Re: https://www.hifa.org/dgroups-rss/mhealth-innovate-71-cost-implications-m...
Hello everyone,
So amazing to see discussion on top-down implementation of digital health programs on healthcare workers in India. Sunanda, Joseph's and Neil's views have been really helpful!
Answering some of the questions Neil raised-
"This sounds like a simple failure of implementation. Health workers are expected to carry and use a mobile phone provided by the health system, but what they are given is not fit for purpose."
- Yes, as it is mentioned in the other links I shared, there is a failure of implementation. Added to this, the official apps that healthcare workers have to use (like Poshan Tracker) get updated often with new features or activities, and most often government-provided devices are not able to support such heavy-functioning apps. Along with this, WhatsApp has become compulsory for healthcare workers, as most of the managerial work and communication is done through that. So, healthcare workers in India are doing both, formal and informal use of mobile phones in their work.
"Are you talking here about internet data packs for the phones that are provided by the state and/or personal mobile phones that are used for work purposes?"
The internet data packs are provided for the phones, which are given by the state. The government pays some fixed amount of money for those packs monthly added to the salaries, but most healthcare workers are using their own phones and paying for data packs for their personal phones. They see this money given by the government as some form of compensation, even though it doesn't fulfill the actual cost or fulfil the demand of workers, as workers use more expensive data pack as suited to their needs, and government compensation for the official phone internet data pack is much less.
"This is an important observation. It sounds like health workers are not provided with adequate guidance? Indeed, do they receive any guidance about whether and how they may use their state-provided versus personal mobile phones?"
In my interviews with FLW supervisors, I found that they do tell the workers to not give phones to children and other family members, as it may damage the device, children might delete something accidentally or use the internet data packs until they are finished, which may hinder the routine work. But some supervisors also told me that since most workers are using their own personal phones, they do not have much power to direct workers on how to\how not to use them.
"Has anyone done any research into the role of state-provided mobile phones by health workers? What are the advantages and disadvantages of issuing such phones? In which circumstances are they needed / not needed?"
- This is a great suggestion! However, I am not aware of any such research. Let me know if you have any more questions :)
Best Regards,
Vaishnavi
HIFA Profile: Vaishnavi Mangal is a PhD candidate at Norwegian University of Science and Technology, and is based in India. Professional interests: Digital Health, Informal Digital Health, Community health work. vaishnavimangal6896 AT gmail.com