Visiting Rural Health Posts

I have spent the past 4 days visiting rural Health Posts with my colleague Araya. His phd is looking at the gaps of the Health Extension Workers (HEWs), specifically related to maternal health. Once the gaps are known, the next stage will be to design a programme to fill the hole in knowledge/skills, possibly using technology to help deliver the training.

Altogether he’ll interview 150 HEWs at over 100 Health Posts in 3 districts in Tigray. Over the 4 days I’ve been out with him, he managed to interview 18 HEWs at 14 health posts. Each day has been long – leaving Wukro around 7 am and not returning until after 7pm, so 12 hours to conduct about 5 interviews, each interview lasting about an hour or more.

I’ve been helping with the technology support and will be helping look at what could be appropriate to use in this context. Not all the concerns I mentioned in my earlier post have been realised.

The GPRS coverage has been far better than I’d expected, out of the 13 posts we visited, only one had no mobile or GPRS coverage. A couple had patchy coverage – but it was working for some of the time during our approx 2 hour visits. This is really positive from the point of view of the technology we might like to use in the future.

However, none of the posts had an electricity supply. A couple had electricity poles running very close to the building, but they weren’t connected up. In most cases there wasn’t any electricity supply to the village at all.

My phone battery got to be a real problem for me, despite having wireless and bluetooth turned off, I found that battery was only lasting for about 8-9 hours. I was using the GPS quite a lot, but even on the first couple of days when I was only briefly turning the GPS on (to get the coordinates for the posts), this only gave me a couple of extra hours battery life.

All except one of the HEWs we met had a mobile phone. The reason for the one exception was that she worked at the post with no mobile coverage, so she’d given her phone to a relative. Which for me than raised the question of how they charge the phones given there’s limited power supply. The answer to this was that they must travel to the town to charge their phones (this could be a 2-3 hour walk), or they send the phones with someone else going to town.

The HEWs have very limited English (although much better than my Tigrinya), so delivery of any training materials must be in either Amharic or Tigrinya to have any chance of being effective. One of Araya’s questions is about their use of text messaging, many don’t use text messaging simply because they don’t know the latin alphabet well enough.

What I’ve seen over the past few days is only a small proportion of all the posts that Araya will eventually be covering, but it’s likely that the further interviews will reinforce what we’ve already found out – rather than raising any new issues or significantly altering the results to date.

Over the coming months (after some more of the interview have been conducted), we’d like to get the results from the technology aspects written up into a paper.

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