Utilization of Computers and Mobile Technology by Community Health Workers in Obala Health District, Cameroon: Challenges and Implications for Performance
DOI:
https://doi.org/10.58425/jphs.v4i1.395Keywords:
Community health workers, mobile phone technology, computer access, ICT training, health service deliveryAbstract
Aim: Community Health Workers (CHWs) are increasingly recognized for their role in addressing health workforce gaps in underserved communities. Although digital technologies are widely used to improve healthcare delivery, CHWs often face barriers such as limited access to devices and inadequate skills, affecting their capacity to provide quality services to larger populations. This study sought to identify the reasons for the limited use of computers and mobile devices by CHWs in implementing community health programs and to assess the association between technology adoption and performance.
Methods: A cross-sectional survey design was used with a sample of 86 CHWs selected through a purposive sampling method. Data were collected via structured questionnaires and analyzed using descriptive statistics and correlation analysis in SPSS version 25.
Results: Eighty-nine percent of CHWs owned a mobile phone, yet only 25% reported receiving training on its use for health service delivery. Nonee owned personal computers and 94% reported a lack of access to facility-based computers. A positive correlation (r = 0.525, p < 0.05) was found between access to mobile phones and frequency of use in CHW activities.
Conclusion: CHWs strongly agreed that health facilities should enable access to use computers at the health facility/institution to prepare and submit their reports and embrace ICT usage.
Recommendation: Standardized ICT training should be integrated into CHW curricula, with access to facility-based digital tools ensured and supportive supervision strengthened.
References
Abokyi, E., Ogai, A., Bennin, O., Agyei, S., & Allotey, P. (2023). Mobile health interventions and quality of care in primary health systems: Evidence from Ghana. Global Health Action, 16(1), 2187336. https://doi.org/10.1080/16549716.2023.2187336
Abouzid, M., & El-Sherif, D. M. (2022). Analysis of mHealth research: Mapping the relationship between mobile apps technology and healthcare during COVID-19 outbreak. Global Health, 18, 67. https://doi.org/10.1186/s12992-022-00856-y
Araque, J. C., Maiden, R. P., Bravo, N., Estrada, I., Evans, R., Hubchik, K., Kirby, K., & Reddy, M. (2013). Computer usage and access in low-income urban communities. Computers in Human Behavior, 29(4), 1393–1401. https://doi.org/10.1016/j.chb.2013.01.032
Ballard, M., Bancroft, E., Nesbit, J., Johnson, A., Holeman, I., Foth, J., Rogers, D., Yang, J., Nardella, J., Olsen, H., Mehl, G., Panjabi, R., & Palazuelos, D. (2020). Prioritising the role of community health workers in the COVID-19 response. BMJ Global Health, 5(6), e002550. https://doi.org/10.1136/bmjgh-2020-002550
Ballard, M., Montgomery, A., Arora, J., Keita, K., Haag, E., Palazuelos, D., Rosenberg, J., & Weintraub, R. (2022). Community health workers in pandemics: Evidence and investment implications. Global Health: Science and Practice, 10(2), e2100648. https://doi.org/10.9745/GHSP-D-21-00648
Crigler, L., Hill, K., Furth, R., & Bjerregaard, D. (2013). Community Health Worker Assessment and Improvement Matrix (CHW AIM): A toolkit for improving community health worker programs and services (Revised version). USAID Health Care Improvement Project, University Research Co., LLC.
George, S., Silva, L., Llamas, M., Ramos, I., Joe, J., Mendez, J., Salazar, R., Tehan, J., Vasquez, T., Nealy, S., & Balcazar, H. (2021). The development of a novel, standards-based core curriculum for community health workers. Ghana Medical Journal, 55(2), 118–127. http://dx.doi.org/10.4314/gmj.v55i2.4
Hajizadeh, M., Mehrolhasani, M., & Arab, M. (2021). Education and the adoption of digital health tools. Health Policy and Planning, 36(3), 275–284. https://doi.org/10.1093/heapol/czaa176
Kuule, Y., Dobson, A. E., Woldeyohannes, D., Zolfo, M., Najjemba, R., Edwin, B. M. R., Haven, N., Verdonck, K., Owiti, P., & Wilkinson, E. (2017). Community health volunteers in primary healthcare in rural Uganda: Factors influencing performance. Frontiers in Public Health, 5, 62. https://doi.org/10.3389/fpubh.2017.00062
Lee, K. (2011). Global health promotion: How can we strengthen governance and build effective strategies? Health Promotion International, 26(suppl_2), ii5–ii9. https://doi.org/10.1093/heapro/dar073
Malcarney, M., Pittman, P., Quigley, L., Horton, K., & Seiler, N. (2017). The changing roles of community health workers. Health Services Research, 52(Suppl. 1), 360–382. https://doi.org/10.1111/1475-6773.12657
Mastellos, N., Tran, T., Dharmayat, K., Barlow, J., Tully, M. P., & Majeed, A. (2018). Training community healthcare workers on the use of information and communication technologies: A randomized controlled trial in Malawi, Africa. BMC Medical Education, 18, 61. https://doi.org/10.1186/s12909-018-1175-5
Ministry of Public Health (Cameroon). (2020). National Digital Health Strategic Plan 2020–2024 (Plan stratégique national de santé numérique 2020–2024). Yaoundé, Cameroon: Ministry of Public Health.
MINSANTE. (2020). National digital health strategic plan 2020–2024. Ministry of Public Health, Cameroon.
Mlambo, C., Sibanda, K., Ntshangase, B., & Mvuyana, B. (2022). ICT and women’s health: An examination of the impact of ICT on maternal health in SADC states. Healthcare, 10(5), 802. https://doi.org/10.3390/healthcare10050802
Mumo, J., Mtei, G., Njuguna, R., Karanja, S., Kimani, S., & Resnick, D. (2021). Digital health adoption among frontline health workers in Kenya. BMC Health Services Research, 21, 1120. https://doi.org/10.1186/s12913-021-07114-8
Mupara, L. M., Besigye, I., Lule, I., & Samsa-Ba, M. (2023). Community health worker programmes in sub-Saharan Africa: Integration into health systems. African Journal of Primary Health Care & Family Medicine, 15(1), a3422. https://doi.org/10.4102/phcfm.v15i1.3422
Nguyen, T. N., Tran, B. X., Hinh, D. D., Pham, H. Q., Phan, T. L., Nguyen, V. H., Dang, A. K., Tran, M. T., & Latkin, C. A. (2022). Digital health interventions for community health workers in low- and middle-income countries: A systematic review. Journal of Medical Internet Research, 24(7), e37612. https://doi.org/10.2196/37612
Nyoni, T., Mahachi, N., & Stephen, A. (2021). Privacy and confidentiality in HIV services in Africa. BMC Public Health, 21, 180. https://doi.org/10.1186/s12889-021-10186-9
Okeke, C., Okechukwu, E., & Nwachukwu, I. (2021). Gender-based vulnerabilities of community health workers in Africa. African Journal of Primary Health Care & Family Medicine, 13(1), a2873. https://doi.org/10.4102/phcfm.v13i1.2873
Owhor, T. C., Adebimpe, W. O., Ameh, A., Akinola, H., Amoo, E. O., Akyeampong, Y., Onwuhafua, P. I., Adebiyi, O., Abiola, A. O., & Uthman, O. A. (2023). Digital readiness and ICT adoption among health workers in sub-Saharan Africa. BMC Health Services Research, 23, 984. https://doi.org/10.1186/s12913-023-09858-3
O’Meara, W., Tsofa, B., Molyneux, S., Goodman, C., & McKenzie, F. (2011). Community and facility-level engagement in planning and budgeting for the government health sector — a district perspective from Kenya. Health Policy, 99(3), 234–243. https://doi.org/10.1016/j.healthpol.2010.08.027
Perry, H. B., Zulliger, R., & Rogers, M. M. (2014). Community health workers in low-, middle-, and high-income countries: An overview of their history, recent evolution, and current effectiveness. Annual Review of Public Health, 35, 399–421. https://doi.org/10.1146/annurev-publhealth-032013-182354
Sabo, S., Allen, C. G., Sutkowi, K., & Wennerstrom, A. (2017). Community health workers in the United States: Challenges in identifying, surveying, and supporting the workforce. American Journal of Public Health, 107(12), 1964–1969. https://doi.org/10.2105/AJPH.2017.304096
Singh, L. (2020, April 28). BMC's community health volunteers: In the frontline of the COVID-19 fight, but poorly paid, exposed to risk. The Indian Express. https://indianexpress.com/article/cities/mumbai/bmcscommunity-health-volunteers-in-the-frontline-of-covid-fight-but-poorlypaid-exposed-to-risk-6382159
Tozan, Y., Negin, J., & Wariero, J. O. (2011). The Millennium Villages Project: Improving health and eliminating extreme poverty in rural African communities. In E. Blas, J. Sommerfeld, & A. S. Kurup (Eds.), Social determinants approaches to public health: From concept to practice (pp. xx–xx). World Health Organization.
UNESCO Institute for Statistics. (2023). Cameroon country profile – Literacy rate. https://uis.unesco.org/en/country/cm
United Nations Department of Economic and Social Affairs. (2022). World population prospects. https://population.un.org/wpp/
Upadhyay, P., Sharma, S., Singh, R., & Gupta, R. (2023). Digital innovations in community health: Empowering women through ICT. Journal of Global Health, 13, 04018. https://doi.org/10.7189/jogh.13.04018
Wekesah, F., Waweru, E., Mwai, A., & Egondi, T. (2022). Gender and digital health: Opportunities and challenges in Africa. Global Health Action, 15(1), 2108792. https://doi.org/10.1080/16549716.2022.2108792
World Health Organization. (2018). WHO guideline on health policy and system support to optimize community health worker programmes. https://apps.who.int/iris/handle/10665/275474
World Health Organization. (2019). Recommendations on digital interventions for health system strengthening. https://apps.who.int/iris/handle/10665/311941
World Health Organization Regional Office for Africa. (2012). Health systems in Africa: Community perceptions and perspectives – The report of a multi-country study. https://apps.who.int/iris/handle/10665/137377
World Health Organization Regional Office for Africa. (2017). Community health worker programmes in the WHO African Region: Evidence and options – Policy brief. https://apps.who.int/iris/handle/10665/254739
World Health Organization Regional Office for Africa. (2021). The state of the health workforce in the WHO African Region. https://apps.who.int/iris/handle/10665/348221
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