This is a guest blog written by Perry Fernan Flores, a Research Consultant with Zapienza.
What are CHWs?
Do you know what CHWs are? If you work in the fields of healthcare or development or if you are a consumer from either Africa or South Asia who relies on them for some health support, you will probably know what the term means.
CHWs stands for Community Healthcare Workers, also known as community care givers, lay health advisors, village health workers, community health aides or community health promoters. In India, they are widely known as ASHAs, acronym for Accredited Social Health Activists. Due to the shortage of qualified healthcare professionals in many developing markets, CHWs play an important role as healthcare systems’ front-liners, who provide health or medical information as well as basic care to the communities in which they reside.
Research on Mobile Technology and CHWs
As part of GSMA’s Pan-African mHealth Initiative (PAMI), the Mobile for Development mHealth team has recently conducted a piece of research in South Africa, the aim of which was to understand how mobile technology could be used to aid CHWs in doing their day-to-day tasks more efficiently. This research was funded by UK Aid. Similar research will also be conducted across further 10 Sub-Saharan countries, including Côte d’Ivoire, Ghana, Kenya, Malawi, Mozambique, Nigeria, Rwanda, Tanzania, Uganda and Zambia, as part of the nutrition initiative, funded by UK Aid and Norad.
CHWs and Society
While we were able to answer the primary questions of the research, one of the most valuable insights we gained is the realisation that CHWs’ contribution to society goes far beyond providing basic healthcare support.
CHWs can also act as information gatekeepers, informing patients (who CHWs call clients) about their rights to receive social grants and sometimes applying for the grants themselves on behalf of their clients. They also act as protectors of the community and report any physical or child abuse that they become aware of to the proper authority. And despite the meagre stipend they receive as part of their work (which is still classified as voluntary even by organisations that contract them), CHWs often spend some of their own money in order to buy food for their clients who have nothing to eat and, hence, could not take any medication making them more susceptible to other infectious diseases. What is more poignant is the realisation that CHWs themselves are trapped by poverty and have difficulty moving up the social ladder just like the people they serve.
In recognition of the value of CHWs to the country’s healthcare system, since 2011 the South African government has been gradually integrating CHWs into structured ward-based outreach teams (WBOT), which are tasked to deliver primary healthcare services mainly to the uninsured population in the country. One of the initiative’s goals is to provide them with the necessary education and training as well as mobile-based job aid tools, which are used primarily for population-based registration, so that they can become more empowered in fulfilling the responsibilities of their roles.
The majority of roll-outs are still in pilot stages across a number of districts, due for the most part to resource constraints, but they have already proven to be successful and, hence, warrant a national roll-out. Thousands of CHWs therefore continue to work as volunteers, some of them unpaid, patiently waiting for their turn to be officially part of the WBOT initiative.
One wonders how long the CHWs can wait. After seeing their resilience first hand, I and my fellow researchers involved in this project are confident that they will be able to survive and can patiently wait for their opportunity to be part of the WBOT, whenever that will be. We hope that that time will come sooner rather than later.
Information Sharing
We will be sharing learnings from the South African research in the upcoming weeks and all findings will be presented at an event on 1st July. We look forward to sharing knowledge from the field with you. All feedback is, as always, very welcome.
For more information on the GSMA Mobile for Development mHealth, please contact us on mhealth@gsma.com. For information on various mHealth initiatives, click here. For more information on GSMA mHealth resources, click here.