Abstract
BackgroundThe unprecedented access to mobile phones in resource-poor settings has seen the emergence of mobile-health (mHealth) applications specific for low- and middle-income contexts. One such application is the Mobile Technology for Community Health Suite (MOTECH Suite). Given the importance of community health worker (CHW) perceptions of a health program toward its successful implementation, this study explores whether the introduction of an mHealth application, as a human resource management tool, is associated with changes in CHW perceived supervision, motivation, work engagement, and job satisfaction over time. MethodsWe employed a 3-arm randomized longitudinal cohort design in Bonthe District, Sierra Leone. Three hundred twenty-seven CHWs were assessed over an 18-month period, with 3 different rounds of data collection. CHWs were assigned to 3 different intervention groups and given either a mobile phone with access to both the application and to a closed user group; a phone set up on a closed user group but with no application; or no mobile phone but the same level of training as the previous 2 groups. ResultsFindings indicated that there were no initial or sustained differences in perceived supervision and motivation across the 3 experimental groups over time with the introduction of the MOTECH Suite as a human resource management tool. Furthermore, there was no significant change in the self-reported measures of work engagement and job satisfaction across each of the intervention groups over time. Discussion/ConclusionFindings suggest that there are no systematic changes in perceived supervision, work engagement, job satisfaction, or motivation between CHWs who received a mobile phone set up on a closed user group with the MOTECH Suite application and those who either only received a phone with the closed user group or no phone at all. Therefore, the results of this study do not provide sufficient evidence to support the use of mobile technology or mHealth applications to strengthen these organizational factors within CHW programs and interventions. We argue that strengthening the organizational factors within CHW programs must therefore extend beyond the introduction of a technological solution.
Highlights
The evidence for the effectiveness of community health workers (CHWs) is strong, and with appropriate support and sufficient training, CHWs can substantially strengthen health systems in areas with scarce human resources for health.1 As a result, CHWs have been deployed across a number of different maternal and child health interventions.2-4 World Vision Ireland’s Access to Infant and Maternal Health (AIM-Health) uses CHWs to regularly promote 7 key health intervention messages targeting pregnant women and 11 intervention messages targeting mothers of children younger than 2
The policy states that CHWs must undergo a minimum 10-day basic training course; each CHW is expected to serve between 100-500 people, should be willing to serve as a volunteer, and must be a resident of the village and willing to work with the community
A total of 327 of the 334 CHWs agreed to participate in the study, representing 26 peripheral health unit (PHU)
Summary
The evidence for the effectiveness of community health workers (CHWs) is strong, and with appropriate support and sufficient training, CHWs can substantially strengthen health systems in areas with scarce human resources for health. As a result, CHWs have been deployed across a number of different maternal and child health interventions. World Vision Ireland’s Access to Infant and Maternal Health (AIM-Health) uses CHWs to regularly promote 7 key health intervention messages targeting pregnant women and 11 intervention messages targeting mothers of children younger than 2. Dubbed the 7-11 Timed and Targeted Counseling (7-11 TTC) strategy, these health interventions are encouraged using a behavior change communication and counseling approach, held across a minimum of 10 household visits by a CHW. The unprecedented access to mobile phones in resource-poor settings has seen the emergence of mobile-health (mHealth) applications specific for low- and middle-income contexts. One such application is the Mobile Technology for Community Health Suite (MOTECH Suite). Given the importance of community health worker (CHW) perceptions of a health program toward its successful implementation, this study explores whether the introduction of an mHealth application, as a human resource management tool, is associated with changes in CHW perceived supervision, motivation, work engagement, and job satisfaction over time
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
