Taking knowledge for health the extra mile: participatory evaluation of a mobile phone intervention for community health workers in Malawi.
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Date
2014-10-03
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Abstract
In Malawi where the majority of the population resides in rural areas community health workers CHWs are the first and often only providers of health services An assessment of health information needs however found that these frontline workers often lacked essential health information A pilot project implemented in 2 rural districts of Malawi between 2010 and 2011 introduced a mobile phone system to strengthen knowledge exchange within networks of CHWs and district staff To evaluate the mobile phone intervention a participatory evaluation method called Net Map was used an approach built on traditional social network analysis Together CHWs and district personnel discussed information needs and gaps and the roles of different actors in their information networks They then used drawings and 3 dimensional objects to create baseline and endline maps showing the linkages and levels of influence among members of the information network Net Map provided them with powerful evidence of differences before and after the mobile phone initiative At baseline CHWs were not mentioned as actors in the information network while at endline they were seen to have significant connections with colleagues beneficiaries supervisors and district health facilities as both recipients and providers of information Focus groups with CHWs complemented the Net Map findings with reports of increased self confidence and greater trust by their communities These qualitative results were bolstered by surveys that showed decreases in stockouts of essential medicines lower communication costs wider service coverage and more efficient referrals As an innovative participatory form of social network analysis Net Map yielded important visual quantitative and qualitative information at reasonable cost
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Keywords
Adult, Workforce, Community-based health worker, Access to information or data, Supply of services, Health worker competence, Addressing individual beliefs and practices, Geographic inaccessibility, Unnecessary referrals and transportation, Pilot, Effectiveness, Optimization, Individual based, Health education or promotion, Hotlines and information services, Provider training and education, Provider-to-provider communication, Service delivery statistics, Voice, SMS, Internet, Text, Audio