Enhancing the Supervision of Community Health Workers With WhatsApp Mobile Messaging: Qualitative Findings From 2 Low-Resource Settings in Kenya.
Enhancing the Supervision of Community Health Workers With WhatsApp Mobile Messaging: Qualitative Findings From 2 Low-Resource Settings in Kenya.
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DOI：
10.9745/ghsp-d-15-00386
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发表时间：
2016-06-20
期刊：
影响因子：
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通讯作者：
Wanjiru H
中科院分区：
文献类型：
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作者：
Henry JV;Winters N;Lakati A;Oliver M;Geniets A;Mbae SM;Wanjiru H
社区卫生工作者与他们的主管一起使用WhatsApp记录他们的工作，促进了两个试点社区卫生工作者之间的良性竞争和团队建设。虽然每个参与者发布消息的次数有很大的差异-从1条消息到270条消息-但他们在6个月内总共发布了近2,000条消息。88%的信息至少符合3个定义的监督目标中的1个：（1）创造社会环境，（2）共享通信和信息，或（3）提高服务质量。社区卫生工作者与他们的主管一起使用WhatsApp记录他们的工作，促进了两个试点社区卫生工作者之间的良性竞争和团队建设。虽然每个参与者发布消息的次数有很大的差异-从1条消息到270条消息-但他们在6个月内总共发布了近2,000条消息。88%的信息至少符合3个定义的监督目标中的1个：（1）创造社会环境，（2）共享通信和信息，或（3）提高服务质量。据估计，肯尼亚所有移动的电话用户中有一半使用WhatsApp，这是一个即时通讯平台，为用户提供了一种经济实惠的方式来发送和接收一对一，一对多，多对一或多对多级别的短信，照片和其他媒体。在肯尼亚的基贝拉和马奎尼，一项旨在加强对社区卫生工作者的监督支持的移动的学习干预措施为社区卫生工作者及其主管创建了一个WhatsApp小组，以支持监督、专业发展和团队建设。我们分析了6个月的WhatsApp聊天记录（从2014年8月19日到2015年3月1日），并与CHW及其主管进行了访谈，以了解他们如何使用这个即时通讯工具。在研究期间，41名参与者发表了1，830个帖子。照片是社区工作者与其主管沟通的关键组成部分：所有帖子中有430个（23.4%）包含照片或其他媒体。在其馀1，400个以文字撰写的职位中，87.6%（1，227个）与三个既定督导目的中至少一个有关：（1）品质保证;（2）沟通及信息;或（3）支援环境。 这种监督是在关于推出新的移动的学习干预措施和提供常规保健服务以及团队建设努力和社区发展的帖子的背景下进行的。我们的初步调查表明，以最少的培训，CHW和他们的主管量身定制的多路通信功能的这种移动的即时通讯技术，制定虚拟的一对一，组，和点对点形式的监督和支持，他们切换的沟通渠道，根据监督目标。我们鼓励开展更多研究，探讨卫生工作者如何将移动的技术纳入其实践，以开发和实施有效的监督系统，保护患者隐私，加强正规卫生系统，并为社区卫生工作者创造以社区为基础、数字化支持的创新形式的专业发展。
CHWs used WhatsApp with their supervisors to document their work, spurring healthy competition and team building between CHWs in the 2 pilot sites. While there was considerable variation in the number of times each participant posted messages—from 1 message to 270 messages—in total they posted nearly 2,000 messages over 6 months. 88% of messages corresponded to at least 1 of 3 defined supervisory objectives of (1) creating a social environment, (2) sharing communication and information, or (3) promoting quality of services. CHWs used WhatsApp with their supervisors to document their work, spurring healthy competition and team building between CHWs in the 2 pilot sites. While there was considerable variation in the number of times each participant posted messages—from 1 message to 270 messages—in total they posted nearly 2,000 messages over 6 months. 88% of messages corresponded to at least 1 of 3 defined supervisory objectives of (1) creating a social environment, (2) sharing communication and information, or (3) promoting quality of services. An estimated half of all mobile phone users in Kenya use WhatsApp, an instant messaging platform that provides users an affordable way to send and receive text messages, photos, and other media at the one-to-one, one-to-many, many-to-one, or many-to-many levels. A mobile learning intervention aimed at strengthening supervisory support for community health workers (CHWs) in Kibera and Makueni, Kenya, created a WhatsApp group for CHWs and their supervisors to support supervision, professional development, and team building. We analyzed 6 months of WhatsApp chat logs (from August 19, 2014, to March 1, 2015) and conducted interviews with CHWs and their supervisors to understand how they used this instant messaging tool. During the study period, 1,830 posts were made by 41participants. Photos were a key component of the communication among CHWs and their supervisors: 430 (23.4%) of all posts contained photos or other media. Of the remaining 1,400 text-based posts, 87.6% (n = 1,227) related to at least 1 of 3 defined supervision objectives: (1) quality assurance, (2) communication and information, or (3) supportive environment. This supervision took place in the context of posts about the roll out of the new mobile learning intervention and the delivery of routine health care services, as well as team-building efforts and community development. Our preliminary investigation demonstrates that with minimal training, CHWs and their supervisors tailored the multi-way communication features of this mobile instant messaging technology to enact virtual one-to-one, group, and peer-to-peer forms of supervision and support, and they switched channels of communication depending on the supervisory objectives. We encourage additional research on how health workers incorporate mobile technologies into their practices to develop and implement effective supervisory systems that will safeguard patient privacy, strengthen the formal health system, and create innovative forms of community-based, digitally supported professional development for CHWs.