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Paper short abstract:

'Informal' mHealth - the self-directed use of personal mobile phones by health-workers - has become an integral part of healthcare delivery in many developing countries, albeit with some challenges. Our mixed-methods study of informal mhealth practices in Ghana can help inform policy and practice.

Paper long abstract:

Mobile health (mHealth) has been seen as a panacea for bridging healthcare gaps in resource-poor areas in many developing countries. While much research has focused on formal (top-down) mhealth initiatives, little is known about what community health nurses in Ghana are doing with their own mobile phones, and with what implications for healthcare. Using a mixed-method approach, we collected data from over 500 community health nurses from 15 districts in three regions, representing three ecological zones in Ghana. In addition, relevant national stakeholders were interviewed while nine FGDs were held across the three regions. We found that there is virtually no formal mHealth in the selected health facilities. However, Community Health Nurses (CHNs) across Ghana are using their own mobile phones and airtime to facilitate healthcare delivery, and saving lives in critical emergency situations. They use their phones to facilitate arrangements for ambulances, medicine supplies, and referral cases, as well as communication with colleagues, superiors, and patients (clients). However, most CHNs (especially those in rural areas) face several challenges in the use of their mobile phones for healthcare delivery, including poor network coverage, inadequate battery charging facilities, the expense of airtime, and unwanted calls at odd hours. In collaboration with the Ministry of Health and Ghana Health Service, we seek to use our evidence base to inform policy and practice on the use of personal mobile phones for healthcare delivery in Ghana.