immunization default, monitoring effectiveness of the government incentives given to mothers in pre-natal clinics as well as defining the ground for establishing of community targeted Royalty rewards schemes. ChanjoTap has ease of use , effective amongst caregivers with low literacy levels , has no or limited access to the internet or mobile network services and enables health service providers to plan outreach and reduce vaccine wastage.

In future through further development ChanjoTap will have a text to speech option that sends vaccine information in local dialect on importance of child immunization and disease outbreak in the area. 

Parents and caregivers are served and impacted as follows

1. ChanjoTap has unlocked and is enabling caregivers in marginalized remote areas in Kenya and lacking of access to mobile network plan and monitor their children’s vaccines uptake diligently. Its enabling children in resource based settings to access the much needed vaccines, build their resilience towards preventable diseases and overall contribute to lower morbidity and mortality. Our vision is to expand and serve the millions of children and caregivers through assistive technology so that no matter what economic backgrounds they come from, language they speak, what culture they are brought up in, that  within the first 1000 days young children will be assured of good health now and in the future. We are enabling every caregiver to take charge of their child health. It’s improving access and equity in access to child vaccines.
2. By the use of different lights and vibration , caregivers with no access to mobile phones and those with low literacy levels are informed and able to take action in relation to their child health.
3. Caregivers in future will form peer to peer groups made up of ten caregivers with a leader. Members are then paired with each other within the group whereby they monitor each other’s ChanjoTap to check for default and adherence
4. If the Child health booklet is lost, forgotten at home, or the caregiver and child migrate to another area, information will not be lost and upon tracing the CHV or health facility will just need to scan their pendant or bracelet QR code in a nurse station or CHV phone and information in regards to immunization will pop up. This will result in administering missed vaccines and avoid repetition.. Nurses administering the vaccine will just click  on vaccine taken rather than the current tedious hand written records which are easily misplaced in the remote areas thus securing the record. This will sync immediately with ChanjoTap immunization Information Record System (CIIRS), update the CHV dashboard and simultaneously change the child bracelet and mother pendant color to green in real time signifying adherence.
5. Caregivers will be allowed to keep the unique ChanjoTap as a souvenir and the same can be scanned to print the child immunization record certificate. It allows caregivers to develop their own pathways in the Royalty program.

Health service providers and communities benefits

1. ChanjoTap will strengthen the participating community owned immunization advocacy processes which resulted in a transformative approach to immunization and vaccine adherence. The program benefits children aged 0-12 months and their caregivers and provides guidance and information for Government and other stakeholders in designing their reward schemes for caregivers.
2. ChanjoTap will result in high surveillance of caregivers in relation to vaccine adherence, attendance of health education forums, increased sustainability, ownership and improved adherence of vaccines uptake by 85% within target areas.
3. Creation of a sustainable monitoring system that increases child immunization, addressing immunization apathy due to AEFIs (after effects following immunization) , record a history of other child health related information ( treatent , sickness , developmental milestones ) on the child which will be easily accessible to other health service providers attending to the child .
4.  Government and other health service providers will get immunization uptake information in real time, act on emergent health issues on real time, and enroll more mothers which will result in decreased child mortality. This will also aid in government and stakeholders interventions planning and response.
5. The ChanjoTap in long run will complement or replace the hand copy of immunization booklet that prone to mutilation, loss and getting torn in these hardship areas.

ChanjoTap has piloted in two communities with 150 caregivers successfully trained and on board are 1 volunteer doctor, 10 Community health volunteers, IT volunteer and data analysts during the initial pilot phase. The project is able to mobilize quickly and build distributed teams of community champions and healthcare workers, creatively pushing successful project implementation despite staff resource constraints. The community and caregivers' ownership of the project and feedback on what is working and what can be improved in real time has created trust and belief in the process. The project has an advisory team made up of caregivers, community health volunteers, health professionals working in the area and an IT team that spends time voluntarily in the community.

The team of volunteers underwent training from Openideo, IDEO and Gates foundation vaccines initiative and are well versed on the problem they are solving for their community which is

1. Missing and disjointed health and immunization data across communities they live in.
2. A gap in knowledge, trust, and access to the immunization process.
3. A lack of caregiver agency to control their children’s health data.
4. How does community-led, personalized support further encourage caregivers to join a health program that includes rewards and what type of rewards would caregivers be most interested in.

The team worked with assumptions and we tested and verified them through a process with the target caregivers and stakeholders on how a community-led, personalized support further encourages caregivers to join a health program.

 The Lead staffs are

Keneth Ndua Mitambo (https://www.linkedin.com/in/ke... )   a seasoned social entrepreneur, product and project design specialist. He is the lead innovator for this project and works closely with all stakeholders in project design. He is an accomplished Program manager in water and health advocacy targeting marginalized women and children. Keneth has won numerous awards in regards to designing simple health related products and services as follows

1. Finalist Openideo and Infuse urban immunization challenge in 2019
2. TOP IDEA - Empowering caregivers in immunization innovation challenge. Openideo and Bill and Melinda Gates foundation vaccine-innovation/top ideas 2019.
3. Winner and Top Idea at the Science and Technology Summit 2018 at the United Nations Headquarters New York for his innovative energy and clean water access project targeting children. ·
4. Winner innovation pitch Issued by NEPAD , Gates Foundation, Grand challenges Canada, Africa Academy of science · Mar 2016
5. Star in Global Health research grant awardee Issued by Grand Challenge’s Canada · Apr 2014 for a project titled “Reduce Incidences of child mortality due to water-borne diseases and increase access to clean water.

Monica Sena Kundu (https://www.linkedin.com/in/mo... ) a tech leader passionate about making technology work for organizations and users, her guiding principle is "it’s not only success being needed,” systems are built for users and its role is to enable users get the best value. She has experience in building successful user centric teams and believes in hiring great people and supporting them to grow, learn and add value to the organization with building skills that align with their career goals. She has been at the backbone in designing the Royalty program platform and linking it to the Chanjo Tag smart bracelet and pendant.

Dr Bernice muhati(https://www.linkedin.com/in/bernice-muhati-511418193/?originalSubdomain=ke) . She is a medical doctor working in maternal child health. She has advised on the project design, curating caregivers’ trainings and recruiting volunteer doctors who continue offering valuable lessons to the caregivers. She is in-charge of the health docket

Emmanuel Njihia Ndua 17 year’s old tech enthusiast and social innovator who have been critical in bringing the new way of thinking and design solutions that speak to the young generation.

Faith Wanjiku Gachagua . Community Health Volunteer and lead mobilizer / trainer.

The Solve grant will enable us to reach our short-term budget targets and introduce us to partners who could strengthen our long-term financial outlook, either through direct funding, coaching or connections with other funders and government partners. Funding from this challenge will enable us to learn and to address the following:

1. Expand our process to other communities to refine ChanjoTap bracelet and pendant and monitoring platform.
2. Enhance our skills in health design and innovating for community transformation through peer learning and support from experts in the field. Our team will gain new knowledge and network with peers resulting in improved project delivery and impact measurement.
3. The team will learn more and have enhanced skills which will be cascaded to our CHVs, Community Care group’s leaderships on running sustainable community led initiatives, enhancing collaboration with health service providers serving the ultra-poor and vulnerable communities.
4. Improve the ChanjoTap immunization Information Record System (CIIRS)dashboards to enable the stakeholder to log into specific dashboards and enable them get prerequisite information that will enable them to make informed choice. To do this, we need more technical thinkers, data analysts and to train more of our community champions (children and caregivers) in designing community based programs that are embedded in our system.

The Solve community experts will equip us with more skills in technology, data security, monitoring, evaluation and scaling.  Solve and its MIT-backed network will offer support and advice on how we can change the way digital tools for community health are built and deployed by creating and fostering an independent Global network. 

ChanjoTap smart bracelet and caregiver pendant are both water proof, small, light-weight and have non-intrusive flashing light and tingling vibration that creates a distraction for the child leading to them crying, laughing or making sounds alerting the caregiver to check. ChanjoTap is programmed to work off grid in remote settings with no internet or mobile network. It’s also programmed as per individual child immunization schedule as per the information in individual child health card upon enrollment.  

ChanjoTap integrates seamlessly with existing CHvs and child immunization records processes in hospitals, hospital procedures and supports current CHVs and nurse behavior and workflow. With minimal additional training, caregivers CHVs and nurses can quickly activate the ChanjoTap device in both the clinic and home settings and is optimized for use with existing ChanjoTap immunization Information Record System (CIIRS) that can easily share information with existing children immunization record systems both at the CHVs phone and at the vaccine administering nurses' station. When the time for vaccine is near, due or past has arrived, the rapidly blinking amber or green or red LED interface or vibration activates and alerts’ the caregiver and CHVs accordingly and when they visit the immunization clinic by just tapping the nurse or doctor gets all the information they need in relation to child immunization adherence or default and other information on the child growth and development of any other health issues as had been prerecorded in the monitoring system.

1. Commits caregiver to take responsibility of their child’s immunization schedule and take lead role in their children’s health. Create alerts and reminds caregivers and CHVs with no education and based in remote marginalized areas to plan in advance.
2. Unlocking and enabling caregivers in resource based settings with lack of access to internet or mobile phones to adhere, plan and monitor their children’s vaccines uptake thus addressing inequalities in vaccines uptake.
3. Allows scanning of  caregiver pendant and child bracelet to send a request for delivery of vaccines using geolocation software, recording of vaccination status and uploading data into the Child immunization Information Record System (CIIRS)which sends daily updates on children for whom vaccination is overdue and contact details of families and tracing. This enables generation of customized vaccination schedules, creation of virtual immunization record and syncing with calendar for scheduling.
4. Mitigates loss of child immunization information in case child health booklet is lost, forgotten at home, caregiver migrates to another location for information is stored electronically thus securing immunization record keeping. Upon tracing, a caregiver scans the child’s bracelet or their pendant QR code in a nurse station or CHV and the phone produces the record
5. Adaptability for further development to enable text to speech option that sends vaccine information in local dialect and an embedded child immunization related disease outbreak alert feature.
6. Government and other health service providers get child vaccines uptake information in real time, act on emergent issues on real time, enrolling more caregivers thus decreases child mortality and morbidity due to high surveillance, improved vaccine adherence, attendance of education forums and increased sustainability in target areas.
7. Chanjo Tag facilitates marginalized and poor children access to the much needed vaccines, build their resilience towards preventable diseases and overall contribute to lower morbidity and mortality. It strengthens participatory immunization advocacy processes resulting in a transformative approach to immunization and vaccine.
8. Improved monitoring and early warning system that provides actionable data checks.

Year 1 impact goals

1. Human and community centered design approach fully adopted and enabling mobilization and training of 50 community immunization champions who will act as last mile entrepreneurs in distribution and activation of ChanjoTap off grid assistive products.
2. 1000 caregivers in remote settings able to adhere to immunization schedules.
3. Real time monitoring and interventions for roaming resulting in creation of a credible database and social map by registering and enrolling 1000 caregivers and children in the program.
4. The ChanjoTap will enable parents’ access to immunization facilities when the maternal child health book is lost, mutilated or forgotten at home. This will also reduce double counting and repeat immunization which may lead to After Effects Following Immunizations.
5. The platform will enable mapping and use data to predict preventable diseases by undertaking immunization by mapping areas with low uptake and default using captured data. Cases of Polio, yellow fever, smallpox, monkey pox and other emergent diseases will be captured in real time enabling immediate attention by Government and other stakeholders.
6. Over 100 CHVs and 50 health service providers will be able to plan in advance and order the much needed vaccines on time and as per actual projections responses , simultaneously enroll pregnant mothers, and map areas with social cultural and prohibitive religious issues. This will reduce wastage and personnel costs. 
7. CHVs and health service providers will provide much needed education on immunization efficacy and after effects following immunization.

Year 5 Impact Goals

1. Reach 100,000 caregivers and children in remote settings through a digitization process with 85 % increase in adherence.
2. 500 CHVs and 200 health service providers adequately informed and equipped to access the ChanjoTap process and system thus results to reduced mortality and morbidity rates due to enhanced resilience towards preventable diseases
3. Better data for health planning and resource distribution that communicates, have community and stakeholder’s contribution and builds up community alliances that collaboratively address cultural, religious prejudices, community based prejudices and it’s contextual.
4. The platform will aid in mapping and prediction of preventable diseases by undertaking immunization by mapping areas with low uptake and default using captured data. Cases of Polio, yellow fever, smallpox, monkey pox and other emergent will be captured in real time enabling immediate attention by Government and other stakeholders.

 Impact Outcomes year 1 to 5

1. Children reaching full development milestones with resilience to preventable diseases.
2. Reliable Geo spatial data on impact of immunization health solution with each caregiver having accurate, reliable  GPS location and migratory movement which will produce  a GIS social map on immunization distribution and uptake addressing historical anomalies and cooked data by CHVs and mobile vaccine clinics. ( By year 5)
3. Strengthened, comprehensive and sustainable health systems in remote and marginalized areas for accountability, vaccine safety and quality.
4. Government and community owned health facilities providing education on child immunization, early warning and effects for delayed vaccines uptake. ( by year 5)
5. Vibrant mentorship in communities and replication in other places in Kenya. ( by year 5)
6. Vibrant community based advocacy interventions leading to realization of rights of every child access to vaccines. ( by year 5)
7. Inclusion in policy change, adequate resource allocation.  ( by year 5)

The project will have four primary KPIs that will drive the final outcomes geared towards enhancing the project’s impact: increased child immunization uptake, health education thus reduced child mortality and morbidity within the first 1000 days of a child life. An inclusive policy formulation and advocacy process will result in adequate resources allocation for vaccine distribution interventions in marginalized areas. 

Key primary KPIs are 

We will measure the intervention impact by looking at:

1. A 10% monthly enrollment increase of children and their caregivers in remote settings monthly in the project and actively adhering to children immunization schedules.
2. Percentage increase in number of caregivers , CHVs , health service providers and stakeholders  registering , knowledge in relation to the ChanjoTap program and consistent use of the ChanjoTap program .
3. 75 % of CHVs, nurses recruited actively participating in the project. 
4. 80 % increase in immunization  champions actively participating in  advocacy programs with men making 40% of the total resulting in  increased in numbers of immunization advocacy groups in their communities 

Strategy

1. Baseline and end line survey at registration of infants and their caregivers within households and subsequent monitoring on a real time monitoring system that will update monthly on child vaccine progress through visits.
2. Documentation of most significant changes observed in communities after training's conducted by community health volunteers during household visits and community forums.
3. Awareness creation and mobilization .CHVs will recruit the caregivers of new born children, key in the data using availed low cost android phones. The collected data will include current household status in relation to livelihoods, number of children, properties and GPS. Progressively every six months a repeat of the same will be done for progressive comparison.
4. Activation and delivery of ChanjoTap.CHVs provide caregivers and children with the ChanjoTap devices and activate them once they enroll them on the ChanjoTap integrates seamlessly with existing CHvs and child immunization records processes in hospitals, hospital procedures and supports current CHVs and nurse behavior and workflow. 
5. Child immunization Information Record System (CIIRS).Health service providers will record child vaccine immunization uptake progress using a record sheet on an android phone and syncing it to the ChanjoTap monitoring platform. They will help in identification of new mothers, health progress and needed health education for both current and future beneficiaries. The ChanjoTap platform will also capture any other relevant data like child weight and other emergent health related issues. This data will inform the CHVs to offer relevant education and support during follow up and inform policy change and resource providers for future planning.
6. Impact measurement.To measure the success of our ChanjoTap a 10 % increase in infants and caregivers enrollment on a monthly within a target areas will be interpreted to mean more lives saved, reduced child morbidity and mortality. This is hoped will translate in improved household well-being since caregivers and siblings will have more time to attend to other chores with affected children falling sick less often. Households will have more income to spend on basic needs.
7. Immunisation champons.Formation of inclusive ChanjoTap champions with 50 % being caregivers of children who fully adhered.

Our theory of change involves health service providers and non-health support measures ,services, implementing agencies, gap analysis and identification in the current vaccines administration ecosystem, knowledge, feedback , non-financial support measures and services currently in place to encourage caregivers uptake of child based vaccines targeting hard to reach communities in Kenya.

We hope to generate data with a human face that will influence policy change, resource allocation and enhanced interventions by government and other stakeholders in addressing vaccine adherence amongst children. Technology will be core in information sharing and it will be simple, user friendly in such a way that even the illiterate will have control over their child health reducing the burden of health costs due to missed vaccines and children affected will fully development milestones.  

Through enrolling caregivers and children in remote settings into the digitized immunization monitoring system, adopting the Chanjo Tag products will enable children and their caregivers, community health volunteers and health service providers’ better understanding the immunization. This will broadly and gradually evolve important support mechanism that will inform resource allocation, policies and advocacy interventions resulting in actualization of sustainable and transformative vaccines intervention strategies facilitate innovative social innovation  that effectively support children and their caregivers. Formation of an inclusive community of immunization champions with 50 % being caregivers of children fully immunized.

The success of our program has been through the use of ChanjoTap and linked M&E platform with the function of synchronizing data with mobile phones and tablets. ChanjoTap works through machine learning model for real time data upload and analysis, automatic classification as per regions, data extraction/capture of child health records, date of birth that enables planning of interventions.

We are working on the SMS automation to CHVs and nurses with a Simple Mail Transfer Protocol (SMTP) being integrated into the system to enable conversion of emails to SMS for quick response. ChanjoTap App is in the offing and it will be linked to our database system for it will make work easy for CHVs and Nurses.

The ChanjoTap is being connected to enable scanning to send request and delivery of vaccines using relocation software , record vaccination status and upload data into the Child immunization Information Record System (CIIRS) which sends daily updates on children for whom vaccination is overdue and contact details of families for tracing.

The project is also powered through Salesforce for interactive collection of data on real time. We have integrated GPS location for each ChanjoTag bracelet and pendant and exploring collaboration with Kenya space Agency and Regional Center for mapping development for remote mapping of caregivers and children through their GIS system.

We are currently working with machine learning model for automatic document classification & data extraction/capture of birth records / household wellbeing / livelihoods so that it can enable the project plan scaling and reach more caregivers and children in remote settings in relation to vaccines uptake.

CHVs in communities and Nurses in vaccination stations  are the key primary health care data collectors. 

The project has a team of community health volunteers (Formerly Traditional Birth attendants), immunization champions (Caregivers who participated in the pilot stage) and nurses in hospitals who are equipped with an android phone to collect data through scanning Chanjo Tag bracelet and pendant. There is also a support team of volunteer medical doctors, social workers and IT specialists. Community health volunteers are the primary data collectors. We do hope to improve the system so that more community health volunteers and caregivers in future can upload data and monitor adherence on real time.

With much success during the pilot period and lessons learnt the program has now evolved and caregivers are now being grouped in a group of ten where each is paired with another within the group under guidance of a locally based community health volunteer. Each caregiver monitors the other in the group in relation to vaccine adherence, attendance of education forums. It has also increased sustainability, ownership and improved adherence of vaccines uptake by 75% within target areas.

The CHVs are incentivized through getting advanced training in public health on emerging issues and certification by Government and other service providers. They also get ease of access to health services at no cost by the volunteer doctors who are also specialists. Access to other organizations in agribusiness, health and education for opportunities and access to services, specialized training's amongst others.

1. The project does not discriminate caregivers or stakeholders by the ethnicity, social cultural or religious beliefs or their sexual orientation. We are inclusive and embrace diversity. Our management team has 70% women and recruits people of all diversity. 
2. Formation of an inclusive community of care champions with 50 % being caregivers of children.

1. ChanjoTap Social Business model Canvas. https://canvanizer.com/canvas/...
2. B2B Government, NGOs who will act as agents and implement the project to help them track their project geared towards caregivers and children’s access to vaccines and support. They will pay a subscription to access customized dashboard and training from STAMP Cleantech team
3. Selling Chanjo Tags to middle class caregivers and organizations willing to outsource their immunization monitoring to us.
4. B2C. Subscription of SMS

1. Licensing NGOs and government institutions at a fee to access to customized dashboard and training from STAMP Cleantech team.  A fee will be charged for this
2. Charging for SMS services sent on behalf of Government and NGOs to caregivers and CHVs
3. Franchise and licensing to third party users to use the technology in their projects
4. Skills transfer, Training's and consultancy on use and application to Government and NGOs working in the space Fees for accessing customized dashboard, data sharing with health service providers, CSOs and other interested parties for targeting and research on immunization uptake and sustainability. 
5. Fees from internship and apprentice as administrative and training Fees charged to interns/ apprentices who express interest in being attached in the project 
6. ChanjoTap Pendant and bracelets sales  to other service providers

The project has been funded by through internal funding. The following is currently happening

Test results have generated interest with devolved units in Kenya who have expressed intentions of subscribing and adopting our system at a subscription

1. Collaboration with NGOs, National and local government to access customized dashboards which they will pay annual subscription.
2. Future training of NGOs, National and local government on our system for a fee.
3. We are working on getting impact investors to invest in the program and commercialism the process. The expansion will target government and NGOs sector in adopting and paying for the services.
4. Partnership with an NGO in South Sudan at advanced stages for adoption of the innovative model at a fee and STAMP being subsequent consultant.