Using Technology to Advance Global Health Proceedings of a Workshop (2018) / Chapter Skim
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5 Push Versus Pull at the Community Level
5 Push Versus Pull at the Community Level
Pages 39-52
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From page 39... ...
• The massive adoption of mobile social media occurring in low- and middle-income countries can be leveraged success fully only if the issues of digital professionalism, the eco nomics of participation, and information quality are being addressed. (Pimmer)
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From page 40... ...
(Yelpaala) • The development of digital professionalism requires health care organizations to provide health workers and health pro fessionals with training and systematic guidance on how to use social mobile media tools in a responsible way and to assess the effect of their social media activities.
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From page 41... ...
A major difference between mobile instant messaging and social network sites is accessibility, where instant messaging apps are simple and, in the case of WhatsApp, enable the exchange of audio messages that make them particularly useful for people of lower literacy levels, while social networking applications are usually more complex and also require higher levels of digital literacy to use effectively. Pimmer noted that almost all of the projects he and his collaborators have implemented with nurses and health workers in Nigeria, South Africa, and Zambia use WhatsApp as the primary social media platform.
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From page 42... ...
The organizational function of mobile social media can help manage and coordinate what is often a distributed and remote workforce. Recently, said Pimmer, he studied how rural community health workers in Malawi used WhatsApp groups to organize campaigns, meetings, and drug distribution efforts involving workers in widely dispersed communities (Pimmer et al., 2017)
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From page 43... ...
VALUE PROPOSITION FOR PULLING DATA FROM THE COMMUNITY Adele Waugaman's role in the USAID Global Health Bureau has been to support the development of interoperable and scalable digital technologies to overcome some of the fragmentation and duplication of digital health systems that affect health care delivery in LMICs. As an example, she discussed the research she and colleague Larissa Fast conducted on how data and information flowed in West Africa during the 2014–2015 Ebola outbreak there and whether digital technologies made a difference in those flows (Fast and Waugaman, 2016)
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From page 44... ...
Another example of pushing data out of the community was the Ebola Community Action Platform (ECAP) , a project in which numerous nongovernmental organizations used digital data and information they collected on mobile phones about community knowledge, attitudes, and perceptions about Ebola.
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From page 45... ...
The program analyzed the rumors and provided corrected information to local broadcast journalists, who were able to host locally recognized and trusted experts to debunk rumors over the radio. These examples, said Waugaman, illustrate how digital technologies can help both pull data from and push data to communities and engage community members in public health initiatives.
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From page 46... ...
As an example of the latter, Fast showed a map comparing cell phone coverage for West Africa in 2014 and those regions suitable for zoonotic, or animalborne, disease outbreaks. The map revealed that there was a complete lack of cell phone coverage in some areas most suitable for zoonotic disease outbreaks.
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From page 47... ...
PUSH VERSUS PULL AT THE COMMUNITY LEVEL 47 Power, connectivity, physical infrastructure INFRASTRUCTURE USER Training, capacity, and workflows for ENVIRONMENT digital technologies Consideration of the cultural, physical, and psychological contexts Harmonized, standardized, WORKFORCE and systematic design for data capture G IN Data FEE E PROGRAMM transformed Quality data into information DATA collection at all levels PRODUCTION D BA C K LO O P S Data Use Cycle Enabling policies, Information INFORMATION processes across TIV consumption, Evidence USE sectors INVESTMENT analysis, and based INSTITUTIONAL action AP comprehension STRATEGY CAPACITY AD Harmonized donor Incentivized and skilled investments and decision making sustainable strategies Interoperable data, Strategies and use of standards, preparedness POLICY & protocols for and scalable platforms to support digital health REGULATORY digital health and and emergency response emergency response ‘INFOSTRUCTURE' & STANDARDS FIGURE 5-1 Graphic illustration of recommendations to improve the use of digital information to advance global health. SOURCES: As presented by Adele Waugaman on May 10, 2017.
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From page 48... ...
The final set of recommendations from their study was to coordinate investments in digital health, as well as in the development of common standards on both technical aspects and content to enable data to be shared and compared. BOTTOM-UP INNOVATION TO IMPROVE PATIENT ENGAGEMENT When Kaakpema Yelpaala, a public health practitioner who had worked in the Caribbean, East Africa, and Ghana, founded access.mobile in 2011, his goal was to address the challenge of sustaining impactful digital health solutions with a business model not reliant on funding cycles and trends of donors.
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From page 49... ...
In Yelpaala's opinion, the way for a small company such as his to engage in a public–private partnership is to first establish partnerships with bigger organizations to help overcome initial market challenges and credibility while remaining nimble to adapt and innovate to market needs until ready for scale. Among the challenges for developing and implementing digital health solutions in Africa, said Yelpaala, are the need to create the space for digital health, which is a new and evolving market in Africa, and the need to change the way people seek and use health care.
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From page 50... ...
To foster the bottom-up adoption, his approach has been to go into communities and learn about innovative practices that communities and health workers are developing and then help them to spread those innovations to other communities. However, he commented, given the risks and challenges associated with the current adoption patterns of mobile social media, health workers, health professionals, and health care organizations do require more systematic guidance on how to use social media tools in a responsible way aligned with ethical guidelines and to assess the effect of their social media activities.
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From page 51... ...
Yelpaala replied that solutions can come back into the Western context, but it will require the right partners to translate solution approaches from one market context to another. Fast agreed that context is crucial, and Pimmer added that the development of digital professionalism will have to be a part of any effort to make better use of community health workers regardless of the setting.
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