Abstract
ABSTRACT While mobile phones promise to be an important tool for bridging the healthcare gaps in resource-poor areas in developing countries, scalability and sustainability of mobile phones for health (mhealth) interventions still remain a major challenge. Meanwhile, health workers are already using their own mobile phones (referred to as ‘informal mhealth’) to facilitate healthcare delivery in diverse ways. Therefore, this paper explores some strategies for integrating ‘informal mHealth’ in the healthcare delivery of Ghana, by highlighting some opportunities and challenges. The study mainly employed a combination of literature review, focus group discussions and key informant interviews with community health nurses (CHNs) and other stakeholders, who were purposively selected from the three ecological zones in Ghana. The study found that, while scale-up of ‘formal mhealth’ remains challenging in Ghana, almost all CHNs in our study are using their personal mobile phones ‘informally’ to bridge healthcare gaps, thereby promoting universal health coverage. This provides opportunities for promoting (or formalising) ‘informal’ mhealth in Ghana, in spite of some practical challenges in the use of personal mobile phones that need to be addressed to ensure sustainable healthcare delivery in the country.
Highlights
Healthcare delivery in low- and middle-income countries can be challenging, especially in rural and hard-to-reach areas, with often limited healthcare resources, infrastructure and personnel (Hampshire et al, 2015; Hartzler & Wetter, 2014; Mehl & Labrique, 2014)
A small-scale study by Hampshire et al (2017) reported that health workers in Ghana and Malawi, especially those working at community level, were using their own mobile phones creatively and strategically as an important therapeutic resource – a phenomenon described as ‘informal mhealth’ by Hampshire et al (2015; 2017). This is welcoming as there are still large gaps in access to and utilisation of healthcare between rural and urban dwellers as well as between the rich and poor, reflecting the inadequate and unequal distribution of health infrastructure; limited access to health facilities especially by deprived communities; inequitable distribution of workers at different levels of services delivery; and inadequate staff numbers (Peprah et al, 2019). This current paper examines the practices of informal mhealth, and asks whether and how these practices might productively be integrated into the healthcare delivery of Ghana, with the aim of promoting Universal Health Coverage (UHC), which is a guiding principle within the United Nation’s Sustainable Development Goals (SDGs) to ensure that all individuals ‘receive the health services they need, of sufficient quality to be effective while at the same time ensuring that the use of these services does not expose the user to financial hardship’ (United Nations, 2015)
The aim of the intervention was to improve uptake and quality of care of maternal, newborn and child health services (MNCH) through the use of low-cost mobile phone technology to capture, transmit and process health service data collected by community health nurses (CHNs) (Grameen Foundation, 2011)
Summary
Healthcare delivery in low- and middle-income countries can be challenging, especially in rural and hard-to-reach areas, with often limited healthcare resources, infrastructure and personnel (Hampshire et al, 2015; Hartzler & Wetter, 2014; Mehl & Labrique, 2014). In terms of human resource capacities, estimates from the World Health Organisation (WHO) revealed a shortage of about 7.2 million healthcare workers globally; a figure expected to increase to 12. Even where healthcare is relatively affordable, poor road networks can inhibit timely access to healthcare (Hampshire et al, 2015; Hartzler & Wetter, 2014; Owusu & Amoako-Sakyi, 2011).
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
