Paper short abstract:

Short abstract Health Extension Workers (HEWs) in Ethiopia use their own mobile phones to bridge healthcare gaps. In contrast to the top-down focus of most 'mhealth' initiatives, we explore the benefits and drawbacks of this kind of 'informal mhealth' across two Regions of Ethiopia.

Paper long abstract:

Long abstract

Ethiopia's flagship Health Extension Worker (HEW) programme has been heralded as a model for other African countries with large rural populations to adopt in the pursuit of Universal Health Coverage. However, we know very little about the ways that HEWs in Ethiopia are using mobile phones to facilitate their work and with what consequences for patients and the wellbeing of health-workers. We report on a study conducted in two of Ethiopia's largest Regions, Amhara and Oromia, entailing a large survey and focus groups with HEWs and their patients. Overall, both health-workers and patients were enthusiastic about the benefits that mobile phone use can bring in healthcare. However, they also faced some challenges and the idea of being constantly 'in contact' placed extra responsibilities on HEWs. Given that large-scale roll-out of mhealth across Africa remains a distant dream, it is important to understand current digital practices and the connections and disruptions they might entail.