As academic in Mandela University’s Department of Industrial Engineering Dr Lilies recently earned her PhD from Stellenbosch University. She is part of the New Generation of Academics Programme (nGAP), which seeks to develop South Africa's next generation of academics.
Raised by a mother who has worked as a community health worker for nearly two decades, Dr Ratshidi grew up with an appreciation of the vital role these healthcare workers play in their communities.
She also saw first-hand some of the challenges they encounter in delivering healthcare, particularly in communities where resources are limited.
Dr Ratshidi has now brought that lived understanding together with her expertise in systems engineering to explore how technology can better support the people at the frontline of South Africa's primary healthcare system.
Community health workers are a critical link between communities and the formal health system. Dr Ratshidi noted that, according to estimates from the National Department of Health, they account for almost half of South Africa's primary healthcare workforce.
Yet despite their importance, they continue to experience systemic challenges that can limit their ability to deliver healthcare effectively.
This prompted the central question underpinning Dr Ratshidi's doctoral research: if information and communication technologies (ICTs) have such potential to support community health workers, why has that potential not been fully realised?
Her research suggested that part of the problem lies in how technological solutions are designed and introduced. Approaches developed for well-resourced health systems may not adequately account for the realities of community healthcare in resource-constrained settings.
Technology alone, she argued, is not the solution. Successful digital health interventions must also take account of the people who will use them and the systems in which they work. To address this challenge, Dr Ratshidi developed a practical toolkit to guide the implementation of ICT solutions in resource-constrained healthcare environments.
Rather than approaching digital health primarily from a technological perspective, the toolkit puts community health workers at its centre.
It provides guidance for decision-makers, technology developers and community health workers themselves, taking into account factors operating at different levels of the health system, from the experiences of individual healthcare workers to organisational structures and the wider policy environment.
The goal is to help ensure that technology makes the work of community health workers easier and more effective, rather than simply introducing another system they are expected to navigate.
For Dr Ratshidi, this distinction is important. Digital health should not be viewed simply as a mechanism for collecting and managing data. Used effectively, technology can strengthen the integration of community health workers into primary healthcare and equip them to provide more accessible and responsive care.
Her research is particularly timely as South Africa considers how community health workers can be more formally integrated into the health system. Dr Ratshidi believes her toolkit could contribute to this transition by helping policymakers and healthcare organisations implement digital technologies in ways that recognise community health workers as healthcare professionals and respond to the realities in which they work.
The next stage of her research will be to apply the toolkit in practice and study how it performs over time and across changing social, organisational and technological environments.
Ultimately, Dr Ratshidi hopes her research will contribute to a stronger and more equitable public healthcare system by ensuring that technological innovation reaches the people responsible for delivering care at community level.
It is an ambition rooted in something she has understood since childhood: strengthening healthcare systems also means strengthening the people who stand at their frontlines.