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Centre for Statistics (CENSTAT) : project R-8708

Title : Building an evidence base to support and enhance community health workers' (informal) use of mobile phones in Ghana, Malawi and Ethiopia (R-8708)
Abstract: Africa's recent communications 'revolution' has generated optimism that using mobile phones for health (mhealth) can help bridge healthcare gaps, particularly for rural, hard-to-reach populations. However, while scale-up of mhealth pilots remains limited, community health workers (CHWs) across the continent possess mobile phones. CHWs form a vital part of healthcare delivery across Africa and many countries are scaling up their deployment (target of 1 million CHWs). There is thus enormous untapped potential here. While much research has focused on formal mhealth initiatives (small-scale successes, challenges of scale-up), we know almost nothing about what CHWs across Africa are doing with their own mobile phones, and with what implications for healthcare. The potential for what we have called 'informal mhealth' to enhance primary care in resource-limited settings could thus be very significant. The CHWs we interviewed were innovative and adept at harnessing new features on their phones to help manage their work. However, our study also pointed towards challenges, both for patient care and health-worker well-being, including: the financial burden of phone costs and emotional burden of being available to patients 24/7; decreased face-to-face interaction with patients; concerns about patient confidentiality when communicating through personal phones; and difficulties in accessing reliable online information, etc. Our aim is to build a strong evidence base of current mobile phone use among community health workers in Ghana, Malawi and Ethiopia (three countries committed to major CHW programmes), in order to enhance the effectiveness of 'informal mhealth' and address challenges. If our hypothesis is correct, and CHWs' 'informal' mobile phone use is widespread, this study could provide crucial evidence to support innovative ways to strengthen health systems in resource-limited settings.
Period of project : 1/01/2018to31/12/2019

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