Using Mobile Technology to Train Community Health Workers

by Lucy Mele, Communications Officer, Dalberg Global Development Advisors

Dalberg, the global consulting firm, has been involved with researching how mobile technologies can help developing sectors produce qualified employees. Here, Dalberg looks specifically at the global health sector.

Mobile technologies have shown countless benefits to the global health sector. Emerging tools, such as handheld devices that assist with data collection and medical assessments, help community health workers create and store patient records, alert providers when patients need treatment, and increase accuracy of diagnoses while decreasing margin for error. They can also track population-level data and alert broader health systems about disease outbreaks in remote areas.

We discussed the ways that these emerging technologies could help fulfill the need for health education and training in developing countries in a report released last year titled, “mHealth Education: Harnessing the Mobile Revolution to Bridge the Health Education & Training Gap in Developing Countries.” But as we move forward, can these technologies also be leveraged to efficiently scale training for community health workers (CHWs), and improve the quality and reach of care?

There is currently a global shortage of four million health workers, with critical need in many developing countries. Community health workers, who offer cost effective interventions in low-access regions, are critical to meeting this need, but require training to perform well in their roles. In preparation for the Mobile Health Summit in Cape Town in June, we collaborated once again with the iHeed Institute, with sponsorship from the mHealth Alliance, the MDG Health Alliance, and the Barr Foundation, to look more deeply into how we can best realize the potential of mHealth technology in CHW training.

Rocio Funes, a senior consultant in Dalberg’s Washington D.C. office, contributed to the new report and said that mobile health technologies provide health systems with an opportunity to rapidly expand and improve services, provided that some elements of traditional training are incorporated.

“By nature, community health workers have been very isolated because they typically serve areas with little health infrastructure,” she said. “We need scalable training that allows them to be part of the broader national health system. We can achieve this with a blended approach, where CHWs receive in-person training, but also are given access to multimedia and mobile technology in the classroom as well as the field.”

Dalberg’s analysis highlights an opportunity to use blended approaches to training, which complement and facilitate preferred pedagogies, such as interactive and repetitive learning techniques, and can be more appropriate and adaptable to rural settings because they allow for onsite learning while CHWs are in the field. Additionally, by incorporating multimedia such as video animation and voice instruction, blended approaches can use a variety of ways to engage trainees.

In addition to their effectiveness and appropriateness, the use of blended approaches to training would also require less time and personnel than conventional approaches, and are more cost-efficient to scale: the projected cost of content and instruction necessary to meet the demand of one million trained CHWs in sub-Saharan Africa would be ~75 percent less using a blended approach than the cost to scale using traditional methods. The report also found that an estimated 80 percent of training content is transferrable between countries, suggesting that customizing training content to local contexts – including adjustments for language, culture, and literacy – may not be as big a barrier as perceived.

The blended training model is not without challenges. According to Rocio, the upfront cost of developing digital content is high. When coupled with an emerging, yet sparse, evidence base around blended approaches in CHW settings, it can be difficult to persuade reluctant donors to invest in product development and launch at a large scale. However, if content developers and funders work together to ensure their platforms facilitate knowledge sharing and commit to a robust monitoring and evaluation plan to help build the evidence base, this challenge can be addressed.

As mobile technology continues to penetrate Africa, and as momentum toward accomplishing the health Millennium Development Goals continues to grow, approaches to health services and training that incorporate emerging technologies offer a great opportunity to scale existing CHW networks in a cost-efficient way and increase access and healthcare quality for more people around the globe.

For the full report, titled “Preparing the Next Generation of Community Health Workers: The Power of Technology for Training,” please click here.