It is a well-known fact that the health of a person depends on where he/she lives. Access to health care services for poor individuals living in disadvantaged communities is a global problem spanning both developing and developed nations. Be it the slums of Nairobi, the densely populated low income communities of East Los Angeles or the remote tribal villages of rural India, members of vulnerable population groups experience devastating public health problems such as maternal mortality, child health and mental health issues. Critical illness in a family is one of the key contributors to poverty in such communities for whom access to healthcare is plagued with physical and economic barriers.
Extensive grass roots outreach efforts by community health workers has proven to be an effective tool for improving health conditions in these vulnerable communities. Known as Promotoras in Mexico, Community Health Doctors in China and ASHAs (Accredited Social Health Activists) in India, these workers reach out to individuals in poor communities and provide critical health care services at extremely low cost (or free services). Hailing from the local community and being familiar with the language and other cultural aspects of the community, they serve as primary health care providers enabling the crucial link between the community and formal health systems. As front line workers, they have the enormous task of reaching out to medically underserved populations in urban and rural areas who, for the most part, have extremely low levels of literacy and find it difficult to navigate the structural barriers for accessing health services.
Community health and mobile technology
Community health workers are therefore an integral part of the continuum of care, especially for people living in disenfranchised communities across the globe because they act as the bridge between community members and medical authorities, doctors, nurses etc. Empowering these front line health workers with trainings on latest health care information is of paramount importance in order for them to educate the disadvantaged communities on health related practices and proactively prevent catastrophic health situations in the future. Supporting these grass roots workers globally with technological tools such as mobile or tablet enabled health information platforms and training them with digital technology has proven to have sufficient evidence of effective outreach to vulnerable populations. The digital tools enable workers to better sustain the knowledge acquired and apply them in identifying health problems early on in these poor communities. Technology is truly a game changer in the way disadvantaged communities can have access to much needed health services.
Example – mSakhi
An example of such a technological tool used by community health workers in India (i.e., ASHAs) is mSakhi. The Hindi word mSakhi translates to the meaning ‘mobile friend’. mSakhi is a multimedia communication tutorial application loaded on to a mobile phone that provides pragmatic health messages on crucial maternal and new born child health issues. Studies assessing the impact of mSakhi on ASHAs have indicated that this technological tool is useful for the frontline workers in several ways. Workers enjoyed the advantage of being able to articulate health related messages better, especially when counseling members of the disadvantaged communities on reproductive health, child health etc. The combination of visuals with images on a mobile phone (as opposed to books and flipcharts that are heavy to carry) enabled better interaction and engagement with the community residents. The community health workers found mSakhi to be effective in promoting disease prevention and educating the residents on healthy life style choices apart from connecting them to medical resources when needed.
Example – Swasthya Slate
Another example of a technological tool that aids community health workers in their outreach efforts is Swasthya Slate. The Hindi word Swasthya translates to the meaning ‘centered in one’s own self’ as reflecting an inward focus. Thus, Swasthya Slate refers to a medical examination of oneself to understand how healthy he or she is. It is a digital health care application that can be run on a mobile phone or a tablet to conduct 33 types of diagnostic tests including blood pressure, Malaria identification, blood sugar, etc. The application users can upload data regarding the patient’s diagnosis (based on the tests) and medical services are organized accordingly. Even the geographical details of service delivery is recorded in the form of GPS coordinates that lends itself for spatial analysis to have a better understanding of health service needs in the community and the impact of service outreach.
In both examples, the local language interface makes the technological application user friendly for the frontline health workers and for the community members themselves who, for the large part, have only a basic level of education. The application features also simplify analysis of community members’ health data in a way that minimally-trained health workers can easily understand.
Digital communication technology has tremendous potential to transform how community practice social workers can conduct outreach to enable members of disenfranchised communities across the globe to have better access to health and human services. Mobile technology applications such as mSakhi and Swasthya Slate can reshape the social worker and client relationship in any disadvantaged community across the globe enabling the social work profession to have a progressive identity.
Harnessing technology for social good is one of the grand challenges for social work practice in the 21st century. According to the NASW (National Association of Social Workers) and ASWB (Association of Social Work Boards) Standards for Technology and Social Work Practice (9-2), it behooves social work professionals to be aware of and proficient with technology that facilitates community well-being and to advocate for adoption of such innovative technology systems where needed. With the NASW code of ethics underscoring the integration of technology for professional practice, it is my hope that front line social workers incorporating sustainable digital technology as part of their practice with clients will become a global reality irrespective of whether they operate in rural or urban areas in India or pockets of low income communities in urban or rural USA.Gokul Mandayam is a husITa Board Member and an international social work research consultant.
Featured image credit | World Bank Photo Collection