Himarika – building a new brand for East Africa
Simon Moore talks to Annrita Ikahu and Robert Kimathi from Avert’s takeover partner LVCT Health about their future plans for Avert’s job aid for community health workers, Boost.
Simon Moore (Director of Programmes, Avert) with Annrita Ikahu (Special Projects and Business Development Director, LVCT Health) and Robert Kimathi (Programme Manager, Digital Health & one2one Youth, LVCT Health).
I met Annrita Ikahu and Robert Kimathi for this interview towards the end of Avert’s 12-month transition strategy, which has seen Avert work with three Africa-based partners to take over its work. With funding from ViiV Positive Action, over the past six months, LVCT Health has translated Avert’s job aid for community health workers Boost into Swahili and carried out a user engagement and co-creation exercise to rebrand the app for East Africa. The result is Himarika – hima means fast and rika means peers in Swahili – a tool that will enhance peer educators’ and community health workers’ knowledge, skills and confidence. LVCT Health will own, manage, roll out, and scale up Himarika across Kenya and the wider East African region.
How did you first come to know about Boost?
Annrita Ikahu: We first heard about Boost at the ICASA conference in Zimbabwe in 2023.
Robert Kimathi: I was presenting the stepped care model as a digital session with other partners. During that time, I met Avert’s CEO, Sarah. We started discussing Boost, and we could see immediately how it could support our existing strengths and strategy.
What were your reactions when the idea of taking over the ownership and management of the Boost brand in Kenya and East Africa came up?
Annrita Ikahu: We were very excited because one of our strategic areas is digital health, so it was very well aligned. We were excited to start working with Sarah and the team on how we could adapt it.
Robert Kimathi: And that excitement, actually, has just solidified as time has gone on. Strategic discussions, technical sessions with the team, understanding the theory of change, and how the product and content have been developed for the current population – it's become more exciting every day to envision the impact of Himarika across Kenya and East Africa.
You said Boost fitted well into the organisation's strategy. What would you say is most valuable thing about Himarika?
Annrita Ikahu: It's such a powerful tool in giving information to community health workers, peer educators, and any young person who has a role in health outcomes in Kenya. When you look at the health outcomes in Kenya for young people starting from unplanned pregnancies to SRH to HIV, adherence to care and treatment, the outcomes are so poor. We see Himarika as a very important tool peer educators can use to help young people access accurate information about mental health prevention, HIV prevention, pregnancy, and so much more.
It's such a powerful tool in giving information to community health workers, peer educators, and any young person who has a role in health outcomes in Kenya.
Are there any specific examples you can give of how it will complement your existing programming?
Annrita Ikahu: Yes, one of the key areas we are looking at is integrating Himarika into our large PEPFAR grants, such as DREAMS, that focus on adolescent girls and young women. A lot of girls have unintended pregnancies, and we need new solutions for that. We are also looking at integrating Himarika within the youth programming within the PEPFAR grants so that we can improve the HIV and SRH outcomes for young people. There is huge leverage because we have the same management structures and systems as OPHID in Zimbabwe (the Boost takeover partner in Southern Africa who piloted and implemented Boost), to give oversight. We see these programmes as the low hanging fruit where we can make quick progress.
Robert Kimathi: In addition, Himarika will help us continue to strengthen our leadership in health and digital health, especially by exploring tech-driven preventative approaches, in Himarika’s case, an empowerment product. I think that is critical for us in Kenya and East Africa.
One of the highlights of the takeover process for me has been your branding process – both fast and putting co-creation and users at the centre. What are the highlights of the process for you?
Robert Kimathi: Thanks for noticing that. The branding process for myself and Annrita was also a highlight. We gave young people the time and invested in them, and they gave us the product—they gave us Himarika. The branding process was fast but very intentional.
Another highlight has been the commitment of the Avert staff. It’s hard if you know your job is ending, but the team has been so committed to seeing this product being handed over successfully. Seeing the teams work long hours to make sure the transition is a success is also very touching and very human. It’s been quite unique and really illustrates the culture and passion of what you and the team are doing.
Tell us a bit about your immediate plans for Himarika. What’s next?
Annrita Ikahu: I think for the next six months, it will be planning and carrying out the implementation of our programmes. So we’ll visit and see what is happening in OPHID in Zimbabwe. We’ll ask as many questions as possible so that when we return to implement, we have identified and understood the practicals. Because sometimes what you hear in theory and when you go to the field and see in practice are two different things.
We also want to bring together stakeholders to discuss the implementation. Among the stakeholders, we’ll be bringing our donors to alert them that we have this intervention. We hope that in the next one to two years, PEPFAR will be able to fund it within current projects.
In addition, we need to develop an impact evaluation protocol as early as possible so that we can start monitoring the interventions. Boost has worked elsewhere in a similar setting. So, by the end of the first year, we want to see what the gains are and harness them.
It's about planning and hitting the ground running because we want to quickly start showing stakeholders results.
Himarika will help us continue to strengthen our leadership in health and digital health, especially by exploring tech-driven preventative approaches
What's the most exciting thing about Himarika now going forward for you?
Annrita Ikahu: It is helping us to move forward our agenda within digital health It's in our strategic plan, so it's helping us move that idea. Also, within our adolescent girls and young women programme we have a lot of unintended pregnancies so I’m excited to see how Himarika helps us reduce this and poor adherence to treatment for the young people. We are confident that it can help us achieve more in those areas and look forward to seeing how that will work out.
Robert Kimathi: We’re clear about what we're planning to do, the activities, what is the unique value proposition, and how we are contributing to the community health system. Himarika provides community health promoters unique support, equipping them with the tools and the knowledge. The ripple effect is what we are seeing with Boost already in Zimbabwe – over 200,000 client consultations using Boost, that's the ripple effect; over 90,000 referrals through Boost – that's the impact that we're talking about, stronger health systems and healthier communities.
When you're developing a product, you need to have an end product that is sustainable and scalable, and that's what Boost is now in my regard. It’s been proved in the context of Zimbabwe and now is being replicated as Himarika in Kenya. We’re interested in thinking around sustainable models that have scalability, tech for public good that can be replicated across contexts.
So for me that’s what’s exciting.
Do you have any worries about taking Himarika forward?
Robert Kimathi: When we started work on Boost as an organization, we prioritized this work and we invested our time to capitalise on the opportunity. But the challenge going forward in the short term is a resource gap to bridge the time from implementation to scale. We know there's a lot of demand but it goes without saying, you cannot release a product in the market if you cannot sustain it.
Annrita Ikahu: It's a huge responsibility because when you listen to the Avert staff who have been working and delivering Boost, giving technical support, you see their excitement and commitment. That creates a good ‘worry’ for us, because it gives us a very huge responsibility to ensure that we succeed. It's like every time that we are trying to push and implement and scale up, we're just thinking in our minds, “I hope we’re living up to the Avert team’s dream, I hope they would be pleased with this”. That's what puts a very big responsibility on us.
So if we are sitting here in three years’ time. What will you be telling me? What will have happened with Boost? What's been achieved?
Annrita Ikahu: One of the things that I'm 100% sure is that we will have made Himarika work in our programmes. It's then going to be taken up by donors in Kenya and even PEPFAR. We hope that if it's funded within government-to-government funding then even when we are not there it's going to keep working for the reduction of some of the poor outcomes that we are seeing right now.
Also we want to have created a business model where anyone else who wants to use Himarika is able to, and that we have capacity to train them, to give them technical support and to ensure that they can start implementing. All this at a fee that is sustainable. I think we will have fully figured this out in the second year of implementation.
In all our projects we also work with the government and one of the reasons why we do that is because we know then that when we are not there as an NGO it will be sustained. So we’re planning that it's going to be a multi-track business model to ensure it continues.
Robert Kimathi: We will also have moved beyond Kenya. We’ll have gone to Tanzania, to Uganda, Southern Sudan. The beauty is we have links there, we have reputation in those areas. Our initial modelling suggests the potential reach is enormous.
We have a lot of unintended pregnancies so I’m excited to see how Himarika helps us reduce this and poor adherence to treatment for the young people.
What are your hopes for ongoing collaboration with Avert’s Boost takeover partner OPHID in Zimbabwe?
Annrita Ikahu: There is so much opportunity for collaboration. OPHID in Zimbabwe has a huge experience in implementation of Boost which we don’t have yet. They have lots of data already, which would be incredibly useful during our stakeholder meetings and to demonstrate impact and value to donors and stakeholders. So there is so much we can learn from them.
Our settings are also similar, so there could be new additional content that they develop that is useful for us, and vice versa. We can also fundraise together, for example going for open calls related to digital. So collaborating to reduce duplication of effort.
We plan to visit OPHID and see their roll out in practice. And we hope they can also be able to come and also observe and see what we are doing in Kenya. I see them becoming like our Big Brother. We can share our progress, our results, ask each other questions, and continue to learn from each other and use our data to inform our programmes.
Is there anything else that you would like to say to donors and supporters who might be reading this interview?
Annrita Ikahu: Yes, I want to ask them to listen and to support us in making decisions and especially making this a viable business model. Donors want Boost/Himarika to succeed but we know they won’t keep funding it for the next ten years. So a sustainable business model is critical. We want their support, and even more their ideas on how they think we can do it well. That's our expectation.
Robert Kimathi: I think there is strong value proposition for donors to invest in making Himarika a success. It’s a low-cost, effective intervention with a lot of reach and a ripple effect in the broader health systems. Investment in Boost/Himarika empowers community health workers so they can give their community members agency and power to make their own choices about their health. Investing in this also has a ripple effect within the community. I think if donors invest then they’ll see a lot of ripple effect over the next five or ten years to come.
Avert has every trust in LVCT Health and your ability and commitment to make Himarika a success. What final words do you have for those who don’t know LVCT Health like we do?
Annrita Ikahu: We are a big organisation and integrity is one of our core values. That's how we've been funded for this long. That’s how we have four major PEPFAR grants in Kenya. We perform, we sometimes make mistakes, but we wake up very fast, and we learn very fast. So we are confident. We are putting in systems so that in Avert’s absence, we can be supported by OPHID, our African brothers in Zimbabwe. We are not worried. This will be sustained, this will be a success. People can trust us. We are not a newcomer, we have our history.
Simon Moore is the Director of Programmes and Digital Health Strategy at Avert. This interview took place on Wednesday 20 November 2024 in Brighton, UK.
This is one of three blogs that showcase the incredible work of Avert's transition partners as they take over the ownership of transformative digital tools like Be the Know, Boost, and HimaRika. The partners' innovative approaches highlight the bright future of these brands – they will not just continue but thrive and drive meaningful change in health education and outcomes. We hope these interviews offer a glimpse of what lies ahead and we invite you to stay engaged with these evolving brands and the organisations taking them forward.