Abstract
IntroductionIn low-resource settings, community health workers are frontline providers who shoulder the health service delivery burden. Increasingly, mobile technologies are developed, tested, and deployed with community health workers to facilitate tasks and improve outcomes. We reviewed the evidence for the use of mobile technology by community health workers to identify opportunities and challenges for strengthening health systems in resource-constrained settings.MethodsWe conducted a systematic review of peer-reviewed literature from health, medical, social science, and engineering databases, using PRISMA guidelines. We identified a total of 25 unique full-text research articles on community health workers and their use of mobile technology for the delivery of health services.ResultsCommunity health workers have used mobile tools to advance a broad range of health aims throughout the globe, particularly maternal and child health, HIV/AIDS, and sexual and reproductive health. Most commonly, community health workers use mobile technology to collect field-based health data, receive alerts and reminders, facilitate health education sessions, and conduct person-to-person communication. Programmatic efforts to strengthen health service delivery focus on improving adherence to standards and guidelines, community education and training, and programmatic leadership and management practices. Those studies that evaluated program outcomes provided some evidence that mobile tools help community health workers to improve the quality of care provided, efficiency of services, and capacity for program monitoring.DiscussionEvidence suggests mobile technology presents promising opportunities to improve the range and quality of services provided by community health workers. Small-scale efforts, pilot projects, and preliminary descriptive studies are increasing, and there is a trend toward using feasible and acceptable interventions that lead to positive program outcomes through operational improvements and rigorous study designs. Programmatic and scientific gaps will need to be addressed by global leaders as they advance the use and assessment of mobile technology tools for community health workers.
Highlights
In low-resource settings, community health workers are frontline providers who shoulder the health service delivery burden
Most articles reported on projects in developing countries Africa, with several focused on Asia, and a few in Latin America
A broad range of health issues were addressed; the most common included the interrelated set of issues around sexual, reproductive, maternal and child health, of which more than half focused on HIV/AIDS
Summary
In low-resource settings, community health workers are frontline providers who shoulder the health service delivery burden. We reviewed the evidence for the use of mobile technology by community health workers to identify opportunities and challenges for strengthening health systems in resource-constrained settings. CHWs can increase access to care for groups who are difficult to reach, such as secluded women, the extremely poor, or the lowest classes of society. With their links to the health system, CHWs can offer an entry point for and at times directly provide health services, such as contraceptive methods, home-based care for people living with AIDS, directly observed therapy of tuberculosis, and community-integrated management of childhood illnesses [7]
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