Understanding the usability of digital app by lady health worker program for delivering maternal child care in two district of Pakistan- An exploratory case study

Date of Award

2019

Document Type

Thesis

Degree Name

Master of Science in Health Policy & Management (MSc Health Policy & Mgmt)

First Supervisor/Advisor

Dr. Shehla Zaidi

Second Supervisor/Advisor

Ms. Anam Feroz

Third Supervisor/Advisor

Dr. Maryam Huda

Department

Community Health Sciences

Abstract

Abstract: Understanding the usability of digital Apps by Lady Health workers for delivering Maternal and Child Health Care in the two District of Pakistan.
Background: Mobile health(M-Health) is an extension of electronic-health in which health services are reinforced and monitored through mobile Phones' Mobile health integrates into the existing health systems and provides a holistic approach to services. The mobile technology improves health as it enhances patients' access to health services, real-time monitoring' better training and service delivery and addressing the human resources issues. The mHealth also provides facilitation to the health care providers in. establishing better communication with patients, performance monitoring and in strengthening referrals, reduce administrative burden and cost, reduce leakages and bring transparency in information, better resource allocation etc. The Family planning and primary Hearth care (FP&PHC) has introduced a mobile health application known as "Hayat application" for improving timeliness and supervision of LHWs with the help of The Aga Khan Development Network Digital Health Resource Center (AKDN dHRC). Therefore, there is a need to understand the interface between the users, LHWs and Teeko app for delivering primary health care in two districts Chitral and Gilgit. User friendly mobile app has a potential to enhance competence and self-confidence of community health workers for delivering maternal and childcare services. However, in regards to the interface' obstacles such as lack of knowledge of technology, networking and technical errors, between the app and users have been 9 revealed.
Objective: This study aims to understand the experiences with Digital app used by Lady Health Workers for delivering maternal and child care in two districts Chitral and Gilgit of Pakistan.
Methods: This study was a qualitative exploratory case study. All together four focus groups were conducted in the two districts (Chitral and Gilgit Northern region of Pakistan). Forty eight LHWs were enrolled to participate in the FGDs by using purposive sampling. Topic guidelines were used for conducting interviews. Translated English transcriptions were analyzed by using Nvivo 11.4 QSR.
Results: The result of this study has three main domains as defined by conceptual framework which includes; Operability, Usefulness and integration outcomes in the MlS. In operability the LHWs were experienced digital app user-friendly, easily operatable and beneficial for their routine work. The Digital apps perceived as useful by added value in providing services, improves clients' compliance with immunization, improve understanding of community through video features and also improve the competency of the LHWs and app-based monitoring was also accepted among them. The LHW perceived that real-time online data and monitoring provided a better understanding of their performance and their hard work in providing primary health care. Upon integration in the LHWs services, it value add to the program by improving quality and accessibility of data, communication and satisfaction. However. there is need to resolve technical issues and user reservation for enhancing acceptance and satisfaction of the Mobile application used by Community workers.
Conclusion: This study concludes that the usable features of the digital app used by the LHWs were User friendly, easily opera table and error preventive. The users accepted and were satisfied with the implementation of Digital app for providing maternal and childcare however wages and technical errors and lack of awareness of patients' information in the medical record was the major obstacle to achieve use of the app. The study did not look into translation of digital technology into effective supervision, which could be a future area of research.

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