Will our control rates match what DHIS2 shows?

That is the design goal. The controlled, uncontrolled and lost-to-follow-up indicators are implemented to the DHIS2 hypertension package's own definitions, including the rules about which patients count in the denominator, so the number a clinic sees in AfyaConnect is computed the same way as the national dashboard.

Why is the first blood pressure reading discarded?

Because it reads systematically high. The HEARTS approach takes more than one reading and averages the later ones, and the system does that automatically so the recorded value is the one a protocol decision should be based on.

Can we use our county's treatment protocol?

Yes. The protocol is data, not code. AfyaConnect ships a default stepped protocol based on the Kenya Essential Medicines List, labelled as a starting point, and the clinic replaces or edits the steps to match the protocol its county uses.

Does it follow up patients who stop coming?

Yes. Patients overdue for review appear on a defaulter list, and staff can contact them from the record. Patients who have been dormant are reported separately, without being dropped from the denominators the national indicators require.

Diabetes and Hypertension Clinic Software for Kenya

Hypertension and diabetes registers whose control rates match your DHIS2 dashboard, with treatment protocols, complication screening and follow-up for patients who stop coming.

What’s included

Hypertension register built to the DHIS2 hypertension package and WHO HEARTS
Blood pressure taken as several readings with the first discarded and the rest averaged
Controlled, uncontrolled and lost-to-follow-up rates calculated to the DHIS2 definitions
Treatment protocol stored as editable steps, so the clinic follows its county protocol
Diabetes register with HbA1c trajectory, glucose logs and time-in-range
Complication screening: eGFR (CKD-EPI 2021), albuminuria, foot examination and ulcer tracking
Defaulter lists and patient outreach for missed reviews
ICD-11 coding and DHIS2 export

Non-communicable diseases are now a large share of every Kenyan outpatient department, and they are managed badly on paper for one reason: chronic care is about the trend, and a paper file shows you one visit at a time.

AfyaConnect's NCD module is built around the registers and indicators that hypertension and diabetes programmes actually use, so the clinic and the national dashboard are looking at the same numbers.

Hypertension, done to HEARTS

The hypertension register follows the DHIS2 hypertension package and WHO HEARTS rather than an invented scheme.

Better readings. Several blood pressure readings per visit, the first discarded, the rest averaged.
A protocol everyone follows. The stepped treatment protocol is stored as editable data. HEARTS works because a whole clinic follows the same protocol, whichever one it is.
Indicators that reconcile. Controlled, uncontrolled and lost-to-follow-up rates and quarterly cohorts are calculated exactly as the package defines them. We kept the package's denominator rules even where they look odd, because a number that cannot be compared with DHIS2 is not useful to a programme.

Our guide to hypertension control with WHO HEARTS explains the indicators in plain language.

Diabetes

Register with risk stratification
HbA1c trajectory, glucose log and time-in-range
Therapy with Kenya Essential Medicines List formulary and insulin titration support
Complication screening: kidney function (eGFR by CKD-EPI 2021, albuminuria), feet (examination and ulcer tracking) and more
Acute events, including a DKA flowsheet
Self-management goals and education sessions

Keeping patients in care

A chronic disease clinic's biggest loss is the patient who stops coming. Defaulter lists surface them while they are still recoverable, and staff can reach them from the record. Dispensing history doubles as an adherence signal: sixty days of tablets collected in a hundred and twenty days shows up in the data long before it shows up in the blood pressure.

Reporting

Diagnoses are coded in ICD-11 and the indicators export to DHIS2, so programme reporting comes from the clinical record rather than a parallel tally sheet. See how KHIS monthly reporting works.

The NCD module runs on the same patient record as the rest of the hospital management system, with lab results flowing in and prescriptions flowing out to the pharmacy. Register your facility to try it with your own cohort.

Frequently asked questions

Will our control rates match what DHIS2 shows?: That is the design goal. The controlled, uncontrolled and lost-to-follow-up indicators are implemented to the DHIS2 hypertension package's own definitions, including the rules about which patients count in the denominator, so the number a clinic sees in AfyaConnect is computed the same way as the national dashboard.
Why is the first blood pressure reading discarded?: Because it reads systematically high. The HEARTS approach takes more than one reading and averages the later ones, and the system does that automatically so the recorded value is the one a protocol decision should be based on.
Can we use our county's treatment protocol?: Yes. The protocol is data, not code. AfyaConnect ships a default stepped protocol based on the Kenya Essential Medicines List, labelled as a starting point, and the clinic replaces or edits the steps to match the protocol its county uses.
Does it follow up patients who stop coming?: Yes. Patients overdue for review appear on a defaulter list, and staff can contact them from the record. Patients who have been dormant are reported separately, without being dropped from the denominators the national indicators require.