One digital card, one story for every Zanzibari linked to healthcare

Zanzibar.  The hospital used to be a place of prolonged waits and anxiety for Juma Hamisi, a 51-year-old resident of Welezo, Zanzibar, an island with an estimated population of over 1.8 million. But that's now history.

On Saturday last week, during his routine check-up at Chumbuni District Hospital for vision and heart problems, it felt different.

Healthcare is accessible for every citizen on the Indian Ocean Archipelago; however, for years, patients like Hamisi faced an arduous journey when visiting hospitals for healthcare.

Doctors had to go through piles of fragmented records and ask the patients for repeated explanations. Previously, patient medical records could be accessed through exercise books (daftari), famously named by locals as “buku.”

Each new patient visits at a different clinic, and each new doctor starts with the same questions: Have you been here before? What medications are you on?" Mr Hamisi remembers the countless times trying to recall every detail, every forgotten prescription, and every past diagnosis, a burden that added to the stress of his illness.

A sigh of relief 

Like 93% of all Zanzibaris, Hamisi’s healthcare experience has now been transformed through the rollout of an innovative e-service known as “Kadi ya Matibabu,” whose implementation started in 2021. 

This unique patient ID serves as a digital gateway for accessing healthcare across Zanzibar. It allows each patient to be uniquely identified, with their entire medical history embedded in the ID. As a result, patient information is now digital, so it's simple to transfer and retrieve, a shift from the previous inefficiencies of the old paper systems.

The Kadi ya Matibabu initiative in Zanzibar was born out of a collaborative effort between the Ministry of Health, Zanzibar and PharmAccess from 2020. This is part of the Revolutionary Government of Zanzibar’s efforts in digitising healthcare services as a key stepping stone to achieving Universal Health Coverage (UHC). The initiative has now been fully handed over to the government, marking a significant step in ensuring it remains sustainable.

"Now, as long as I have this card, I don't have problems, and I don't have to pay,“ narrates Hamisi, displaying the card, with a broad smile on his face, just moments after he received treatment at Chumbuni. The digital connection had just made all the difference for Hamisi at the hospital.

Hamisi’s day at the hospital 

Approaching the registration desk, he simply presented his Kadi ya Matibabu instead of an exercise book, which previously kept the medical records. The receptionist scanned the QR code on the card, and in moments, Mr. Hamisi's basic details and a summary of past visits appeared—no fumbling for old records, no trying to recall dates or diagnoses.

The card serves as every Zanzibari’s connection to an interoperable health system, linking all district, regional, and primary healthcare facilities across the Isles. It is integrated with the Ministry of Health–designated Electronic Medical Records (EMR) systems, enabling healthcare providers to access patient data seamlessly and in real time, significantly enhancing the quality and efficiency of healthcare delivery.

In Hamisi’s case, when called in to see the doctor, his complete medical history appeared instantly. He received personalised care without having to go through redundant medical tests.

Suppose you are a Zanzibari and you hold the card. In that case, it means your entire medical history is linked to a unique digital identifier (ID) through a system powered by the Zanzibar Health Interoperability Layer (ZHIL). 

Last week, the initiative was honoured with the WSIS Prizes 2025 Award in the e-Health category. This award was presented at the WSIS+20 High-Level Forum in Geneva, highlighting its success in transforming healthcare access and delivery in Zanzibar. 

The Ministry of Health began collaborating with PharmAccess in 2020 to drive the digital transformation of healthcare services in Zanzibar. PharmAccess provided technical assistance by co-developing key tools such as the Digital Platform for Kadi ya Matibabu registrations and the healthcare utilisation dashboard, which supports the collection and visualisation of service utilisation data.

As the Ministry’s ICT Unit accelerated digitisation efforts, additional partners joined to strengthen the initiative. Organisations such as UNICEF, ZEDCo, NSK Tanzania, and Saifee Hospital brought in their expertise to support and expand the functionality of Kadi ya Matibabu. This collaboration helped solidify the card's role not only in uniquely identifying patients but also in storing individual healthcare utilization and medical histories within Zanzibar’s growing digital health ecosystem. These partnerships ensure the system aligns with national policies and is built for long-term sustainability.

The partnerships and the digital system make everything, from a quick check-up to managing a long-term condition, faster, smoother, and truly connected. No more lost records. Experts agree it's not just about speed; it's about getting continuous, well-informed care.

Ms. Thamrati Haji, 21, who had also come to Chumbuni District Hospital for checkups, was initially unaware of the card's full benefits when registered back in May this year.

She later learned, "Our records don't get lost in the system. I believe I won't have to repeat unnecessary tests or medical history next time."

The move to this digital system is a step up from how things used to be, explains Mwaka Ameir, a community health worker in Zanzibar's Mwanakwerekwe.

"Back then, we relied on notebooks for patient information, which really dragged out the whole process," Ameir recalls.

"But now, people are really waking up to these digital cards, and they really want them! Before, when I would visit people in households and tell them to go to the hospital, they'd grumble about having to buy notebooks. Since healthcare is free, they saw that it bothered them."

Ameir adds that she and other CHWs are still working to reach everyone. "Some people haven't registered yet because of where they live, or they might be new to Zanzibar. Our job is to find them, house by house, and get them signed up."

On broader impact, Abdul Latif Khatib Haji, Director of Planning, Policy, and Research at the Ministry of Health in Zanzibar, says, “By registering 93% of citizens on the card, it shows that our referral system in hospitals has improved, from dispensaries to regional hospitals.”

He explains that it also means improved information and disease trends, ensuring continuity of care. The system further helps the Ministry understand different citizen groups and their economic status, allowing them to tailor health services and plan effective strategies for achieving universal health insurance. Crucially, Haji adds, it even aids in determining the actual costs of medicines and medical supplies, leading to more evidence-based budget planning.

But the Ministry isn't stopping there. "Currently, we have plans to ensure the remaining percentage of unregistered people is reached, and this is through the Community Health Workers (CHW) program," Haji explains. 

The CHWs have been trained and will soon be going house-to-house for registrations, building on earlier efforts that utilised hospitals and Community Health Volunteers (CHVs).

"We are now striving to ensure all systems are interoperable and to ensure that even private health facilities become part of this system," he emphasises, clearly outlining the Ministry's commitment to a unified digital healthcare platform for all Zanzibaris.