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Original Articles
Open Access

Taking knowledge for health the extra mile: participatory evaluation of a mobile phone intervention for community health workers in Malawi

Natalie Campbell, Eva Schiffer, Ann Buxbaum, Elizabeth McLean, Cary Perry and Tara M Sullivan
Global Health: Science and Practice February 2014, 2(1):23-34; https://doi.org/10.9745/GHSP-D-13-00141
Natalie Campbell
aManagement Sciences for Health, Arlington, VA, USA
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  • For correspondence: ncampbell@msh.org
Eva Schiffer
bWorld Bank, Washington, DC, USA
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Ann Buxbaum
cPublic Health Consultant, Boston, MA, USA
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Elizabeth McLean
dManagement Sciences for Health, Boston, MA, USA
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Cary Perry
cPublic Health Consultant, Boston, MA, USA
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Tara M Sullivan
eJohns Hopkins Bloomberg School of Public Health, Center for Communication Programs, Baltimore, MD, USA
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A participatory evaluation process called Net-Map showed that providing community health workers (CHWs) with mobile phones and essential technical information changed CHWs, from passive recipients of information with little influence to active information agents who sought and provided information to improve health services.

Abstract

In Malawi, where the majority of the population resides in rural areas, community health workers (CHWs) are the first, and often only, providers of health services. An assessment of health information needs, however, found that these frontline workers often lacked essential health information. A pilot project, implemented in 2 rural districts of Malawi between 2010 and 2011, introduced a mobile phone system to strengthen knowledge exchange within networks of CHWs and district staff. To evaluate the mobile phone intervention, a participatory evaluation method called Net-Map was used, an approach built on traditional social network analysis. Together, CHWs and district personnel discussed information needs and gaps and the roles of different actors in their information networks. They then used drawings and 3-dimensional objects to create baseline and endline maps showing the linkages and levels of influence among members of the information network. Net-Map provided them with powerful evidence of differences before and after the mobile phone initiative. At baseline, CHWs were not mentioned as actors in the information network, while at endline they were seen to have significant connections with colleagues, beneficiaries, supervisors, and district health facilities, as both recipients and providers of information. Focus groups with CHWs complemented the Net-Map findings with reports of increased self-confidence and greater trust by their communities. These qualitative results were bolstered by surveys that showed decreases in stockouts of essential medicines, lower communication costs, wider service coverage, and more efficient referrals. As an innovative, participatory form of social network analysis, Net-Map yielded important visual, quantitative, and qualitative information at reasonable cost.

  • Received: 2013 Sep 26.
  • Accepted: 2013 Dec 17.
  • Published: 2014 Feb 1.
  • © Campbell et al.

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of this license, visit http://creativecommons.org/licenses/by/3.0/

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Global Health: Science and Practice: 2 (1)
Global Health: Science and Practice
Vol. 2, No. 1
February 01, 2014
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Taking knowledge for health the extra mile: participatory evaluation of a mobile phone intervention for community health workers in Malawi
Natalie Campbell, Eva Schiffer, Ann Buxbaum, Elizabeth McLean, Cary Perry, Tara M Sullivan
Global Health: Science and Practice Feb 2014, 2 (1) 23-34; DOI: 10.9745/GHSP-D-13-00141

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Taking knowledge for health the extra mile: participatory evaluation of a mobile phone intervention for community health workers in Malawi
Natalie Campbell, Eva Schiffer, Ann Buxbaum, Elizabeth McLean, Cary Perry, Tara M Sullivan
Global Health: Science and Practice Feb 2014, 2 (1) 23-34; DOI: 10.9745/GHSP-D-13-00141
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