D-tree International
D-tree International, Inc.
Dar es Salaam, Tanzania, United Republic of · Founded 2004
https://www.d-tree.org/Headquarters location
Mission
D-tree International strengthens health systems in low-resource settings by designing and implementing digital clinical decision support tools that guide frontline health workers through evidence-based protocols, ensuring every patient receives quality care regardless of where they live.
Current technology use
D-tree builds clinical algorithms that run on mobile devices, guiding community health workers and nurses through patient consultations by asking screening questions, interpreting symptoms, recommending treatments or referrals, and ensuring protocol adherence.
Their flagship system in Zanzibar provides integrated decision support for reproductive health, maternal and child health, HIV/AIDS, tuberculosis, and non-communicable diseases, creating a comprehensive primary care platform.
Public notes
D-tree International's deployment model centers on deep partnership with government health systems to build digital infrastructure that becomes permanent government property rather than externally-owned parallel systems.
Press and research
- Other
Zhang, S., & Tamura-Ho, A.(2024). Branching Out: Annie Hartley Explores D-tree Collaborations in Zanzibar. Yale School of Medicine.
- Academic work
Isabel R Fulcher, Allyson R Nelson, Jalia I Tibaijuka, Samira S Seif, Sam Lilienfeld, Omar A Abdalla, Nadine Beckmann, Erica H Layer, Bethany Hedt-Gauthier, Rachel Lieber Hofmann, Improving health facility delivery rates in Zanzibar, Tanzania through a large-scale digital community health volunteer programme: a process evaluation, Health Policy and Planning, Volume 35, Issue 10, December 2020, Pages 1–11, https://doi.org/10.1093/heapol/czaa068
The utilization of community health worker (CHW) programmes to improve maternal and neonatal health outcomes has become widely applied in low- and middle-income countries. While current research has focused on discerning the effect of these interventions, documenting the process of implementing, scaling and sustaining these programmes has been largely ignored. Here, we focused on the implementation of the Safer Deliveries CHW programme in Zanzibar, a programme designed to address high rates of maternal and neonatal mortality by increasing rates of health facility delivery and postnatal care visits. The programme was implemented and brought to scale in 10 of 11 districts in Zanzibar over the course of 3 years by D-tree International and the Zanzibar Ministry of Health. As the programme utilized a mobile app to support CHWs during their visits, a rich data resource comprised of 133 481 pregnancy and postpartum home visits from 41 653 women and 436 CHWs was collected, enabling the evaluation of numerous measures related to intervention fidelity and health outcomes. Utilizing the framework of Steckler et al., we completed a formal process evaluation of the primary intervention, CHW home visits to women during their pregnancy and postpartum period. Our in-depth analysis and discussion will serve as a model for process evaluations of similar CHW programmes and will hopefully encourage future implementers to report analogous measures of programme performance.