Empowering community health workers with mobile health: learnings from two projects on non-communicable disease care

Abstract

Community-based healthcare is a promising approach to tackling workforce shortage in healthcare, especially in low- and middle-income countries. Community health workers (CHWs) are lay cadres that bridge healthcare disparities by living in the community where they should provide basic health services, mainly through education. However, high attrition rates and underperformance of these health workers limit the scope of such programs. In addition, mobile health is not the hoped-for silver bullet to solve the two challenges. This paper examines two pilot projects using mobile health for non-communicable disease care from an empowerment perspective. We propose design knowledge of mobile health for the structural empowerment of CHWs. Furthermore, we evaluate their psychological empowerment by analyzing mobile health's intended and unintended consequences. Finally, our study demonstrates how the empowerment of CHWs could help overcome the persisting challenges and lead to a sustainable and resilient health system.