Using mHealth to improve health care delivery in India: A qualitative examination of the perspectives of community health workers and beneficiaries


Autoři: Lakshmi Gopalakrishnan aff001;  Laura Buback aff002;  Lia Fernald aff001;  Dilys Walker aff001;  Nadia Diamond-Smith aff002
Působiště autorů: School of Public Health, University of California, Berkeley, United States of America aff001;  Institute of Global Health Sciences, University of California, San Francisco, United States of America aff002;  Department of Obstetrics and Gynaecology, University of California, San Francisco, United States of America aff003;  Department of Epidemiology and Biostatistics, University of California, San Francisco, United States of America aff004
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
doi: 10.1371/journal.pone.0227451

Souhrn

Background

mHealth technologies are proliferating globally to address quality and timeliness of health care delivery by Community Health Workers (CHWs). This study aimed to examine CHW and beneficiaries’ perceptions of a new mHealth intervention (Common Application Software [CAS] for CHWs in India. The objectives of the study were to seek perspectives of CHWs and beneficiaries on the uptake of CAS, changes in CHW-beneficiary interactions since the introduction of CAS and potential barriers faced by CHWs in use of CAS. Further, important contextual factors related to CHW-beneficiary interface and dynamics that may have a bearing on CAS have been described.

Methods

A qualitative study was conducted in two states of India (Bihar and Madhya Pradesh) from March-April 2018 with CHWs (n = 32) and beneficiaries (n = 55). All interviews were conducted and recorded in Hindi, transcribed and translated into English, and coded and thematically analysed using Dedoose.

Findings

The mHealth intervention was acceptable to the CHWs who felt that CAS improved their status in the communities where they worked. Beneficiaries’ views were a mix of positive and negative perceptions. The divergent views between CHWs and beneficiaries surrounding the use and impact of CAS highlight an underlying mistrust, socio-cultural barriers in engagement, and technological barriers in implementation. All these contextual factors can influence the perception and uptake of CAS.

Conclusions

mHealth interventions targeting CHWs and beneficiaries have the potential to improve performance of CHWs, reduce barriers to information and potentially change the behaviors of beneficiaries. While technology is an enabler for CHWs to improve their service delivery, it does not necessarily help overcome social and cultural barriers that impede CHW-beneficiary interactions to bring about improvements in knowledge and health behaviors. Future interventions for CHWs including mHealth interventions should examine contextual factors along with the acceptability, accessibility, and usability by beneficiaries and community members.

Klíčová slova:

Behavior – Behavioral and social aspects of health – Cell phones – Computer software – Children – Nutrition – Pregnancy – Social communication


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