mHEALTH-INNOVATE: exploring healthcare workers’ informal and innovative uses of mobile phone messaging in LMICs.

Summary

The aim of this project is to explore how innovative informal uses of mobile phone messaging apps by healthcare workers can be used to strengthen health systems and inform digital health interventions in low and lower middle-income countries (LLMICs). Digital technologies are seen as an important mechanism for enhancing workforce performance, supporting implementation, advancing universal health coverage and achieving other SDG3 targets. But while much research has focused on ‘top-down’ digital strategies initiated by researchers, governments and NGOs, far less research has explored healthcare workers’ own solutions. Healthcare workers in LLMICs increasingly use free and accessible mobile phone messaging applications (‘apps’) to overcome clinical and health systems challenges and deliver the services expected of them. We will generate new evidence about how healthcare workers use these technologies to create innovative solutions. Further, we will explore how these innovations can be formally integrated within health systems to enhance service delivery and ultimately reduce disease burden and promote equity. We will also examine the implications of these innovations for policy and governance. We will investigate these themes in Uganda—a low-income country where the Ministry of Health has a strategic plan for using ICT to transform health service delivery, and where there is widespread informal use of messaging apps to address health challenges. To secure user involvement when evaluating the transferability of evidence to other settings and the acceptability and feasibility of new solutions, we will convene deliberative dialogues built on the principles of co-design and co-production. Overall, we will promote an interdisciplinary implementation research agenda that cut across policy studies, health services research, medical anthropology and information and communications technology; and identify lessons for future development of digital interventions.