RT Journal Article SR Electronic T1 Taking knowledge for health the extra mile: participatory evaluation of a mobile phone intervention for community health workers in Malawi JF Global Health: Science and Practice JO GLOB HEALTH SCI PRACT FD Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs SP ghs1300141 DO 10.9745/GHSP-D-13-00141 A1 Natalie Campbell A1 Eva Schiffer A1 Ann Buxbaum A1 Elizabeth McLean A1 Cary Perry A1 Tara M Sullivan YR 2014 UL http://www.ghspjournal.org/content/early/2014/01/29/GHSP-D-13-00141.abstract AB 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. 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.