mHEALTH-INNOVATE (4) April 4th WHO webinar “Building the workforce better" (2) How do health workers use mobile phones to communicate with colleagues?

9 April, 2022

Dear Richard and all,

Thank you for your reflections on the WHO webinar. You noted an especially interesting point: 'If primary care staff have inadequate skills, citizens bypass primary care staff to utilize secondary and tertiary care first.'

Indeed many hospitals I have visited in LMICs have problems with too many patients and excessive workload, which inevitably reduces quality and places an intolerable burden on health workers. As you noted from the webinar, a key factor is that some patients bypass the primary care system and seek care directly at the hospital. Can you or others say any more about the contributing factors? In addition to perceived skills of primary health workers, factors might include lack of resources (medicines, equipment...) or lack of health workers at primary care level, as well as weak referral systems associated with communication challenges. Even in a high-income country like the UK, the health system (NHS) would soon collapse if all patients went directly to secondary and tertiary care.

What can be done to support primary care services so that they work synergistically with secondary and tertiary care?

In the context of our current discussion on the informal use of mobile phones by health workers, it would also be interesting to hear how mobile phones are used to communicate between different levels of the health system, and particularly how are mobile phones used (formally or informallY) to refer patients and to get clinical advice?

Best wishes, Neil

Neil Pakenham-Walsh, Global Coordinator HIFA,