scholarly journals “No queremos quedar mal”: A qualitative analysis of a boundary setting training among Latina community health workers.

2021 ◽  
Author(s):  
Luis R. Alvarez-Hernandez ◽  
J. Maria Bermúdez ◽  
Pamela Orpinas ◽  
Rebecca Matthew ◽  
Alejandra Calva ◽  
...  
Keyword(s):  
Qualitative Analysis ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Boundary Setting

scholarly journals Community Health Worker Evaluation of Implementing an mHealth Application to Support Maternal Health Care in Rural India

2021 ◽  
Vol 2 ◽  
Author(s):  
Umesh Charanthimath ◽  
Geetanjali Katageri ◽  
Mai-Lei Woo Kinshella ◽  
Ashalata Mallapur ◽  
Shivaprasad Goudar ◽  
...  
Keyword(s):  
Qualitative Analysis ◽  
Community Health ◽  
Community Health Workers ◽  
Self Efficacy ◽  
Health Workers ◽  
Adverse Outcomes ◽  
Ease Of Use ◽  
Rural India ◽  
Mhealth Intervention ◽  
Auxiliary Nurse

Introduction: PIERS on the Move (POM) is a mobile health (mHealth) application developed for a smartphone to support community health workers (CHWs) for identification and management of women at risk of adverse outcomes from pre-eclampsia. POM was implemented as an addition to routine antenatal care by accredited social health activists (ASHAs) and auxiliary nurse midwives (ANMs) during the community level intervention for pre-eclampsia (CLIP) Trial in Karnataka state, India (NCT01911494). The objective of this study was to evaluate the experiences of CHWs of using POM in rural India and their perceptions of acceptability and feasibility of this mHealth intervention.Methods: A posttrial mixed-methods evaluation was designed to measure CHW knowledge and self-efficacy regarding the care of women with pre-eclampsia and perceptions of CHWs on the ease of use and usefulness of POM. A structured survey with open-ended questions was conducted between October and November 2017. The median values on a 5-point Likert scale for knowledge and self-efficacy questions were compared between trial arms by Mann–Whitney U test (p < 0.05 significant). Qualitative analysis was undertaken on NVivo 12 (QSR International, Melbourne, Australia).Results: A total of 48 ASHAs and ANMs were interviewed, including 24 who used POM (intervention arm) and 24 who did not (control arm). Self-reported knowledge and self-efficacy for the care of women with pre-eclampsia did not differ between groups. The qualitative analysis highlighted that health workers who used POM reported improved interactions with women and families in their communities. POM strengthened the role of ASHA as a CHW beyond a “link-worker” accompanying women to health services. With training, the mHealth application was easy to use even for CHWs who did not have much experience with smartphones.Conclusions: Community health workers found the POM app easy to use, useful, and well-received by women and their families. POM did not improve care through increased knowledge but built capacity by increasing the recognition of the ASHA and ANM as critical members of the continuum of antenatal healthcare within their communities. These findings support the important role that mHealth technologies can play in strengthening health systems to reach rural, remote, and marginalized populations to reduce disparities in health.

scholarly journals “Now You Have Become Doctors”: Lady Health Workers' Experiences Implementing an mHealth Application in Rural Pakistan

2021 ◽  
Vol 2 ◽  
Author(s):  
Mai-Lei Woo Kinshella ◽  
Sana Sheikh ◽  
Sohail Bawani ◽  
Michelle La ◽  
Sumedha Sharma ◽  
...  
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Focus Group ◽  
Qualitative Analysis ◽  
Health System ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Community Level ◽  
Rural Pakistan

Background: PIERS on the Move (POM) is a mobile health application developed to support community health workers identification and management of women at risk of adverse outcomes from pre-eclampsia. The objective of this study was to evaluate the impact of using POM in Pakistan on Lady Health Workers' (LHWs) knowledge and self-efficacy related to caring for women with pre-eclampsia, and their perception of usefulness of the tool.Methodology: An evaluation was designed for health care workers involved in the Community-Level Intervention for Pre-eclampsia (CLIP) cluster randomized trial from 2014 to 2016 in Sindh Province, Pakistan (NCT01911494). A semi-structured focus group guide was developed based on the Technology Acceptance Model (TAM), which theorizes that an individual's behavioral intention to use a system is determined by perceived usefulness and ease of use. Preliminary qualitative analysis was undertaken by the Pakistan and Canadian teams to create a coding framework for full qualitative analysis, which was completed using NVivo12.Results: Three key informant interviews were conducted with two Lady Health Supervisors and one Senior Medical Officer. Sixty-two LHWs were included in three focus group discussions. LHWs found the POM app easy to use and useful for their work as a helpful repository for maternal health information and guiding counseling and management of pre-eclampsia. LHWs reported increased knowledge and confidence in their work. Availability of clinical homecare, including postpartum, was felt to positively impact healthcare provided to pregnant and postpartum women. Potential community level impacts included strengthening relationships between health care providers and communities and between LHWs and the health system. LHWs shared reports of earlier care-seeking and increased awareness of maternal health issues by community members.Conclusions: LHWs carry a large burden of responsibility for community health in rural Pakistan and appreciated the investment in their skills and capacity during the CLIP trial with the POM app. Investing in communications technology for community health workers through improved referrals and follow up may strengthen cohesiveness of the health system overall.

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