CHWs (43) CHWs using WhatsApp

10 June, 2019

HIFA has previously successfully linked with community health workers interacting in local languages on WhatsApp in India and Uganda. We hope to replicate and extend this in the current discussion because it is vital we hear the voices of CHWs (if you are part of a CHW WhatsApp please let me know! ). Below is a new study that looks at the role of WhatsApp in blended learning, peer support, and mentoring.

'In Zimbabwe, primary counselors (PCs) are a cadre of health worker that has been established to support task shifting, providing HIV testing and counseling (HTS) to adult, adolescent, and pediatric patients. This cadre of health worker is secondary school educated, a minimum of 25 years of age, and, in general, has no formal medical education prior to being employed as PCs. These health workers are the target audience for a blended learning course in HTS for children and adolescents...'

Citation and abstract below. Full text here:

CITATION: Health worker text messaging for blended learning, peer support, and mentoring in pediatric and adolescent HIV/AIDS care: a case study in Zimbabwe.

V. BertmanEmail authorView ORCID ID profile, F. Petracca, B. Makunike-Chikwinya, A. Jonga, B. Dupwa, N. Jenami, A. Nartker, L. Wall, L. Reason, P. Kundhlande and A. Downer

Human Resources for Health 2019 17:41


Background: In sub-Saharan Africa, shortages of trained healthcare workers and limited resources necessitate innovative and cost-effective approaches for training, supervising, and mentoring. This qualitative case study describes participants’ and trainers’ perspectives and experiences with a text messaging component of a blended training course in HIV counseling and testing in Zimbabwe, using minimal resources in terms of staff time and equipment requirements. This component included a whole-group discussion forum as well as two-person partner discussions designed to promote reflection and analysis, teamwork, and active learning.

Case presentation: The Ministry of Health and Child Care (MoHCC) of Zimbabwe collaborated with the International Training and Education Center for Health (I-TECH) on adaptation of a 5-day in-service training in HIV Testing Services for Children and Adolescents. The new 7-week blended format included in-person sessions, tablet-based self-study, and discussions using the text messaging application, WhatsApp. Between August 2016 and January 2017, 11 cohorts (293 participants in total) were trained with this new curriculum, incorporating text messaging to support peer-to-peer and work-based education.

Data collected included training participants’ feedback, key informant interviews with the training team, and thematic analysis of WhatsApp messages from full-cohort discussions and a sampling of one-to-one partner discussions.

A total of 293 healthcare workers from 233 health facilities across all provinces in Zimbabwe completed the blended learning course. Participants strongly endorsed using WhatsApp groups as part of the training. In the whole-group discussions, the combined cohorts generated over 6300 text messages. Several categories of communication emerged in analysis of group discussions: (1) participants’ case experiences and questions; (2) feedback and recommendations for work issues raised; (3) inquiries, comments, and responses about course assignments and specific course content; (4) encouragement; and (5) technical challenges encountered using the blended learning methodology. Case discussions were complex, including patient history, symptoms, medications, and psychosocial issues—child abuse, adherence, and disclosure.

Conclusions: Using text messaging in a communication platform that is an ongoing part of healthcare workers’ daily lives can be an effective adjunct to in-service training, minimizing isolation and providing interactivity, supporting students’ ability to fully integrate content into new skill attainment.

COMMENT (NPW): The full text includes two WhatsApp exchanges among CHWs (I would be interested to hear reactions from HIFA members on the content):

Participant 1: A girl 16 came at my clinic …[her grandma] accuses her of having of sleeping with boys ...both parants died she went to her stepmother who came with her at the clinic .she was crying .they came to the counselling room.i gave her tissues and offered thm seats … she stopped crying .and said she want to be tested to prove her grandma wrong

we discussed about hiv .results outcome .she consented to be tested .i tested her and her result were negative …

Participant 2: You need to discuss about SRH [sexual and reproductive health] issues its important she is sexual active

Participant 3: How about window period,Social welfare Childline,SRH,widen system,dig for more information.Not bad.

Participant 1: Guys help me what is perinatal

Participant 2: Death of the infant soon after delivery with 72 hours in Maternity.

Participant 3: Perinatal is not death.its a period immediately before and after birth

Participant 3: Usually between 20-28 weeks of pregnancy to 4_6weeks after birth [...]

I have invited the authors to join us.

Best wishes, Neil

Coordinator, HIFA Project on Community Health Workers

Let's build a future where people are no longer dying for lack of healthcare information - Join HIFA:

HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - ), a global community with more than 19,000 members in 177 countries, interacting on six global forums in four languages. Twitter: @hifa_org FB: