{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T18:05:25Z","timestamp":1790273125884,"version":"4.1.0"},"reference-count":15,"publisher":"American Society of Tropical Medicine and Hygiene","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,24]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>As digital health tools are increasingly deployed to support community-based primary healthcare, understanding frontline user experiences is critical for effective implementation and scale-up. Here, community health workers\u2019 (CHWs) perspectives on the digitally integrated disease management system (d-IDS) in Rwanda are discussed. The d-IDS intervention was intended to improve the cost-effectiveness of community-based screening, patient management, and disease surveillance through a mobile digital platform. Before implementation, user acceptance testing and cascade training prepared CHWs, their supervisors, and health facility staff. During implementation, continuous supervision and qualitative assessments of the system were conducted. Qualitative data were collected through focus group discussions and semi-structured key informant interviews. The CHWs widely appreciated the system\u2019s ease of use, comprehensiveness, availability in Kinyarwanda (local language), offline functionality, improved data management, and ability to expedite effective patient management cascades compared with paper-based registers. Home-based screening reduced patient time and costs of care and enhanced equity and access to care, bringing Rwanda closer to achieving Universal Healthcare Coverage. However, challenges included increased workload, inadequate or lack of incentives, internet connectivity constraints, system rigidity in updating household records, and initially low digital literacy among some CHWs. Ongoing digitalization initiatives will inform national scale-up and policy choices.<\/jats:p>","DOI":"10.4269\/ajtmh.26-0053","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T17:18:41Z","timestamp":1790270321000},"source":"Crossref","is-referenced-by-count":0,"title":["Digitally Integrated Disease Management System in Rwanda: Community Healthcare Worker Perspectives"],"prefix":"10.4269","author":[{"given":"Jean Claude Semuto","family":"Ngabonziza","sequence":"first","affiliation":[{"name":"Rwanda Biomedical Centre, Kigali, Rwanda;"},{"name":"University of Rwanda, Kigali, Rwanda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nouh Saad","family":"Mohamed","sequence":"additional","affiliation":[{"name":"Pan-Africa One Health Institute, Kigali, Rwanda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie Fidele","family":"Muremba","sequence":"additional","affiliation":[{"name":"Rwanda Biomedical Centre, Kigali, Rwanda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herv\u00e9","family":"Rutebuka","sequence":"additional","affiliation":[{"name":"Society for Family Health, Kigali, Rwanda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvere","family":"Mugumya","sequence":"additional","affiliation":[{"name":"Institute of Endemic Diseases, University of Khartoum, Khartoum, Sudan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manasseh Wandera","family":"Gihana","sequence":"additional","affiliation":[{"name":"Society for Family Health, Kigali, Rwanda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayman","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Pan-Africa One Health Institute, Kigali, Rwanda;"},{"name":"Ministry of Health, Kigali, Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Soc Sci Med","first-page":"87","article-title":"Utilizing community health worker data for program management and evaluation: Systems for data quality assessments and baseline results from Rwanda","volume":"85","author":"Mitsunaga","year":"2013"},{"issue":"4","key":"b2","series-title":"BMJ Open","first-page":"e079776","article-title":"Public health surveillance through community health workers: A scoping review of evidence from 25 low-income and middle-income countries","volume":"14","author":"Alhassan","year":"2024"},{"issue":"5","key":"b3","series-title":"Am J Trop Med Hyg","first-page":"1093","article-title":"Assessment of the COVID-19 surveillance system in Sudan: Performance, limitations, and recommendations","volume":"111","author":"Mohamed","year":"2024"},{"issue":"3","key":"b4","series-title":"Vaccines (Basel)","first-page":"307","article-title":"The mpox response among key populations at high risk of or living with HIV in Rwanda: Leveraging the successful national HIV control program 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study","volume":"12","author":"Omorou","year":"2024"},{"issue":"1","key":"b8","series-title":"Malar J","first-page":"36","article-title":"Determinants of the persistence of malaria in Rwanda","volume":"19","author":"Rudasingwa","year":"2020"},{"issue":"3","key":"b9","series-title":"Trans R Soc Trop Med Hyg","first-page":"193","article-title":"The role of integrated programs in the prevention of COVID-19 in a humanitarian setting","volume":"116","author":"Ali","year":"2022"},{"key":"b10","article-title":"Global Tuberculosis Report 2024.","year":"2024"},{"key":"b11","series-title":"EBioMedicine","first-page":"106168","article-title":"Implementation and evaluation of a community health workers-led digital integrated diseases screening system to provide healthcare for patients at community level in Rwanda","volume":"125","author":"Ngabonziza","year":"2026"},{"issue":"5","key":"b12","series-title":"Comput Inform Nurs","first-page":"206","article-title":"Health worker mHealth utilization: A systematic review","volume":"34","author":"White","year":"2016"},{"key":"b13","series-title":"Digit Health","first-page":"20552076241253994","article-title":"Experiences of community health workers on adopting mHealth in rural Malawi: A qualitative study","volume":"10","author":"Kachimanga","year":"2024"},{"issue":"11","key":"b14","series-title":"PLOS Digit Health","first-page":"e0001099","article-title":"Bridging the gap between community health workers\u2019 digital health acceptance and actual usage in Uganda: Exploring key external factors based on technology acceptance model","volume":"4","author":"Chraish","year":"2025"},{"issue":"1","key":"b15","series-title":"BMC Prim Care","first-page":"173","article-title":"Barriers and benefits of mHealth for community health workers in integrated community case management of childhood diseases in Banda Parish, Kampala, Uganda: A cross-sectional study","volume":"25","author":"Kansiime","year":"2024"}],"container-title":["The American Journal 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Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/aop\/article-10.4269-ajtmh.26-0053\/article-10.4269-ajtmh.26-0053.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/aop\/article-10.4269-ajtmh.26-0053\/article-10.4269-ajtmh.26-0053.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T17:18:41Z","timestamp":1790270321000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/aop\/article-10.4269-ajtmh.26-0053\/article-10.4269-ajtmh.26-0053.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,24]]},"references-count":15,"URL":"https:\/\/doi.org\/10.4269\/ajtmh.26-0053","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,24]]}}}