Who bears the cost of ‘informal mhealth’? Health-workers’ mobile phone practices and associated political-moral economies of care in Ghana and Malawi

by Kate Hampshire, Gina Porter, Simon Mariwah et al.
Health Policy Plan (2016) 1-9 – Published: 26 July 2016

9 pp. 148 kB
https://academic.oup.com/heapol/article-
pdf/doi/10.1093/heapol/czw095/7814138/czw095.pdf

In the absence of large-scale mhealth programmes, health-workers in Ghana and Malawi are using their own mobile phones to bridge healthcare gaps, particularly for rural, hard-to-reach populations. Health-workers use their own mobile phones for many purposes: to obtain help in emergencies, communicate with patients/colleagues, obtain clinical advice/information and manage logistics. However, the costs of this ‘informal mhealth’ are being borne by the health-workers themselves, particularly by low-paid community health-workers serving impoverished rural settlements. Serious consideration should be given to the implicit task shifting and cost shifting that informal mhealth may entail, to maximize healthcare benefits without placing excessive demands on health-workers.

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