7.2 million. That’s the global shortage of health professionals. The World Health Organization reports that 83 countries are below the basic threshold of 23 skilled professionals per 10,000 needed to care for the basic health of all people. The shortage in trained healthcare professionals is a gap that will take decades to fill.
One solution that can make a meaningful difference now is Community Health Workers (CHWs). They are community members who receive basic health care training and live and work in the communities they serve. India has a community-based workforce one million strong. Brazil has over 220,000 CHWs serving more than a million people. The African Union has endorsed a call for 1 million CHWs in Africa. It has been estimated that full utilization of CHW would significantly improve the health of children and could potentially save the lives of 3.6 million children every year.
Two major challenges to the full utilization of community health workers are training and workforce management. Grameen Foundation has developed digital technology that can meet both these challenges.
In India, we have partnered with the government to train one million frontline health workers to deliver improved maternal and infant care. In Ghana, we have used digital technology to improve the management and training of health care workers and nurses in remote villages.
As part of a nation-wide initiative to lower maternal and infant mortality, in early 2016 the Government of India, with Grameen Foundation and BBC Media Action launched a national program to better train its one million frontline health workers in maternal and infant care.
The initiative, known as Mobile Academy, uses a digital health program based on the MOTECH system to train community health workers to deliver information to families. They can take the course by dialing a short mobile number from any mobile handset. Mobile Academy is being used to train India’s one million community health workers, known as ASHAs (Accredited Social Health Activists). ASHAs are selected by the village they serve, and are central to India’s strategy to improve maternal and child health.
Our early work in mobile health included Mobile Midwife and Nurses Application, designed to help reduce infant mortality. In Ghana, roughly one in 13 children dies before age five, and risk is highest during the first month of life. Mobile Midwife and Nurses Application in Ghana provided information on safe motherhood to 24,000 pregnant women and used mobile phone technology to equip health workers to better serve those women.
This work was followed in 2014-15 by the CHN-on-the-Go (Community Health Nurse) app, piloted with Concern Worldwide, John Snow International and the Ghana Health Service. The app gives nurses working in remote areas point of care tools to strengthen the quality of diagnosis and care; professional development and workplace support through up-to-date medical reference and training guides, work planning tools, and wellness aids.
Where possible, CHNs work with Community volunteers to extend the continuum of care to hard-to-reach households. Community health volunteers are equipped with Grameen’s MobiHealth Volunteers App which, among other things, allows them to send medical alerts to a CHN when required.
As community nurse Stella Nuque told us, "My volunteer alerted me using the mobile app about a woman who had a home delivery but had the placenta in the womb for hours. I quickly followed up to the client, assessed the situation and we took the client to the district hospital. For me, that timely communication I received from the volunteer contributed to saving the life of the woman.”
While Grameen Foundation’s direct role in the program has ended, the Ghana Health Service has decided to do a nationwide scale-up of CHN-on-the-Go, and Community Health Volunteers continue to use MobiHealth Volunteers App.