Who bears the cost of 'informal mhealth'? Health-workers' mobile phone practices and associated political-moral economies of care in Ghana and Malawi.
Who bears the cost of 'informal mhealth'? Health-workers' mobile phone practices and associated political-moral economies of care in Ghana and Malawi.
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DOI：
10.1093/heapol/czw095
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发表时间：
2017-03
影响因子：
3.2
通讯作者：
Milner J
中科院分区：
文献类型：
--
作者：
Hampshire K;Porter G;Mariwah S;Munthali A;Robson E;Owusu SA;Abane A;Milner J
非洲最近的通信“革命”使人们乐观地认为，使用移动的手机促进健康（mhealth）有助于弥合医疗保健差距，特别是对农村、难以接触的人口。然而，虽然移动保健试点的规模仍然有限，但整个非洲大陆的卫生工作者都拥有移动的手机。本文根据对加纳和马拉维的采访，询问卫生工作者是否/如何非正式地使用手机以及会产生什么后果。卫生工作者使用个人移动的电话的目的很广泛：在紧急情况下获得帮助;与病人/同事沟通;促进社区护理、病人监测和药物依从性;获得临床咨询/信息和管理后勤。然而，这些费用由保健工作者自己承担，特别是由农村社区的较低级别的保健工作者承担，他们的津贴/工资往往很低，甚至需要他们付出很大的个人费用来“照顾”病人。虽然“非正式mhealth”在改善（农村）医疗保健方面有很大的潜力，但相关的道德和政治经济学将加强现有的社会经济和地理不平等。
Africa’s recent communications ‘revolution’ has generated optimism that using mobile phones for health (mhealth) can help bridge healthcare gaps, particularly for rural, hard-to-reach populations. However, while scale-up of mhealth pilots remains limited, health-workers across the continent possess mobile phones. This article draws on interviews from Ghana and Malawi to ask whether/how health-workers are using their phones informally and with what consequences. Health-workers were found to use personal mobile phones for a wide range of purposes: obtaining help in emergencies; communicating with patients/colleagues; facilitating community-based care, patient monitoring and medication adherence; obtaining clinical advice/information and managing logistics. However, the costs were being borne by the health-workers themselves, particularly by those at the lower echelons, in rural communities, often on minimal stipends/salaries, who are required to ‘care’ even at substantial personal cost. Although there is significant potential for ‘informal mhealth’ to improve (rural) healthcare, there is a risk that the associated moral and political economies of care will reinforce existing socioeconomic and geographic inequalities.
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影响因子：
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