The Role of Mobile Learning in Supporting Community Health Workers’ Continuous Learning: A Case of Village Health Teams in Patongo and Lokule Sub Counties-Uganda

Main Article Content

Mwebaze Mukisa Moses

Abstract

The study assesses the role of Mobile learning in supporting Community Health Workers' continuous learning using a Smartphone application. The Community Health Workers are members of the community commonly known as Village Health Teams in Uganda. This group is presumed not be a priority for training. The aim is to objectify using Mobile learning affordances to support Community Health Workers' training, an activity presently considered to be irregular and underfunded. This is achieved through the implementation of a Mobile App prototype used as a learning tool for digitized training content on the subject of diseases, reproductive health, sanitation, and family wellbeing. The study involved 41 participants categorized as Community Health Workers, community health students, and Community Health Leaders who selectively participated in piloting the mobile application, responded of a survey questionnaire, took an interview and attended a feedback session. The study examined the availability of Smartphone devices, ease of Mobile App use, challenges of the existing approach to training and information delivery, Mobile Application accessibility issues, and anticipated technical challenges. Despite the conspicuous challenges of mobile technology in a rural setting, 97% of the participants indicated that Mobile learning is a favorable alternative to support the training of Community Health Workers, though, only 48% had access to a Smartphone. Attrition of volunteer workers was identified as the primary challenge to the training of Community Health Workers.  The identified advantages relate to geographic convenience, cost of training, numerous mobile services, ease of access, update, storage, and sharing of content. However, imminent bottlenecks identified include the availability of Smartphone devices among Community Health Workers, lack of electricity, unreliable networks, and lack of internet data. Notable interventions from stakeholders aiming to mitigate the challenges are highlighted.

Keywords: Mobile Learning, continuous learning, Community of Practice

Article Details

How to Cite
MOSES, Mwebaze Mukisa. The Role of Mobile Learning in Supporting Community Health Workers’ Continuous Learning: A Case of Village Health Teams in Patongo and Lokule Sub Counties-Uganda. Medical Research Archives, [S.l.], v. 12, n. 1, jan. 2024. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/4938>. Date accessed: 03 mar. 2024. doi: https://doi.org/10.18103/mra.v12i1.4938.
Section
Case Reports

References

1. McCann D. A ugandan mhealth moratorium is a good thing. ICTworks. November 3, 2023. Accessed December 19, 2023. https://www.ictworks.org/ugandan-mhealth-moratorium-good-thing/.
2. Manglani Y. MHealth for maternal health: Mhealth pilotitis – time for recovery or relapse? Maternal Health Task Force. August 10, 2016. Accessed December 19, 2022. https://www.mhtf.org/2014/03/31/mhealth-for-maternal-health-mhealth-pilotitis-time-for-recovery-or-relapse/.
3. Huang F, Blaschke S, Lucas H. Beyond pilotitis: Taking Digital Health Interventions to the national level in China and Uganda. Globalization and Health. 2017;13(1). doi:10.1186/s12992-017-0275-z
4. Uganda Bureau of Statistics. Uganda Bureau of Statistics. December 18, 2023. Accessed December 19, 2023. https://www.ubos.org/.
5. Achest. Hospitals in crisis in Uganda as Middle Eastern countries poach medical staff. Africa Health. September 26, 2017. Accessed December 19, 2023. https://africa-health.com/news/hospitals-crisis-uganda-middle-eastern-countries-poach-medical-staff/.
6. The World Bank. Nurses and midwives (per 1,000 people) - Uganda. World Bank Open Data. Accessed December 19, 2023. https://data.worldbank.org/indicator/SH.MED.NUMW.P3?locations=UG.
7. Ministry of Finance and Economic Development. Rural Development | Development policy and performance portal. Ministry of Finance and Economic Development. Accessed July 8, 2022. https://development.finance.go.ug/rural-development.
8. Ozdamli F, Cavus N. Basic elements and characteristics of Mobile Learning. Procedia - Social and Behavioral Sciences. 2011;28:937-942. doi:10.1016/j.sbspro.2011.11.173
9. Wilson K. Mobile cell phone technology puts the future of health care in our hands. Canadian Medical Association Journal. 2018;190(13):1-2. doi:10.1503/cmaj.180269
10. Ventola CL. Mobile devices and apps for health care professionals: uses and benefits. P T. 2014;39(5):356-364. May 2014. Accessed December 20, 2023. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4029126/.
11. Wallace S, Clark M, White J. “it’s on my iphone”: Attitudes to the use of mobile computing devices in medical education, a mixed-methods study. BMJ Open. January 1, 2012. Accessed December 20, 2023. https://doi.org/10.1136/bmjopen-2012-001099.
12. National Planning Authority. Third national development plan (NDPIII) 2020/21 – 2024/25. Ministry of Health. January 2020. Accessed December 19, 2023. http://library.health.go.ug/sites/default/files/resources/Third%20National%20Development%20Plan%20III%2C%202020-21-2024-25.pdf.
13. Ministry of Health Uganda. (2017). Uganda National eHealth Strategy [Review of Uganda National eHealth Strategy]. In Ministry of Health. Government of Uganda. https://health.go.ug/sites/default/files/National%20e_Health%20Strategy_0.pdf.
14. Winters N, Langer L, Nduku P, et al. Using mobile technologies to support the training of community health workers in low-income and middle-income countries: Mapping the evidence. BMJ Global Health. 2019;4(4):1-10. doi:10.1136/bmjgh-2019-001421
15. Allen-Duck A, Robinson JC, Stewart MW. Healthcare Quality: A concept analysis. Nursing Forum. 2017;52(4):377-386. doi:10.1111/nuf.12207
16. Musoke D, Ndejjo R, Atusingwize E, Mukama T, Ssemugabo C, Gibson L. Performance of community health workers and associated factors in a rural community in Wakiso District, Uganda. African Health Sciences. 2019;19(3):2784-2797. doi:10.4314/ahs.v19i3.55
17. Umunyana J, Mwali AK, Radeny S. Piloting An eLearning Course for Community Health Worker Training. IntraHealth International. May 2022. Accessed December 19, 2023. https://www.intrahealth.org/sites/ihweb/files/attachment-files/tb2pilotingelearningcourserev-5-22hr-d.pdf.
18. Musoke D, Ssemugabo C, Ndejjo R, Atusingwize E, Mukama T, Gibson L. Strengthening the community health worker programme for health improvement through enhancing training, supervision and motivation in Wakiso District, Uganda. BMC Research Notes. 2019;12(1):1-5. doi:10.1186/s13104-019-4851-6
19. National Information Technology Authority. (2018). National Information Technology Survey 2017/18 Report [Review of National Information Technology Survey 2017/18 Report]. In NITA Uganda (pp. 1–274). NITA-U. https://www.nita.go.ug/sites/default/files/2022-01/National%20IT%20Survey%20April%2010th.pdf
20. Gillwald A, Mothobi O, Tusubira FF, Ndiwalana A. The state of ICT in Uganda. Research ICT Africa. September 11, 2021. Accessed December 19, 2023. https://researchictafrica.net/publication/the-state-of-ict-in-uganda/.
21. Uganda Communication Commission. (2022). Market Performance Report 3Q21 [Review of Market Performance Report 3Q21]. In Uganda Communication Commission (pp. 1–56). https://www.ucc.co.ug/wp-content/uploads/2023/10/UCC-September-2021-Market-Intelligence-Report.pdf
22. Zhou X, Snoswell CL, Harding LE, et al. The role of telehealth in reducing the mental health burden from covid-19. Telemedicine and e-Health. 2020;26(4):377-379. doi:10.1089/tmj.2020.0068
23. Ahimbisibwe P, Otage S. 1,500 poor families to get free solar iPads, internet. Monitor. March 15, 2021.
24. Trayner W. Introduction to Communities of Practice. Wenger. June 4, 2023. Accessed December 19, 2023. https://www.wenger-trayner.com/introduction-to-communities-of-practice/.
25. Battista A. An activity theory perspective of how scenario-based Simulations Support Learning: A Descriptive Analysis. Advances in Simulation. 2017;2(1). doi:10.1186/s41077-017-0055-0
26. Young SWH. Chapter 1. principle 1: Create shareable content. Library Technology Reports. Accessed December 19, 2023. https://www.journals.ala.org/index.php/ltr/article/view/6144/7941.
27. Trudell, B. (2009). Local-language literacy and sustainable development in Africa. International Journal of Educational Development, 29(1), 73–79. https://doi.org/10.1016/j.ijedudev.2008.07.002
28. Imtinan U, Chang V, Issa T. Common Mobile Learning Characteristics-An Analysis of Mobile Learning Models and Frameworks. Eric - Institute of Education Sciences. Accessed December 17, 2023. https://files.eric.ed.gov/fulltext/ED556901.pdf
29. Agarwal S, Abuya T, Kintu R, et al. Understanding Community Health Worker Incentive Preferences in Uganda using a discrete choice experiment. Journal of Global Health. 2021;11. doi:10.7189/jogh.11.07005
30. Ludwick T, Brenner JL, Kyomuhangi T, Wotton KA, Kabakyenga JK. Poor retention does not have to be the rule: Retention of Volunteer Community Health Workers in Uganda. Health Policy and Planning. 2013;29(3):388-395. doi:10.1093/heapol/czt025
31. Musoke D, Atusingwize E, Ndejjo R, Ssemugabo C, Siebert P, Gibson L. Enhancing Performance and Sustainability of Community Health Worker Programs in Uganda: Lessons and Experiences From Stakeholders. Global Health: Science and Practice. 2021;9(4):855-868.
32. Pandya S, Hamal M, Abuya T, et al. Understanding factors that support community health worker motivation, job satisfaction, and performance in three Ugandan districts: Opportunities for strengthening Uganda’s Community Health Worker Program. International Journal of Health Policy and Management. Published online 2022. doi:10.34172/ijhpm.2022.6219
33. O’Donovan J, Kabali K, Taylor C, et al. The use of low-cost Android tablets to train community health workers in Mukono, Uganda, in the recognition, treatment, and prevention of pneumonia in children under five: A pilot randomised controlled trial. Human Resources for Health. 2018;16(1). doi:10.1186/s12960-018-0315-7
34. Short SS, Lin AC, Merianos DJ, Burke RV, Upperman JS. Smartphones, trainees, and Mobile Education: Implications for graduate medical education. Journal of Graduate Medical Education. 2014;6(2):199-202. doi:10.4300/jgme-d-13-00238.1
35. World Health Organization. Value gender and equity in the Global Health Workforce. World Health Organization. Accessed December 19, 2023. https://www.who.int/activities/value-gender-and-equity-in-the-global-health-workforce.
36. Musoke D, Ndejjo R, Atusingwize E, Mukama T, Ssemugabo C, Gibson L. Performance of community health workers and associated factors in a rural community in Wakiso District, Uganda. African Health Sciences. 2019;19(3):2784-2797. doi:10.4314/ahs.v19i3.55
37. Malikane J. Case study: Digitalizing a village health team in Uganda. UN Capital Development Fund (UNCDF). Accessed December 19, 2023. https://www.uncdf.org/article/7409/case-study-digitalizing-a-village-health-team-in-uganda.
38. Geldsetzer P, De Neve J-W, Boudreaux C, Bärnighausen T, Bossert TJ. Improving the performance of community health workers in Swaziland: Findings from a qualitative study. Human Resources for Health. 2017;15(1). doi:10.1186/s12960-017-0236-x