Perspectives and experiences of community health workers in Brazilian primary care centers using m-health tools in home visits with community members

Abstract

BackgroundMobile health (m-health) tools are a promising strategy to facilitate the work of community health workers (CHWs) in low- and middle-income countries (LMICs). Despite their potential value, little is known about CHWs’ experiences working with m-health tools in their outreach activities with community members.MethodsTo understand the benefits of and barriers to using m-health tools for CHWs, we conducted semi-structured interviews with 57 CHWs employed in six primary care centers in São Paulo, Brazil. All CHWs had experience using a cell phone application called Geohealth for collecting health and demographic data of community members. We assessed their experiences using Geohealth and recommendations for improvements.ResultsCHWs described key benefits of using Geohealth as helping them save time with bureaucratic paperwork, organizing the data that they needed to collect, and by replacing sheaves of paper, reducing the weight that they carried in the field. However, there were many technical and social barriers to the successful adoption of the m-health tool. Key among these were poor quality hardware, faulty software programs, and negative community member perceptions of the m-health program. The CHWs provided valuable input as to how Geohealth could be improved to fit their needs.Conclusionm-health tools have the potential to facilitate the work of CHWs in LMICs. However, such tools must be designed and implemented thoughtfully. Technical barriers related to both hardware and software must be anticipated and addressed to maximize their efficiency and successful adoption. CHW input on the design of the tool should be sought to maximize its utility and minimize barriers to use.

Pregnant women’s experiences with an integrated diagnostic and decision support device for antenatal care in Ghana

“…There are mixed reports on how mHealth may facilitate or hinder woman-provider interaction [ 30 – 32 ]. A study on the perceptions of community health workers in Brazil to the use of a data collection and transmission tool, reported social barriers to utilizing the cell phone intervention despite its reported advantages [ 31 ]. Such barriers included the negative impact of the tool on social interaction (i.e.…”

Experiences of midwives and community health workers using mHealth to improve services to pregnant women in rural Burkina Faso, Africa

“…Findings have shown that there is high acceptance of mhealth among CHWs as it is perceived as superior to their traditional method of care delivery, in the best interest of their communities, and more aligned with future trends in health systems. [12,13] Overall, CHWs perceived these applications to be easy to use and useful as they helped them to overcome field-related barriers such as the challenge of balancing multiple priorities, lacking appropriate tools to provide clinical services and collect data, and limited access to training and supervision. [14] In addition, digital data collection helped CHWs organize data, save time with bureaucratic paperwork, and reduce the weight carried in the field.…”

“…[14] In addition, digital data collection helped CHWs organize data, save time with bureaucratic paperwork, and reduce the weight carried in the field. [12] Access to patient data and regular mobile phone consultations between the CHWs and midwives were considered to reinforce CHW's knowledge on maternal newborn care and thus boosted their social status in the community. [15] Conversely, midwives indicated that on the one hand, mhealth improves communication processes and strengthens support structures within the system, and on the other hand, it increases interaction and information exchange between midwives and patients; both contributing to improving midwives' motivation and job satisfaction.…”

“…[16] Despite these documented benefits, CHWs and healthcare professionals indicated that the implementation and sustainable use of mhealth at scale would be daunting without first providing ongoing training and technical support, securing mobile network airtime and improving key functions of the larger health system. [12,17] Despite general concordance of user experiences originating from across the globe, successful implementation and scaling of mhealth initiatives must be based on an exploration and documentation of the experiences of frontline workers and context-specific challenges in particular rural regions as even in-country conditions can vary greatly. Hence, this qualitative descriptive study explored the experiences of midwives and CHWs using an mhealth remote monitoring platform to improve the care provided to pregnant women living in the rural Diapangou region of Eastern Burkina Faso (BF), Africa.…”

Operability, Usefulness, and Task-Technology Fit of an mHealth App for Delivering Primary Health Care Services by Community Health Workers in Underserved Areas of Pakistan and Afghanistan: Qualitative Study

“…The CHWs were also excited about the possibility of abolishing registers that were a hassle to work with. CHWs using the Geohealth app in Brazil also reported that replacing paper with the app greatly reduced the load they carried into the field [ 30 ].…”