Paper short abstract:

Most community health workers use personal mobile phones for work purposes. Our study shows that lack of airtime, lack of electricity to charge phones and poor networks limit use of mobile phones. Addressing these problems would significantly improve the use of mobile phones for work purposes.

Paper long abstract:

HSAs constitute the lowest cadre in Malawi's Ministry of Health, are based at community level and serve a population of 1,000 people. They are responsible for promotive and preventive health services. This paper explores the use of mobile phones among HSAs and how this impacts on their work. Eighteen FGDs were conducted with HSAs in Lilongwe, Mzimba and Zomba Districts: 57 FGD participants were males while 83 were females.

Most HSAs use their own mobile phones for (i) recording data at village clinics; (ii) communicating TB and HIV testing results to clients; (iii) following up clients who have defaulted ART and TB treatment; (iv) sending reminders to clients; (v) communicating among themselves; (vi) ordering medicines; and (vii) sending reports to their supervisors. HSAs appreciated the use of mobile phone technology as initially they walked long distances to reach clients and filled many forms including sending hard copies of reports to supervisors.

HSAs, however, cited challenges such as lack of airtime as in most cases it is not provided, the lack of electricity to charge phones especially for HSAs in rural areas and poor mobile phone networks. The charging of phones especially for HSAs in rural areas is expensive. These results demonstrate that the use of mobile phone technology by HSAs improves service delivery but there is a need to address the prevailing challenges.