SQLCipher-encryptedCase study
[Case study title — programme and country]
[Problem → what was implemented → verified outcome. Use only figures the partner has approved.]
HIV & PrEP Continuity of Care
Continuity of care, offline-first.
LenZA is a clinical workflow app that keeps HIV and PrEP patients in care across Africa. It runs on any Android device with zero internet — a nurse opens it each morning and sees exactly who needs action today.
The Problem
Patients don't leave care loudly. They just stop showing up.
Every year, millions of patients on HIV treatment or PrEP quietly disengage. Facilities running on paper registers often don't notice until it's too late — and community health workers frequently rely on manual, delayed tracing lists rather than a real-time view of who needs a follow-up call today. Patients become formally "lost to follow-up" when a single phone call two weeks earlier could have kept them in care.
36%
of patient outcomes were misclassified in a validation study of routine monitoring systems
40%
of deaths were not captured in facility records
43%
of transfers out were not captured by the register — mostly unreported "silent" transfers — leading to individuals being incorrectly classified as lost to follow-up
Source: Etoori et al., Frontiers in Public Health (2020) — a study of 8 rural South African clinics, 2014–2017
Where Follow-Up Breaks Down
The data exists. The follow-up workflow doesn't.
Facilities already record the information needed to keep patients in care. What's missing is a structured, daily way to act on it at the point of care, with or without a connection.
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01
Registers, not reminders
Paper registers hold patient history, but they don't tell a nurse who needs action today.
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02
Systems in transition
Several countries, including South Africa, are modernising their national HIV data systems. Facilities need follow-up tools that work alongside that transition, not ones that wait for it to finish.
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03
No structured path to outreach
Community health workers often work from manual, delayed tracing lists rather than a real-time, prioritised view of who needs a follow-up call today.
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04
Connectivity can't be assumed
Many remote clinics can't rely on power or internet, so tools that need a connection leave gaps at the point of care.
The LenZA Approach
One continuous workflow, from community to programme.
Care breaks down between steps: a follow-up that never happens, a transfer that is never recorded. LenZA connects each step, so every hand-off is tracked by the system rather than left to memory.
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01 · Community
Reach & outreach
People can register interest in HIV prevention directly, and people who may benefit from PrEP are routed to community health workers.
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02 · Linkage
Linkage to care
A reactive HIV test result is flagged on the dashboard for clinician review, with guided ART setup.
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03 · Clinical
Point-of-care depth
ART and PrEP workflows in one record, with protocol gates such as EAC and the lenacapavir Day 2 oral dose.
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04 · Programme
Reporting without re-entry
PEPFAR MER-aligned indicators are generated automatically from point-of-care data, with DATIM-compatible CSV export.
How It Works
From facility spreadsheet to a nurse's morning list.
01
Import Facility Data
Existing patient data imports directly from Excel — up to 137,000+ records, 106 columns, one tap. No manual re-entry, no data clerk.
02
Nurse Opens LenZA
Each morning, she sees who needs action today — overdue pickups, missed viral loads, interrupted treatment. No internet required.
03
One Tap, Full Record
Treatment history, contacts, and clinical status, organised across 5 tabs — not dumped into one long screen.
04
Outreach & Reports — Automatic
People who may benefit from PrEP are routed to community health workers. PEPFAR MER indicators generate automatically from point-of-care data.
What LenZA Does
Built for the realities of facility-level care.
Automated Patient Intelligence
6 real-time line lists — Interrupted Treatment (IIT >28 days, PEPFAR MER definition), Lost to Follow-Up (LTFU >90 days, national programme definition), Missed Drug Appointment, Missed Sample Collection, Missed Biometric, and Newly Initiated Weekly — generated automatically from clinical data, boundary-tested for precision at exact threshold days.
Offline-First Architecture
Full clinical workflow with zero internet — built for remote clinics where power and connectivity are unreliable. SQLCipher-encrypted, so patient data stays protected even if a device is lost or stolen.
Smart Patient Identification
Identify returning patients using biometric face scan, plus national ID OCR — South African Smart ID, Nigerian NIN, Ugandan NIRA. Registration auto-populates from the ID card, and duplicate detection prevents ghost records.
Facility Data Import — Production Scale
Imports real 106-column facility Excel files, designed for 137,000+ records on real Android devices with batched transaction processing. Intelligent merge logic protects locked clinical baselines, and unrecognised columns are preserved rather than dropped.
Patient Data Export — PIN-Secured
Export up to 10,000 records from the patient directory to Excel in one tap, gated by a manager PIN so only authorised staff can pull data off the device. Every export is logged — who ran it, when, which filters were applied, and how many records went out — visible in the app's Export History. The export format is Excel today; the underlying architecture is built to add CSV or other formats as programmes need them.
Clinical Depth
131 fields. 5 tabs. Every pathway in one app.
ART (HIV+) and PrEP (HIV−) workflows organised across Summary, Clinical & Lab, Pharmacy, TB-PMTCT, and Info. LenZA supports both daily oral PrEP and long-acting injectable PrEP, including cabotegravir and lenacapavir, with automated dosing schedules and due-date tracking. Enhanced Adherence Counselling (EAC) workflow gating ensures all three counselling sessions are completed before a repeat viral load is recorded, in line with national HIV treatment guidelines.
PrEP Clinical Pathway
Built for the way PrEP is actually delivered.
PrEP at a Glance
Enrollment status, injection due dates, and pending actions in one view — built for the same at-a-glance triage nurses already use for ART, so switching between caseloads never means switching mental models.
Nothing Slips Through
A reactive HIV test result on a PrEP patient is flagged on the dashboard immediately for clinician review — no separate report to run, no delay before action can be taken.
Protocol, Enforced
The lenacapavir 6-month injection cycle cannot begin until the Day 2 oral dose is confirmed — the app blocks the next step rather than relying on a nurse to remember the sequence.
From Confirmation to Conversion
One journey, fully tracked — start to escalation.
Day 2 oral dose confirmation, the mandatory pregnancy-test gate before initiation, and the guided ART setup that follows a seroconversion — three moments in the same patient pathway, each enforced by the app rather than left to memory.
PEPFAR & Reporting
CSV export with PEPFAR MER-aligned indicators, auto-generated from point-of-care data — DATIM-compatible, no separate reporting system needed.
Community Health Worker View
Privacy-controlled — CHWs see outreach-relevant info without full clinical detail. Structured tasks with outcome recording, plus WhatsApp reminder integration.
Patient Directory
Searchable, filterable directory by facility, LGA, or status, with a viral load suppression badge per patient — across both imported and app-registered patients.
Offline-First Technology
Built to work where connectivity doesn't.
LenZA runs the full clinical workflow on any Android device with zero internet, and syncs securely once a connection is available. Patient data is SQLCipher-encrypted on the device, so it stays protected even if a device is lost or stolen.
- Internet connection required
- 0
- Patient records imported on Android devices in a single operation
- 137,000+
- Columns imported per facility Excel file
- 106
- Clinical fields, organised across 5 tabs
- 131
Traction & Validation
“Brilliant, long overdue — exactly what programmes have needed.”
— Principal Investigator, leading South African HIV research institution
Live Pilot — Nigeria
Supporting real patient workflows in HIV and PrEP care since July 2026, including PrEP2Care follow-up led by the facility's Linkage Officer.
Live Pilot — Eswatini
PrEP2Care workflow running in an active facility pilot.
Production-Scale Testing
137,000+ patient records imported on Android devices in a single operation.
Market Entry — Africa
Country-level partnerships underway across Africa, each with its own subscription-plus-implementation model.
Built for real-world care
- NigeriaLive pilot
- EswatiniLive pilot
- AfricaMarket entry underway
Partners & Stakeholders
Working with the organisations that deliver care.
- [Partner logo]
- [Partner logo]
- [Partner logo]
- [Partner logo]
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