Bridging the gap: empowering community Health workers using mobile technology

A word can carry a connotative or denotative meaning. For starters, denotation refers to the literal meaning of a word, the “dictionary definition.” Connotation, on the other hand, refers to the associations that are connected to a certain word or the emotional suggestions related to that word. For example, to many people, you and I included, a mobile phone, whether an ordinary phone or smart phone is simply a communication gadget but to 35 noble men and women in Mwingi, a phone is more than a communication gadget it is an educational tool that is transforming and saving lives in Mwingi West, it is a health solution, thanks to Amref and partners.

Since 2012, Amref and partners such as Accenture, Safaricom, Mezzanine and the Ministry of Health focused on empowering Community Health Workers through the use of mobile technologies to provide continued learning opportunities and access to information- as cliché as it may sound, information is power!

world over, there is a sharp shortage of health workers. A report released in November 2013 by the World Health Organization called A Universal Truth:No Health without a Workforce estimates that the world will be short of 12.9 million healthcare workers by 2035! Today, that figure stands at an alarming 7.2 million!

A closer look at Mwingi district as at March 2014 for example, one doctor is in charge of a massive 50,000 patients! In Kakululo Dispensary in Mwingi County, one of the areas where the project is being piloted, a single nurse is in charge of whooping 5,000 patients! To bridge this gap Community Health Volunteers are desperately needed but now the limitation is the capacity to train them so that they may confidently volunteer their services to their communities.

That is why concerned stakeholders including governments, International Non-governmental Organizations, Multinationals etc must move with speed to rethink and improve how to teach, train, deploy, and pay health workers so that their impact can widen.

Generally, mobile phone usage in Africa is booming and a large number of people own a mobile phone. The increasing penetration of mobile phones in Kenya for example has led to a rise in SMS-based information dissemination services. Amref and partners took advantage of this opportunity to empower Community Health Workers through use of mobile technologies to provide continued learning opportunities and access to information through Health Enablement and Learning Platform (HELP). This in turn equips the Community Health Workers with the necessary skills to create lasting health impact.

Mr. Bernard Ngombe, a Community Health Worker demonstrates how he uses his phone to learn.
Mr. Bernard Ngombe, a Community Health Worker demonstrates how he uses his phone to learn

The HELP project is being undertaken in Kibera, Mwingi and Samburu. This areas where carefully selected considering that most  African population are either in a rural setting (like mwingi), a nomadic setting (like Samburu) and if in urban areas, then they are in an informal setting (like Kibera).

As a norm and expected standards, a community health worker should have a 10-day face to face training and then released to the community to start working (volunteering)! But the model adopted by Amref and partners reduces the amount of face to face training by three while increasing knowledge retention and promoting continuous learning.

This model has features that allows the community health worker to learn through lectures and role plays, there is a group chat feature that allows them to communicate with each other; the job aide feature gives the community health workers instructions on how to use various basic tools of trade and lastly, the health decision tree feature that supports real-time diagnosis of prevalent diseases within the community.

What melts my heart about the HELP project is the way mobile devices allow health workers to access information without the limitations of cost as it is absolutely free and the health worker can also learn in his/ her own time and pace.

Some of the Community Health Workers in Mwingi
Some of the Community Health Workers in Mwingi

This noble initiative by Amref makes me deeply reflect on what Prof. Mahmoud Fathalla known to be ‘the father of maternal health’ said “Women are not dying because of diseases we cannot treat. They are dying because societies have yet to make the decision that their lives are worth saving.” Having noble men and women who have committed to donate at least 2 hours of their time daily to volunteer for free as community health workers is in itself a decision to demonstrate that lives are worth saving.

I give a standing ovation to Amref and partners and I hope that soon, very soon I, the ‘self-appointed-maternal-health-advocate will be here again to write on the opening of the beautiful maternity wing of Kakululo Dispensary which will be a step higher in reducing maternal and child mortality-most of which are preventable by ensuring that more women deliver their bundle of joy in a health facility with the help of a skilled health worker by reducing the barrier of distance.

The newly constructed maternity wing at Kakululo Dispensary in Mwingi
The newly constructed maternity wing at Kakululo Dispensary in Mwingi

By the way I was encouraged that in the month of January and February, 0 maternal and 2 newborn deaths where recorded in this rural ukambani dispensary! This means, there is light at the end of the MDG5 tunnel, as dim as it appears.


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