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'The phone is my boss and my helper' - A gender analysis of an mHealth intervention with Health Extension Workers in Southern Ethiopia.

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Steege, Rosalind, Waldman, Linda, Datiko, Daniel G, Kea, Aschenaki Z, Taegtmeyer, Miriam ORCID: https://orcid.org/0000-0002-5377-2536 and Theobald, Sally ORCID: https://orcid.org/0000-0002-9053-211X (2018) ''The phone is my boss and my helper' - A gender analysis of an mHealth intervention with Health Extension Workers in Southern Ethiopia.'. Journal of Public Health, Vol 40, Issue suppl_2, ii16-ii31.

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Abstract

Background
There is considerable optimism in mHealth's potential to overcome health system deficiencies, yet gender inequalities can weaken attempts to scale-up mHealth initiatives. We report on the gendered experiences of an mHealth intervention, in Southern Ethiopia, realised by the all-female cadre of Health Extension Workers (HEWs).
Methodology
Following the introduction of the mHealth intervention, in-depth interviews (n = 19) and focus group discussions (n = 8) with HEWs, supervisors and community leaders were undertaken to understand whether technology acted as an empowering tool for HEWs. Data was analysed iteratively using thematic analysis informed by a socio-ecological model, then assessed against the World Health Organisation's gender responsive assessment scale.
Results
HEWs reported experiencing: improved status after the intervention; respect from community members and were smartphone gatekeepers in their households. HEWs working alone at health posts felt smartphones provided additional support. Conversely, smartphones introduced new power dynamics between HEWs, impacting the distribution of labour. There were also negative cost implications for the HEWs, which warrant further exploration.
Conclusion
MHealth has the potential to improve community health service delivery and the experiences of HEWs who deliver it. The introduction of this technology requires exploration to ensure that new gender and power relations transform, rather than disadvantage, women.
Keywords
communities, e-health, gender.

Item Type: Article
Subjects: W General Medicine. Health Professions > W 83 Telemedicine (General)
W General Medicine. Health Professions > W 26.5 Informatics. Health informatics
WA Public Health > WA 30 Socioeconomic factors in public health (General)
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
Faculty: Department: Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI): https://doi.org/10.1093/pubmed/fdy199
Depositing User: Stacy Murtagh
Date Deposited: 18 Dec 2018 13:04
Last Modified: 18 Dec 2018 13:04
URI: https://archive.lstmed.ac.uk/id/eprint/9848

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