mPowering Frontline Health Workers?

It's estimated that more than a billion people will never see a health worker in their entire lives. In developing countries, most of those who do will head directly to frontline health workers - women (in the main) with limited confidence, education, recognition or guidance. Given the exceptional importance of these workers in communities across the world, why are so many still profoundly under-trained?

It's not for want of attention. Western governments, donors, philanthropists and others are currently investing billions in finding solutions to the world's most pressing health needs. Pressure to enhance the knowledge and skills of the massive frontline health workforce is on and the money pouring into this effort continues to increase.

Enter mobile health, or 'mHealth', a relative newcomer in the development field. Over the last five years mobile technologies delivering multi-media health information have been hailed as the solutions that will reach parts of the world other trainings can't reach. Yet the rhetoric of what's possible with smarter, faster and more sophisticated Apps frequently fails to match the reality on the ground: frontline health workers overwhelmed by impossible workloads in demanding contexts and where the only access to a phone is to a basic one.

Are our Google Glasses blinkering us to what's actually needed by that community health worker in that hard-to-reach area in that developing region? Can we really rely on mobile technology to meet the profound training needs of a million frontline health workers?

I believe that we can. Mobile technology has the power to transform the way huge numbers of frontline health workers, and therefore women, are trained, motivated and retained. For women who can't afford or don't have the time to leave their posts and families to participate on training courses, mobile offers unprecedented opportunities to listen, learn and teach, using creative and multimedia health content that goes beyond a simple text message. And when women are connected in this way, they are empowered.

There are compelling examples of how these frontline health workers, using mobile technology, impact on the health of individuals in their communities: providing targeted, timely health messages to a pregnant woman delivered through audio or video; influencing health behaviours such as hand washing or exclusive breastfeeding, and using diagnostic toolkits to correctly identifying danger signs in young children, thus preventing unnecessary deaths.

But there's a 'but.' The current mHealth landscape is characterized by disconnected, fragmented efforts; where projects may be declared a success simply because they got off the ground. How can we move to large-scale efforts that become part of the fabric of health systems and the professional lives of frontline health workers?

Starting small is no bad thing. But sustainable scale-up needs collaboration. Genuine collaboration. That means working with governments, technology companies, mobile network operators - and frontline health workers. This takes time: time to ask a lot of people a lot of questions and listen deeply to their answers, so that mHealth interventions truly respond to what frontline health workers really need.

It's also time to take the spotlight off innovation. While it is important, the dazzle of the cutting edge relegates to the shadows the value of building on and adapting what works in addressing frontline health worker needs.

Let's return to the frontline health worker. Too often, solutions focus on the technology and not the simple fact that at the core of training and health service delivery is human connection. The most exciting, innovative and creative mobile technology cannot on its own strengthen the capacity of training institutions, create appropriate trainers or provide supportive mentorship and supervision for a frontline health worker.

Collaboration is and will continue to be vital to unlocking the health challenges facing our world today and technological innovation needs to serve frontline health workers, not the other way round. If we combine the capacity of mobile with deep understanding of the real needs of frontline health workers and the systems within which they work, a powerful force for change can be created.