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Who bears the cost of ‘informal mhealth’? Health-workers’ mobile phone practices and associated political-moral economies of care in Ghana and Malawi

Hampshire, K.; Porter, G.; Mariwah, S.; Munthali, A.; Robson, E.; Owusu, S.A.; Abane, A.; Milner, J.

Who bears the cost of ‘informal mhealth’? Health-workers’ mobile phone practices and associated political-moral economies of care in Ghana and Malawi Thumbnail


Authors

G. Porter

S. Mariwah

A. Munthali

E. Robson

S.A. Owusu

A. Abane

J. Milner



Abstract

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.

Citation

Hampshire, K., Porter, G., Mariwah, S., Munthali, A., Robson, E., Owusu, S., …Milner, J. (2017). Who bears the cost of ‘informal mhealth’? Health-workers’ mobile phone practices and associated political-moral economies of care in Ghana and Malawi. Health Policy and Planning, 32(1), 34-42. https://doi.org/10.1093/heapol/czw095

Journal Article Type Article
Acceptance Date Jun 17, 2016
Online Publication Date Jul 31, 2016
Publication Date Feb 1, 2017
Deposit Date Jun 22, 2016
Publicly Available Date Mar 28, 2024
Journal Health Policy and Planning
Print ISSN 0268-1080
Electronic ISSN 1460-2237
Publisher Oxford University Press
Peer Reviewed Peer Reviewed
Volume 32
Issue 1
Pages 34-42
DOI https://doi.org/10.1093/heapol/czw095

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Copyright Statement
The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.







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