Abstract
The successful implementation of an Electronic Community Health Information System (eCHIS) in Kenya is pivotal for enhancing healthcare delivery. This study explores the role of co-creation in the implementation of eCHIS, focusing on achieving adaptability, interoperability, and standardization. We employed semi-structured interviews with key informants, including policymakers, implementing partners, and end users. The Consolidated Framework for Implementation Research (CFIR) guided our thematic analysis. Key findings indicate that co-creation facilitated consensus and synergy among stakeholders. The construct of adaptability was highlighted through the customization of eCHIS to meet diverse needs, as reflected in the stakeholders' emphasis on real-time data access and policy-driven evidence. Interoperability was achieved through collaborative efforts to integrate eCHIS with existing health systems, supported by unified standards and protocols. Standardization efforts were underscored by the establishment of uniform data collection and reporting practices across all counties. Stakeholders perceived strong political support and leadership as critical to overcoming implementation challenges. Effective collaboration, continuous training, and capacity building were identified as essential for sustaining the system. The study also revealed that end users, including community health assistants and promoters, felt confident in their ability to utilize eCHIS, attributing this to comprehensive training and support structures. The co-creation approach significantly contributed to the successful implementation of eCHIS in Kenya by fostering adaptability, interoperability, and standardization. These findings underscore the importance of collaborative frameworks in health information system deployments, aligning with broader literature on co-creation and health systems strengthening.