Abstract
BackgroundHealth extension workers (HEWs) are the key cadre within the Ethiopian Health Extension Programme extending health care to rural communities. National policy guidance supports the use of mHealth to improve data quality and use. We report on a mobile Health Management Information system (HMIS) with HEWs and assess its impact on data use, community health service provision and HEWs’ experiences.MethodologyWe used a mixed methods approach, including an iterative process of intervention development for 2 out of 16 essential packages of health services, quantitative analysis of new registrations, and qualitative research with HEWs and their supervisors.ResultsThe iterative approach supported ownership of the intervention by health staff, and 8833 clients were registered onto the mobile HMIS by 62 trained HEWs. HEWs were positive about using mHealth and its impact on data quality, health service delivery, patient follow-up and skill acquisition. Challenges included tensions over who received a phone; worries about phone loss; poor connectivity and power failures in rural areas; and workload.DiscussionMobile HMIS developed through collaborative and locally embedded processes can support quality data collection, flow and better patient follow-up. Scale-up across other community health service packages and zones is encouraged together with appropriate training, support and distribution of phones to address health needs and avoid exacerbating existing inequalities.KeywordsCHWs, equity, ethics, Ethiopia, Health Management Information system, HEP, maternal health, mHealth, TB
Highlights
IntroductionTo ensure universal access to primary health care at community level, Ethiopia launched its flagship health programme known as the Health Extension Programme (HEP) in 2003.1,2 The programme was designed to provide equitable access to primary health care by bringing services to the community
Antecedentes Los agentes de extensión sanitaria (AES) son el equipo clave dentro del Programa de Extensión Sanitaria de Etiopía, llevando la atención para la salud a las comunidades rurales
To ensure universal access to primary health care at community level, Ethiopia launched its flagship health programme known as the Health Extension Programme (HEP) in 2003.1,2 The programme was designed to provide equitable access to primary health care by bringing services to the community
Summary
To ensure universal access to primary health care at community level, Ethiopia launched its flagship health programme known as the Health Extension Programme (HEP) in 2003.1,2 The programme was designed to provide equitable access to primary health care by bringing services to the community. Female community health workers, referred to as health extension workers (HEWs), are the key cadre delivering the HEP packages of services.[1,3] They are recruited from the local community, which is shown to improve relationships within communities,[3,4,5] have completed school until at least grade 10, and received training for 1 year to provide community-based services.[6] HEWs work at health posts based in ‘kebeles’ (the smallest administrative unit). Two HEWs are assigned in each kebele with an average population of 5000 people (~1000 households). They devote 75% of their time to making house-to-house visits.[3]. Methodology We used a mixed methods approach, including an iterative process of intervention development for 2 out of 16 essential packages of health services, quantitative analysis of new registrations, and qualitative research with HEWs and their supervisors
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
