One size does not fit all - The importance of contextually sensitive mHealth strategies for frontline female health workers

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mHealth Innovation in Asia, Mobile Communication in Asia Local Insights, Global Implications, 2018, pp. 7-29
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mHealth solutions represent an exciting new frontier in the fight against myriad health challenges faced in the developing world, where the use of mobile phones has become pervasive across various socioeconomic boundaries. The principal users of these solutions are frontline healthcare workers; mostly women, often working at the lowest rung of health hierarchy. The distinctive value of this workforce lies in its ability to successfully deliver health services whilst being sensitive to the culture and context of their communities. Since these women are from the client communities, they can speak to them in ways outsiders cannot. Using a contextualized case study of lady health workers (LHWs) working in rural areas of Pakistan, this chapter demonstrates how the potential represented by such frontline health workers can be maximized. To this end, it draws upon in-depth longitudinal qualitative accounts of eight LHWs involved in a 2-year pilot mHealth project to improve antenatal health care. This chapter uncovers how sociocultural barriers—such as prohibitive financial concerns and gender-based discrimination—inhibit acceptance of mHealth solutions in Pakistan. The study found that these barriers adversely impact both LHWs’ initial adoption of mobile devices as well their inclination to continue using mHealth solutions. This chapter explores how macro- and micro-level communication strategies can be used to ease these barriers. It also explores how LHWs themselves can use mobile technology to better connect with their client communities. If mHealth is to be the brave new frontier in the domain of health innovations, we need to do more to understand the finer points of its contextually sensitive applications. This chapter seeks to explore how this can become a reality for rural areas of Pakistan
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