Abstract
BackgroundMobile health (mHealth) applications, such as innovative electronic forms on smartphones, could potentially improve the performance of health care workers and health systems in developing countries. However, contextual evidence on health workers’ barriers and motivating factors that may influence large-scale implementation of such interfaces for health care delivery is scarce.MethodsA pretested semistructured questionnaire was used to assess health workers’ experiences, barriers, preferences, and motivating factors in using mobile health forms on smartphones in the context of maternal health care in Ethiopia. Twenty-five health extension workers (HEWs) and midwives, working in 13 primary health care facilities in Tigray region, Ethiopia, participated in this study.ResultsOver a 6-month period, a total of 2,893 electronic health records of 1,122 women were submitted to a central computer through the Internet. Sixteen (69.6%) workers believed the forms were good reminders on what to do and what questions needed to be asked. Twelve (52.2%) workers said electronic forms were comprehensive and 9 (39.1%) workers saw electronic forms as learning tools. All workers preferred unrestricted use of the smartphones and believed it helped them adapt to the smartphones and electronic forms for work purposes. With regards to language preference, 18 (78.3%) preferred using the local language (Tigrinya) version of the forms to English. Indentified barriers for not using electronic forms consistently include challenges related to electronic forms (for example, problem with username and password setting as reported by 5 (21.7%), smartphones (for example, smartphone froze or locked up as reported by 9 (39.1%) and health system (for example, frequent movement of health workers as reported by 19 (82.6%)).ConclusionsBoth HEWs and midwives found the electronic forms on smartphones useful for their day-to-day maternal health care services delivery. However, sustainable use and implementation of such work tools at scale would be daunting without providing technical support to health workers, securing mobile network airtime and improving key functions of the larger health system.Electronic supplementary materialThe online version of this article (doi:10.1186/1478-4491-13-2) contains supplementary material, which is available to authorized users.
Highlights
With the aim of ensuring access to basic promotive, preventive, curative and rehabilitative health services, many developing countries, including Ethiopia, have been revitalizing and accelerating the expansion of primary health care [1].Since 2003, Ethiopia has been expanding access to primary health care through its community-based health extension programme (HEP) and primary referral health centres
Midwives and health extension workers (HEWs) are primarily responsible for the provision of maternal health care services at primary health care units (PHCUs) in Ethiopia
Motivating factors for using Mobile health (mHealth) application Twenty-one (91.3%) of the health workers had been using the smartphone we provided as their primary phone
Summary
With the aim of ensuring access to basic promotive, preventive, curative and rehabilitative health services, many developing countries, including Ethiopia, have been revitalizing and accelerating the expansion of primary health care [1]. Since 2003, Ethiopia has been expanding access to primary health care through its community-based health extension programme (HEP) and primary referral health centres. Between 2003 and 2010, a total of approximately 34,000 health extension workers (HEWs) have been trained and deployed in approximately 15,000 newly constructed health posts. One health post was constructed for each of the 15,000 kebeles (villages) in the country. The HEP is a package of seventeen components comprising four major programme areas: Family Health Services, Disease Prevention and Control, Hygiene and Environmental Sanitation, and Education and Communication. Within the Family Health programme area, HEWs are trained on how to provide and educate people within their kebele on maternal health care. Contextual evidence on health workers’ barriers and motivating factors that may influence large-scale implementation of such interfaces for health care delivery is scarce
Sign-in/Register to view highlights & summary 
Published Version (
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