IEEE Technology and Society Magazine - Spring 2013 - 48

Several technology interventions are
being designed, tested, and utilized to
supplement the hard work of healthcare
professionals.
period and provide daily support to
25 LHWs [4]. In a research study
investigating the LHW perceptions
of their own effectiveness, they
found that "nazr (evil eye), garam
& thanda (hot & cold) food, male
child preference, fear of stigma in
TB and other diseases, and fatalism"
were common barriers to their work.
This study also found that media
campaigns enhanced the credibility
of the LHWs work in their communities [15]. The LHW face challenging terrain that makes it difficult to
reach all clients in a timely fashion,
and malfunctioning equipment such
as weighing scales. The program
is currently trying to construct an
effective information system, "to
respond to the information needs of
various decision making levels of
the health system" [15].

Technologies to Aid CHWs
CHW programs have been developed in many countries with the
most successful programs targeting the needs of specific populations. Certain factors form the
building blocks of successful CHW
programs. First, community participation is essential to securing
participants and involving them in
all aspects of the program. Second,
it is necessary to have adequate
and reliable resources, such as governmental and political support to
ensure crucial involvement with the
other health sector activities. Third,
because of organizational and geographical limitations, sustained
and attentive management plays
a critical role in keeping the program alive. Village health committees (VHCs) are often established
to take charge of selecting CHW
candidates. Fourth, CHW training
programs should ideally be located
48

close to the working context of the
trainee and continuing/refresher
training should be emphasized to
reinforce training and learning of
new skills. Fifth, an incentive package should be arranged, including
financial incentives, such as a salary, and non-financial incentives,
like uniforms and medicine [8].
Many challenges exist for those trying to achieve these five elements of
a successful CHW program. Issues
include constrained resources and
institutional environments, problems of sustaining a volunteer
workforce due to lack of resources
for incentive packages, logistics and
supply chain obscurities, training
and supervision needs, and multisectoral support. However, these
challenges also present opportunities for creating value through technology-based solutions.
Table I outlines the supplies
provided to CHWs by their central
governments to aid their work in the
community. The tools vary widely
from country to country, with some
countries providing more medicines and others providing basic
medical equipment. The supplies
also highlight the various responsibilities of CHWs, from flip charts
and flyers for educational outreach,
to condoms for family planning,
and chloroquine for treating common illnesses. Some of the stipulations, like "bicycle, canoe or ship"
for CHWs in Brazil and various
vaccines in Haiti, raise questions
about their feasibility, practicality,
and sustainability.
Technology can empower community health workers and enhance
their effectiveness in addressing primary healthcare needs, help synergize with the healthcare system, and
amplify their impact. In the case

of Brazil, the family health team
is responsible for collecting demographic data on patients and communities as well as documenting
their efforts and interventions. The
Ministry of Health has made efforts
to digitize data systems and continues to struggle with the task. In the
case of Ethiopia, the HEWs spend
75% of their time in the field providing basic health services to the community [4]. Tools to improve data
collection, management, and organization would greatly enhance the
community level work of CHWs.
Access to portable basic medical
equipment and cell phone technologies could significantly advance the
CHWs ability to accurately assess
a patient's symptoms and correctly
communicate those symptoms to a
doctor. Affordable cell phone-based
technologies can address major gaps
in knowledge and promote information sharing among healthcare
workers at the community and district levels.
Several technology interventions
are being designed, tested, and utilized to supplement the hard work
of healthcare professionals. For
example, the Kenyan Ministry of
public Health and Sanitation's Division of Immunization has initiated
a new system that uses cell phone
technology to track vaccine stocks at
various district stores. The system,
known as Healthtrack, enables users
to manage and automatically update
vaccine stock information through
their cell phones. Employees can
also communicate to each other by
sending text messages and reports
through the system [16]. In another
example, the Ministry of Health of
Zanzibar in Tanzania has initiated an
intervention termed "Wired Mothers." Wired mothers are pregnant
women with cell phones who receive
regular SMS text messages reminding them of appointments and allowing them to call health providers for
advice on acute or non-acute problems [17]. The government of Brazil
partnered with Nokia in 2008, to
launch Mobisus, a cellphone-based

IEEE TECHNOLOGY AND SOCIETY MAGAZINE

SprING 2013

Table of Contents for the Digital Edition of IEEE Technology and Society Magazine - Spring 2013