Contextual challenges experienced by CHVs in the informal use of mobile phones within integrated community case management (ICCM) in Nyaguda sub-location, Western Kenya

Abstract

Since the 1990s, Kenya has made substantial progress towards reducing child mortality. However, Kenya still lags behind regional and global averages in child mortality rates. Developing countries like Kenya face constraints in health system performance and access to services, especially in hard-to-reach areas such as Nyaguda sub-location calling for integrated care. Yet, it faces challenges that the everyday use of mobile phones could potentially address. In Nyaguda sub-location, mobile phones were used informally since they were not part of the integrated Community Case Management feasibility study. Several contextual challenges existed despite the benefits of using mobile phones within iCCM. This paper explores the contextual challenges to the informal use of mobile phones within iCCM in Nyaguda sub-location. The study employed an ethnographic research design. The data collection methods included informal conversations, Focus group discussions (FGDs) and in-depth interviews. This paper found several challenges to the informal use of mobile phones within iCCM, including physical challenges, high expectations on the Community Health Volunteers, cultural obligations, trust issues, and work/family conflict. The article concludes that physical follow-ups providing deeper connections among the various health stakeholders are still vital despite using mobile phones to avert child morbidity and mortality in hard-to-reach areas.