There is a drastic shortage and skills gap of community health workers (CHWs; also known as community health volunteers) in Africa – a gap that is particularly critical in rural and remote areas.
Evidence shows that CHWs can improve health outcomes for large populations in under-served regions, and full utilization of CHWs could save 3.6 million children’s lives each year.1
Increasing global recognition of the importance of CHWs has led the Kenyan Ministry of Health (MoH) to develop a standardized Community Health Volunteers Basic Curriculum to make training more effective and consistent. With this new curriculum now comes the need for a more sustainable, scalable and efficient approach to CHW capacity building.
The penetration of mobile phones across Africa offers a unique opportunity to support CHWs with the knowledge and skills needed to realize lasting health change, as 97 percent of CHWs have mobile phones.
Recognizing this opportunity, Accenture, Amref Health Africa, Mezzanine, Safaricom and the M-Pesa Foundation have joined forces to develop the Health Enablement and Learning Platform (HELP), a unique mobile solution that delivers structured learning, enablement and support content and tools to CHWs using basic phones. HELP facilitates a supplementary training approach to reduce face-to-face training requirements and improve the learning experience – providing CHWs with much needed ongoing support and guidance needed to perform daily tasks. The platform has been successfully piloted in Kenya.
Last month, Accenture and Amref Health Africa led a Solutions Center webinar to walk through the platform and share their intentions for expanding and exploring partnerships with other NGOs and implementers in the years ahead.
What is HELP, and how does it work?
HELP follows a sophisticated learning scheduling system that facilitates the delivery of curriculum topics and learning activities around a structured mPedagogy. Right now, the platform hosts 30 mLearning topics aligned with the MoH CHW strategy and curriculum used to train CHWs in Kenya.
High-level platform capabilities include a content search that allows users to access any mTopic on demand; a group chat feature that promotes collaboration and knowledge-share around health issues between CHWs and community health extension workers (CHEWs), similar to WhatsApp; and productivity enhancement tools like health decision trees that support the real-time diagnosis of prevalent diseases, in addition to gamification tactics to motivate learning.
“The group chat feature is very popular among CHWs, who are now able to feel connected with their peers. This is something that never used to happen,” said Jackline Kiarie, Amref Health Africa HELP Project Manager. “It has been used in communities in a range of innovative ways, for example, to support community mobilization for vaccinations and in identifying and recalling defectives medicines.”
HELP also introduces a supervision and tracking component to improve health worker performance and strengthen workforce management. CHEWs can use mobile reports to monitor CHW progress, identify top performers and motivate learning. Each user is connected to the formal health system with a personal digital record of their training and career development.
HELP is designed to work using the most basic mobile communication channels such as SMS, IVR and USSD in order to reach the 67% of CHWs in Kenya who have basic phones. The solution delivers content in English and Swahili, and the HELP team is continuing to evolve the platform towards smarter devices and richer content.
Caroline Shakwei Mbindyo, Amref Health Africa eHealth Programme Manager, described HELP as a balancing act between mPedagogy, content and technology, founded on six characteristics of good and effective learning (contextual, active, cumulative, collaborative, self-regulated, and goal-oriented).
“We believe we can strengthen the health system broadly by focusing on building the capacity of the community health workforce from the ground up,” said Mbindyo. “We are already seeing CHWs using the platform not just for learning, but for supporting their practice in ways we had not yet imagined.”
In May 2014, the HELP partnership wrapped up a 12-month pilot implementation in Kenya, where the platform was rolled out to 318 CHWs in urban, rural and nomadic regions over the Safaricom network. The pilot resulted in improvements in quiz scores, overall enjoyment in learning and increases in collaboration; 78 percent of CHWs completed all nine training topics with an average quiz score of 80 percent and an overall satisfaction rating of 4.7 out of 5. After four months, knowledge retention was 12 percent higher in the pilot groups.
Scaling through collaboration
The HELP partnership is now rolling out the platform to 3,000 CHWs, reaching 300,000 people, and is looking to partner with a coalition of other NGOs and implementers, private sector, Ministries of Health and donors and foundations to trial the technology in other contexts.
HELP’s capacity-building tools are complementary to other mHealth tools and can run alongside other solutions regardless of middleware or solution provider.
“We see a real interesting opportunity here to get this mHealth learning solution to scale through collaboration. An opportunity to work with others who have built solutions to integrate additional functionality and [an opportunity to] think about how we work alongside other e-solutions like supply chain management and data collection,” said Trip Allport, HELP Partnership Facilitator.
“Ultimately, we’re hopeful that this solution provides a tool that could really power the work that you’re doing on the ground in an affordable and sustainable way, such that we can all benefit,” he said.
Are you interested in leveraging HELP in your programs? The HELP team is available to work with any potential partner to design a program to ensure the platform is most impactful in your work. Contact Trip Allport at firstname.lastname@example.org.