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Open Access

Enhancing the Supervision of Community Health Workers With WhatsApp Mobile Messaging: Qualitative Findings From 2 Low-Resource Settings in Kenya

Jade Vu Henry, Niall Winters, Alice Lakati, Martin Oliver, Anne Geniets, Simon M Mbae and Hannah Wanjiru
Global Health: Science and Practice June 2016, 4(2):311-325; https://doi.org/10.9745/GHSP-D-15-00386
Jade Vu Henry
a UCL Institute of Education, London, United Kingdom
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Niall Winters
b University of Oxford, Department of Education, Oxford, United Kingdom
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Alice Lakati
c Amref Health Africa, Nairobi, Kenya
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Martin Oliver
a UCL Institute of Education, London, United Kingdom
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Anne Geniets
b University of Oxford, Department of Education, Oxford, United Kingdom
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Simon M Mbae
c Amref Health Africa, Nairobi, Kenya
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Hannah Wanjiru
c Amref Health Africa, Nairobi, Kenya
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Figures & Tables

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  • FIGURE 1
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    FIGURE 1

    Number of Messages Posted by Each WhatsApp Learning Group Participant, Kibera and Makueni, Kenya, August 19, 2014 – March 1, 2015 (N=1,830 Messages)

    Abbreviations: CHC, Community Health Committee; CHEW, community health extension worker; CHW, community health worker; MOH, Ministry of Health.

  • FIGURE 2
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    FIGURE 2

    Percentage of All WhatsApp Learning Group Messages Posted by Job Type of Senders, Kibera and Makueni, Kenya, August 19, 2014 – March 1, 2015 (N=1,830 Messages)

    Abbreviations: CHC, Community Health Committee; CHEW, community health extension worker; CHW, community health worker; MOH, Ministry of Health.

Tables

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    TABLE 1 Coding Scheme to Describe Messages Posted by WhatsApp Learning Group Participants, Kibera and Makueni, Kenya, August 19, 2014 – March 1, 2015– (N = 1,830 Posts, Codes Listed in Alphabetical Order)
    CodeDescriptionNo. of PostsaCodeDescriptionNo. of Postsa
    Chain letterGeneric message forwarded to members12Mobile appReferences to child developmental milestones or the project app46
    ClarificationsCorrections to a prior post11Mobile phoneOperational aspects of using mobile phones113
    Community developmentCommunity mobilization efforts in Kibera or Makueni35Moral supportCondolences and encouragement in response to challenges or hardships133
    DisabilityDocumentation of disabled child’s developmental milestones111Mutual learningInformal learning, peer learning, and knowledge exchange108
    Encouragement and praiseEncouragement and praise in response to a prior post281Other health initiativesReferences to health programs other than childhood disability, malnutrition, or water and sanitation110
    EvidenceDocumentation of CHW practice14Other mediaPosts containing only icons, videos, or audio and exclusive of text19
    Follow-upResponses to a prior post or event120PhotosPosts of photos411
    Fundraising and donationsCollection or distribution of money or objects16Photo captionsPosts containing descriptions of photos183
    GreetingsHellos, welcome messages, and holiday wishes215ReferralReferrals of patients to CHEW or health facility79
    Health educationCHW efforts to educate community31ReligionBible verses, blessings, and other references to faith108
    Household visitsEncounters during CHW household visits51ReportingCHW descriptions of patient encounters or community work100
    InspirationWords to motivate forum participants48ReprimandPosts that discipline or challenge other WhatsApp participants16
    Job offers and professional developmentEmployment announcements and outside training22Requesting informationSolicitation of additional information from others83
    Kibera-Makueni exchangeCommunication between Kibera & Makueni participants137SecurityReferences to community violence, fires, or other disturbances4
    KenyaNation building8ServiceStatements about community service6
    Logistics and planningTime, date, location, and agenda of meetings and other events186ThanksExpressions of gratitude304
    MalnutritionDescriptions of work with malnourished children16TrainingFormal learning opportunities122
    mLearn projectReferences to the mLearn project and its site visits, conferences and training activities297Water and sanitationInitiatives to promote clean water and hygiene42
    • ↵a More than 1 code may have been assigned to any 1 post, so percentages will not total to 100%.

    • View popup
    TABLE 2 Categories and Frequency of Text Messages Posted to the WhatsApp Learning Group by Supervision Objective, Kibera and Makueni, Kenya, August 19, 2014 – March 1, 2015
    Supervision ObjectiveCategories of PostsNo. of Posts% of All Posts (N = 1,400)a
    Supportive environmentEncouragement and praise90664.7%
    Greetings
    Inspiration
    Kibera-Makueni exchange
    Moral support
    Mutual learning
    Religion
    Thanks
    Communication and informationEvidence46733.4%
    Job offers and professional development
    Logistics and planning
    Reporting
    Requesting information
    Training
    Quality assuranceFollow-up26619.0%
    Health education
    Household visits
    Referral
    Reprimand
    Any supervision objectiveAny of the above codes1,227b87.6%b
    • ↵a Denominator includes all posts except those containing photos or other media.

    • ↵b More than 1 code may be assigned to any 1 post, so percentages will not total to 100%.

    • View popup
    TABLE 3 Categories and Frequency of Messages Posted to the WhatsApp Learning Group by Broad Theme Related to CHWs’ Everyday Practices, Kibera and Makueni, Kenya, August 19, 2014 – March 1, 2015
    ThemeCategories of PostsNo. of Posts With at Least 1 Code in Category% of Posts in Category (N = 1,400)a
    Posts about mCHW learning interventionDisability43531.1%
    mLearn project
    Mobile app
    Posts about other CHW practices unrelated to the mCHW learning interventionFollow-up44531.8%
    Health education
    Household visits
    Malnutrition
    Other health initiatives
    Referral
    Reporting
    Water and sanitation
    Training
    Posts for team building and community developmentCommunity development81958.5%
    Fundraising and donations
    Greetings
    Inspiration
    Inspiration Job offers and professional development
    Kibera-Makueni exchange
    Kenya
    Moral support
    Mutual learning
    Religion
    Service
    Security
    Thanks
    • ↵a More than 1 code may be assigned to any 1 post, so percentages will not total to 100%.

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Global Health: Science and Practice: 4 (2)
Global Health: Science and Practice
Vol. 4, No. 2
June 20, 2016
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Enhancing the Supervision of Community Health Workers With WhatsApp Mobile Messaging: Qualitative Findings From 2 Low-Resource Settings in Kenya
Jade Vu Henry, Niall Winters, Alice Lakati, Martin Oliver, Anne Geniets, Simon M Mbae, Hannah Wanjiru
Global Health: Science and Practice Jun 2016, 4 (2) 311-325; DOI: 10.9745/GHSP-D-15-00386

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Enhancing the Supervision of Community Health Workers With WhatsApp Mobile Messaging: Qualitative Findings From 2 Low-Resource Settings in Kenya
Jade Vu Henry, Niall Winters, Alice Lakati, Martin Oliver, Anne Geniets, Simon M Mbae, Hannah Wanjiru
Global Health: Science and Practice Jun 2016, 4 (2) 311-325; DOI: 10.9745/GHSP-D-15-00386
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