C-it DU-it

Led by the Global South, Supported by Global Collaboration

C-it DU-it (pronounced see-it; do-it) is a Kenyan-led initiative aimed at transforming how community and facility health data can be linked and used to monitor and improve uptake and antenatal care (ANC) services. LVCT Health leads the project in collaboration with county governments and Kenyan research institutions, with technical support from LSTM.

What is C-it DU-it?

As Kenya transitions from paper-based to digital health records, multiple systems are emerging, but they often don't connect. This project bridges that gap by linking facility and community health data to improve collaboration between community health volunteers (CHVs) and healthcare facilities.

Focusing on ANC services as a model is important as Kenya is adopting the WHO's target of 8 ANC contacts during pregnancy.

The study is funded by

Project Goals

1. Increase ANC uptake and quality in Western Kenya by

linking digital ANC data between community and facility levels to enable health workers and CHVs tracking appointments and care across a woman's pregnancy journey (C-it)
capacity strengthening of work improvement teams and CHVs through data training and quality improvement tools (Du-it)

2. Build Evidence for Scale-Up by

co-developping research strategies with county policymakers
generating evidence to support national and regional scale-up of community health data strategies

3. Strengthen Kenyan-Led Research Capacity by

supporting Kenyan institutions, researchers, and county managers to drive the community health research agenda

Where We Work

The intervention begins in Homa Bay County, with scale-up planned in Kisumu, Migori, and Kakamega counties. Research includes a realist evaluation, a cluster-randomised controlled trial, and health economic analysis.

Homa Bay in Western Kenya plus Scale up counties Kisumu, Migori, Kakamega / created with mapchart.net

Working in Partnership

This study is led by Kenyan partners, with a strong emphasis on local ownership and contextual relevance:

LVCT piloted the approach and is a lead player in strengthening community health system and scale-up. Homa Bay County government are co-investigators. KEMRI conducts large health systems trials in Western Kenya. LSTM supports the research and data digitisation experts from GiND develop and test systems for data linkage adapted to each county. We work with the sub-county county teams and hundreds of community health volunteers that identify pregnancy and refer women to ANC services.

Together, we work alongside hundreds of CHVs and local sub-county teams who are vital to identifying pregnancies and referring women to services.

Our Role

At Liverpool School of Tropical Medicine (LSTM), our role is to support research quality, capacity strengthening, and data system integration. We’re honoured to work alongside Kenyan colleagues in this country-led effort.

As a key research partner in the C-it DU-it project, we bring deep expertise in global health systems, digital health, and implementation science to strengthen community health systems in Kenya.

1. Health Systems Research & Evaluation

LSTM leads the design and delivery of robust scientific evaluations, including:

A cluster-randomised controlled trial assessing the effectiveness of digital data integration on ANC outcomes.
A realist evaluation to understand what works, for whom, and under what conditions.
A health economic evaluation examining cost-effectiveness and impact on women's healthcare expenditures.

2. Capacity Strengthening

LSTM contributes technical expertise to build research capacity among Kenyan researchers and institutions.
Senior researchers from LSTM co-supervise PhD and master’s students involved in the project.

3. Digital Integration & Data Use

LSTM’s digital health experts support the development and testing of data linkage platforms that integrate community and facility health data, enabling near real-time decision-making.

4. Consortium Support & Governance

LSTM serves as the trial sponsor, providing governance, data management support, and oversight through its Global Health Trials Unit.
The institution supports compliance with Good Clinical Practice and international research standards.

A Festival of Learning

“C-it DU-it” hosted its first Learning Event in Homa Bay in October 2024. This was the first time for the Counties 16 Work Improvement Teams to meet, learn and share local innovations around early identification and referral of pregnant women.

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