Two of the three presentations today highlighted the importance of Community Health Workers (CHWs) in health care delivery in the developing world. For me, this is one of the most interesting areas of ICT or eHealth – when communication tools and information management systems can essentially multiply the efficiency and/or effectiveness of non-clinical health care and public health support services.

Brian’s experience with the different CHW models is a key one to focus on. So much of what he found in terms of how useful the mobile tools were had to do with the structure and functional roles of the CHW network in each of the 3 organizations. Where the organization was committed to CHWs serving their clinets/patients in a support capacity, the data entry tools reduced the time they required to collect/record information and increased the time those CHWs could spend providing more/higher quality interactions with the people they were there to help. Where the organization was more interested in data collection and surveillance, the CHW’s were perhaps more efficient at that task, although that didn’t necessarily translate into more or better services being provided for the patients/clients. This seems much more an issue of the underlying organizational culture and context for the CHW work than an issue with the mobile health ICT project/tool itself. I appreciate that Brian made that clear, albeit very respectfully!

In the Boda’s for Life project I loved that there was really no rocket science involved in leveraging an existing network and service (taxi motos) and pairing that with a communication and alert system. In this case, as in the CommCare project, mHealth implementation offers a whole range of potential opportunities for increasing the skills that CHWs already have and, by design, the services that they can provide. Likewise the fact that this model was designed form the beginning to be a sustainable social enterprise model is really important. This is so often missing form the donor-supported “dependency” models that have been at work for so long. One of the most exciting elements of this project was the focus on regional scalability of the pilot as the next step. Way to go beyond pilots!

Finally, to see these projects’ themselves motivating more interest in capacity building and training among CHWs is great. CHWs and non-physician services are enormously important in increasing access to health care services and the fact that ICT and eHealth tools are largely being targeted at this part of the picture is exciting.