Could future Community Health Workers use drones to bring needed supplies to the point of care? What about Bitcoin vouchers to incentivize behavior or subsidize care? Or digital health records to track all of their community members’ health over time?
At the recent Nairobi Technology Salon exploring “How are Community Health Workers using ICT?“, we started with an expected focus on the humble mobile phone as the technology tool of choice for community health workers, mainly due to the ubiquity of mobile devices. We also touched on using radio, data, and call centers to support CHW activities. Yet time and again, we circled back to two central themes.
What do community health workers need?
We agreed that technology decisions should not be pushed down the development process, from donor to implementer, to health system, to CHW. Rather there should be an active engagement with all frontline health workers, including CHWs, as to their needs in preparing for their assigned (and unassigned) role, continuous improvement in their work processes, and monitoring and evaluation of both their patient care and the overall health outcomes sought by their respective health systems.
Community Health Workers are in the best position to understand their own needs and define the goals and scope of technology interventions.
How can we learn from the private sector?
Where donor-driven development can often be top-down, and bad ideas can linger on, while good ones end, never to be seen again, the private sector often is much more dynamic. Driven by customer demand and objective data, ideas that thrive are invested in and scaled quickly, while ideas that do not are discarded just as fast. There is no stigma for failing, only for not trying hard enough to see what works and not constantly tweaking products to increase customer satisfaction.
Health systems could learn from this by focusing on fewer, more important data collection activities that drive fast intervention prototyping and quick scale or discard decisions, where failure is rightly seen as a norm.
While there are many services that should be government supported, we still have a lot to learn by our friends who live by quarterly profit and loss statements.
So back to the drones…
It is understandably fun to dream of what technology community health workers might use in the future, from emergency drone response, to Bitcoins earned by or paid for health activity, all tied to lifelong, portable medical records, the reality is that we do not really know what technology Community Health Workers need.
Well, not without a participatory design process, where CHWs and their stakeholders are the prime participants, and a data-driven decision process to decide which resulting technology innovation is actually successful, and then long-term and flexible funding to see it to scale.