mHEALTH-INNOVATE: What can we learn from health workers' informal use of mobile phones?

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Overview

HIFA is contributing to a major research project: mHEALTH-INNOVATE: exploring how healthcare workers' informal and innovative uses of mobile phones are shaping service delivery and governance in LMICs. HIFA is engaged as a subcontractor to provide a channel for multi-stakeholder involvement and discussion around the issues raised, thanks to our wide reach (>20,000 members in 180 countries) and the diversity of our members (health professionals, civil society, policymakers, library and information professionals, publishers...).

Background: Previous work on mHealth has focused largely on formal 'top-down' approaches, but it is increasingly recognised that health workers use mobile phones in informal and innovative ways to support their work. We're interested in all types of health workers, including lay or community health workers and supervisors, at all levels of health care. How do health workers use their mobile phones and informal channels of communication to get clinical information or advice, seek practical advice or support (e.g. access to patient transport), communicate with supervisors or other parts of their organisation, communicate with patients and their families, seek emotional support from their peers?

The 4-year project was supported by a thematic discussion on HIFA and a systematic review (in press), which will then inform primary research in Uganda followed by governance analysis and deliberative dialogue.

Contact: Neil Pakenham-Walsh, Global Coordinator, HIFA: neil@hifa.org

Photo credit: Mark Leong, WHO HRP

Activities

How HIFA members contributed

HIFA members with an interest in the subject were recruited to join a working group (see Members) that also comprised key members of the research consortium. In 2022 HIFA hosted a 4-week in-depth discussion on the HIFA forum, in collaboration with Makerere University, Norwegian Institute of Public Health, WHO and other research partners. This discussion made an important contribution to the early phase of the wider research project. In particular, the discussion helped to develop a working definition for ‘informal use’ of mobile devices, and the outputs of the discussion were published (Glenton et al 2022). HIFA forum participants and project group members also shared relevant studies on the topic. The results of the HIFA discussion, published research on the topic, and input from experts within our research team and its international advisory group, to develop our working definition of health workers’ informal mobile device use. The final definition we adopted was: 'healthcare workers’ use of mobile phones and other mobile devices to support their work, using approaches that are initiated by the healthcare workers themselves and that are not initially standardised, regulated, or endorsed by the health system or organisation to which they belong'.

The thematic discussion explored the following questions:

1. Do you use a mobile phone to help you in your work? How do you use it?

2. How do you use your phone to communicate with colleagues, patients and families?

3. How do you use your phone for other work-related purposes? (eg searching for healthcare information and guidance, tracking supplies, referring patients...)

4. Can you give any examples of *informal* use of mobile phones by health workers? (ie uses of mobile phones that have not been directed by the employer, but have been initiated, adapted or developed by health workers themselves)

5. How can the informal use of mobile phones be improved to strengthen healthcare?

Publications

Healthcare workers' informal uses of mobile phones to support their work: a qualitative evidence synthesis

2024

Glenton C et al. Healthcare workers' informal uses of mobile phones and other mobile devices to support their work: a qualitative evidence synthesis. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD015705.pub2/...

Authors' conclusions: By finding their own informal solutions to workplace challenges, healthcare workers can be more efficient and more responsive to the needs of patients, colleagues and themselves. But these solutions also have several drawbacks. Efforts to strengthen formal health systems should consider how to retain the benefits of informal solutions and reduce their negative effects.

Professor Claire Glenton, Principal Investigator: “HIFA has been a vital part of the mHealth-Innovate research project as it has given us a unique opportunity to discuss topics with healthcare workers, managers and policy makers from across the world..."

Oxford Open Digital Health: Using an online community of practice to explore the informal use of mobile phones by health workers

2023

CITATION: Using an online community of practice to explore the informal use of mobile phones by health workers
Claire Glenton, Josephine Nabukenya, Smisha Agarwal, Michele Meltzer, Elisabeth Mukendi, Immaculate Nakityo Lwanga, Josephine Namitala, Sunanda Reddy, Geoff Royston, Tigest Tamrat ... Show more
Oxford Open Digital Health, https://doi.org/10.1093/oodh/oqac003
Published: 04 January 2023

ABSTRACT: Health workers are increasingly harnessing mobile phones to develop their own solutions to work challenges. The mHEALTH-INNOVATE project aims to explore this topic further. In 2022, Healthcare Information for All (HIFA) organised an online discussion among health workers and other stakeholders to inform the project. Twenty-five people joined the discussion. Contributors’ descriptions of the varieties of mobile phone use tallied with previous research, including for communication with patients and colleagues. In addition, they described increased mobile phone use in response to the Covid-19 pandemic and the increased need for communication, monitoring and reporting, including during lockdowns. Some solutions were health worker-initiated, including the establishment of WhatsApp groups. The discussion has helped develop a definition of informal mobile phone use.

HIFA mHEALTH-INNOVATE discussion May2022: Presentation

2022

In April/May 2022, HIFA organised an online discussion on health workers’ informal use of mobile phones, as part of the mHEALTH-INNOVATE project (https://www.fhi.no/en/cristin-projects/ongoing/mhealth-innovate/). The discussion list aimed to explore how mobile phones are used, their benefits and weaknesses, and how they could lead to better health care, particularly in resource-constrained settings. The following questions were discussed:

1. Do you use a mobile phone to help you in your work? How do you use it?
2. How do you use your phone to communicate with colleagues, patients and families?
3. How do you use your phone for other work-related purposes? (eg searching for healthcare information and guidance, tracking supplies, referring patients...)
4. Can you give any examples of *informal* use of mobile phones by health workers? (ie uses of mobile phones that have not been directed by the employer, but have been initiated, adapted or developed by health workers themselves)
5. How can the informal use of mobile phones be improved to strengthen healthcare?

HIFA mHEALTH-INNOVATE discussion May2022: Report

Members

Name		Country
	Claire Glenton	Norway
	Denis Joseph Bukenya	Uganda
	Didier Demassosso	Cameroon
	Elisabeth Tshiama Mukendi	Congo (Kinshasa)
	Eshwar Rajesh	India
	Geoff Royston	United Kingdom
	Immaculate Nakityo Lwanga	Uganda
	John Eastwood	Australia
	Josephine Namitala	Uganda
	Josephine Nabukenya	Uganda
	Meena Cherian	Switzerland
	Michele Meltzer	United States
	Michelle Janse van Rensburg	South Africa
	Neil Pakenham-Walsh	United Kingdom
	Smisha Agarwal	United States
	Sunanda Reddy	India
	Tigest Tamrat	Switzerland

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