Rebuilding CBIMS to Support 600+ Frontline Health Workers 

The Challenges of a Desktop Application  

For many years, CBIMS — built in Microsoft Access — provided a practical solution for aid workers in South Africa. However, using dated technology comes with challenges that will evidently surface over time. Gill Cleeren, CTO of Xebia Microsoft Services Belgium, explains: "For example, all databases were installed on the workers' PCs. So, when a new colleague started, the database would be copied onto that PC. Workers would sync the data collected with the central PC whenever they returned from the field. It was a time-intensive way of working, which only became more demanding when, every few months, in-depth reports had to be generated." 

Meanwhile, the importance of secure, centralized data management, particularly with sensitive health information, became increasingly clear. At the same time, the frequent power cuts in South Africa meant that any new solution needed to offer offline availability. These conditions made a strong case for moving to a web-based platform. One that could provide seamless scalability, careful data handling, top-notch security, and reliable offline functionality. 

Partnering With Xebia  

Recognizing the need to modernize, the CBIMS lead in South Africa set out to rebuild the platform tools using .NET and Blazor, a strategic choice, primarily motivated by Blazor’s strong offline capabilities. Cleeren, "The team attended one of my online Blazor courses, and through that connection, started working with Xebia." What followed was a close and productive collaboration. Each year, a budget was allocated for Xebia to modernize and expand the app's functionality.  

A Leap of 30 Years 

Over the last few years, Xebia has worked closely with CBIMS to bring decades of technology advancement within reach, transforming a trusted 90s-era desktop application into a modern, web-based platform. 

I. Rebuild & Build  

Since Microsoft Access code cannot be reused in .NET, the new CBIMS was developed from the ground up. Cleeren, "While we kept some original functionality, we added many new features, like modules for registrations, training, surveys, and advanced reporting. The result was not just a replacement, but a significantly enhanced and future-ready application." 

II. The Path to a Future-Proof Web Application 

1. Awareness 

Before development began, it was essential to help the team understand how a web application is built — and how to work with one. "Even though the team didn't need to do a lot of hands-on work, they did need a basic understanding of how the new system works, particularly when handling sensitive data. Topics like secure architecture, identifying potential attack vectors, and the value of penetration testing were part of the onboarding and learning process," says Cleeren.  

2. Security 

Given the nature of the data, including personal health records, security was a priority from day one. The team worked together to design a secure application architecture, ensuring data protection at every level. From authentication to encrypted storage and communication, security was woven into every decision and reviewed continuously throughout development. 

3. Scalability 

The application needed to handle large volumes of data and accommodate heavy usage peaks, particularly during reporting cycles. This required thoughtful planning around load prediction and infrastructure scaling. The solution was designed to scale up efficiently during high-demand periods and scale down during off-peak times, ensuring both performance and cost-effectiveness. 

Technologies Used 

Frontend – Blazor 

The choice for Blazor was driven by the team's existing knowledge of .NET and C#. This allowed them to stay within a familiar ecosystem, without adopting new languages like JavaScript. In addition, Blazor offered a crucial advantage in the South African context: offline support. Cleeren, "During scheduled power cuts, users can continue to enter data offline, which will then sync automatically once the connection is restored." 

Backend – ASP.NET Core (.NET 8) 

The backend was built using ASP.NET Core, leveraging the latest features of .NET 8 for performance, stability, and long-term maintainability. 

Authentication – Auth0 

For secure authentication, the project integrated Auth0, offering a rich identity management platform that simplified user onboarding and ensured compliance with best practices. 

Database – PostgreSQL 

PostgreSQL was used as the primary database, offering reliability, scalability, and open-source flexibility — all while keeping hosting costs manageable. 

A Close Collaboration 

Over the course of the project, six team members from Xebia Microsoft Services Belgium contributed to the development, with roles evolving each year to align with CBIMS’s changing priorities. By 2025, CBIMS was on the verge of being feature-complete. However, just two weeks before final delivery, USAID funding was discontinued, and the application was taken offline. * Cleeren, "While our partnership sadly came to an unexpected end, it proves what’s possible when deep domain knowledge, modern technology, and international collaboration come together to address real-world needs."  

*Note: With the unforeseen end of USAID funding, development and use of the application came to a complete stop in early 2025. The platform has since been taken offline, and many of the aid programs it supported have unfortunately been terminated.