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medRxiv PreprintsInternational5 November 2026

Community health workers experiences with a digital clinical decision support system for longitudinal hypertension and diabetes care in rural Lesotho: a mixed-methods study

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Community health workers (CHWs) are increasingly delivering chronic care in resource-constrained settings but require support to manage complex longitudinal clinical workflows. In the Community-Based chronic Care Lesotho (ComBaCaL) project in rural Lesotho, CHWs provide longitudinal hypertension and diabetes care, supported by the ComBaCaL Community Health Toolkit (CHT) application. The application combines longitudinal participant management and task coordination with clinical decision support for screening, diagnosis, treatment initiation and adjustment, cardiovascular risk management, refer
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