Management challenges in mHealth: failures of a mobile community health worker surveillance programme in rural Nepal
Abstract
Community health workers form the backbone of healthcare systems globally. The rapid expansion of mobile communications systems represents an opportunity to improve the productivity of community health workers in rural areas. Here, we describe a programme in rural Nepal that aimed to implement a mobile phone system for collecting health surveillance data, yet did not reach its fullest potential due to several programme management challenges during the implementation of the surveillance programme. Despite early successes with the mobile phone system itself, the programme ultimately failed due to leadership transitions, poor process design and a lack of consistent vision of how to operationalise the data. This field report provides important insights into the design, maintenance and pitfalls of similar community-based mobile health initiatives and technology innovation projects in general.
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For any mHealth intervention to be successful in a low-resourced setting, institutional buy-in, appropriate and actionable data collection techniques, and effective process management are essential.
“The researchers concluded that for any mHealth intervention to be successful in a low-resourced settings, institutional buy-in, appropriate and actionable data collection techniques, and effective process management are essential and should be taken in to consideration [31].”
From Using mobile phones to improve community health workers performance in low-and-middle-income countries (2020) · cites this paper as [31]
In rural Nepal, a mobile phone system implemented to collect health surveillance data did not reach its fullest potential due to management related challenges such as leadership transitions, poor process design, and a lack of consistent vision of how to operationalize the data.
“A mobile phones system was implemented in rural Nepal to collect health surveillance data; however, it did not reach its fullest potential due to several management related challenges such as, leadership transitions, poor process design and a lack of consistent vision of how to operationalize the data [31].”
From Using mobile phones to improve community health workers performance in low-and-middle-income countries (2020) · cites this paper as [31]
A pilot programme in rural Nepal reported that community health workers can collect health surveillance data accurately using mobile technology if they are trained adequately.
“A pilot programme in rural Nepal which tested the feasibility of using mobile phones for collecting health surveillance data reported that community health workers can collect health surveillance data accurately using mobile technology if they are trained adequately [31].”
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- Authors
- Meyers, D. J., Filkins, M., Harsha Bangura, A., Sharma, R., Baruwal, A., Pande, S., Halliday, S., Schwarz, D., Schwarz, R. K., & Maru, D. S. R.
- Affiliations
- Brown University (US)
- University of Massachusetts Chan Medical School (US)
- Contra Costa Regional Medical Center, Contra Costa Family Medicine Residency, Martinez, CA, USA
- Medic Mobile, Kathmandu, Nepal
- Possible, Bayalpata Hospital, Sanfebagar-10, Achham, Nepal
- United Nations Population Fund (US)
- University of Washington (US)
- Brigham and Women's Hospital (US)
- Corresponding author
- Maru, Duncan S R
- ORCID
- Venue
- BMJ Innovations
- Publisher
- BMJ
- Published
- 2017-01-17
- Volume
- 3
- Issue
- 1
- Pages
- 19-25
- ISSN
- 2055-642X (ISSN-L)
- 2055-8074
- OpenAlex
- W2575341316
- Cited by
- 24
- References
- 14
- Citations by year
- 2025: 1 · 2024: 7 · 2023: 4 · 2022: 3 · 2021: 2 · 2020: 3 · 2019: 4
- FWCI
- 3.56
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- BMJ Innovations (publishedVersion)
- Funders
- Thrasher Research Fund
- Grand Challenges Canada (0257-01)
- Topics
- Physical Sciences › Computer Science › Information Systems › ICT in Developing Communities
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Epidemiology › Data-Driven Disease Surveillance
- Keywords
- mobile health, community health workers, program management, leadership transition, process design, rural health, technology implementation, Nepal
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