Today’s post comes from Cynthia Afedi, Research Manager at the School of Public Health University of Ghana, who is conducting field work for HITLAB.
In a country described as having more mobile phones than people, the use of mobile technology for health service delivery and data management –mHealth – has created a valuable avenue to support patient care.
As a researcher, it’s my job to gather hard data to assess the impact of mHealth tools on care delivery and patient outcomes in Ghana. While this objective information is critical, the stories I hear from patients and health workers provide anecdotal insight into the effects of mHealth programs on the ground. Here are some takeaways based on my recent experiences.
Access to Health Information and Healthcare Professionals
With 49.1% of Ghana’s population living in rural communities or hard to reach areas, mobile technology for community health is remarkable just for its sheer convenience. Based on personal experience, I can tell you that it is more rewarding to receive health information you need at home versus walking miles to the health center or waiting hours for public transport. Pregnant women I have encountered are also very enthusiastic about automated clinic reminders, which help them keep track of their ANC attendance.
Increasing mobile phone coverage in rural areas and among vulnerable populations also offers the potential to significantly reduce barriers in connecting with health personnel. Rural dwellers with restricted access due to poor transport systems can easily call health workers for information through their mobile phones. A woman from a rural village recently told me, "I live alone and have no help, so I have collected the numbers of four nurses. When I am ill, I call any of the nurses. If I do not reach the first one, I call the next number till I get the information I need." Another 36-year old mother and farmer with primary education said that having access to a nurse through her mobile phone means that she can call anytime to confirm health practices and ask questions.
It is hoped that this type of regular interaction with a nurse can in itself build trust and improve care-seeking behavior. Even when a health condition requires a patient to be seen by a doctor, nurses often serve as the first point of contact for accessing care. Patient-nurse trust is crucial to improving care-seeking among the vulnerable, especially in rural areas where illiteracy and tradition to a greater extent affect health practices. If mHealth is able to bridge the health gap, the effect of socio-economic status on health outcome could be significantly controlled.
Despite these advantages, it is still uncertain the extent to which mHealth can complement or substitute for in-person patient doctor/nurseinteraction. Furthermore, some mHealth tools and programs only offer one-way communication; remaining on the receiving end of health information can frustrate the informed patient who wishes to engage in a back-and-forth interaction on health issues. mHealth in Ghana may remain a necessary strategy that needs continual improvement.