Characterizing the Flow of Health Information in Rural Uganda: Is there a Role for Mobile Phones?

Abstract

Background: The United Nations’ post-2015 development agenda stresses need for a “data revolution.” In Uganda, capturing recent health data can be challenging. Capitalizing on the expansion of mobile phone access in developing countries, public health providers could use mobile phones in the health system as tools to aid data collection and improve health information reporting. To understand if mobile phones can play a role in connecting policymakers with health information, we sought to characterize the flow of health information between health workers and policymakers in rural Uganda and to evaluate if mobile phone technology can support the work of frontline workers. Methods: From May to July 2013, semi-structured interviews (n=20) were conducted with 9 health workers and 11 policymakers in two rural districts of Southwest Uganda. Qualitative thematic analysis of the transcripts identified the directionality and types of information transmitted; the perceived utility of mobile phones; and health system vulnerabilities. Results: Health information moved primarily in one direction: from health workers to policymakers. Health workers frequently discussed the use of anecdotal reports when making decisions. In contrast, policymakers referred to health information that was summarized, analyzed and compiled. While both groups had a positive perception of mobile phone utility in the health system, noted concerns included scalability and sustainability, in particular with respect to cost and maintenance. Human resource shortages were identified as one of the biggest barriers to adopting new technology and/or improving the health information system. Conclusions: Creating bi-directional channels of communication between health workers and policymakers in Uganda would improve communication and could help strengthen the health information system. Increasing health workers’ access to data summaries may reduce the reliance on anecdotal reports and improve decision-making. Despite a positive outlook on mobile phone utility, noted concerns should be considered and addressed before routinely integrating the mobile phones into the health system.