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Chapter 6 made approximately 163 minutes of voice calls every month. Additionally, as health workers become handier with their smartphone, their use of internet connectivity through their smartphone for other purposes such as internet browsing and Facebook will increase. Though this may help health workers to independently gain access to information and other resources on the internet, it will compromise the primary purpose of using electronic forms for patient assessment, and incur additional costs to the health system. Thus, it would be necessary to manage and restrict health workers’ airtime use. Covering such mobile top up expenses in a larger scale implementation of similar projects for a longer period may be difficult and unfeasible. Hence, implementers of such interface should solicit a mechanism to provide health workers free airtime for uploading forms or restrict the use of mobile top up only for the required purpose. Conclusion In this study, both HEWs and midwives found electronic forms on smartphones easy to use and helpful for day to day maternal health care services delivery. Allowing health workers to use a smartphone and its functions without restriction did not comprise actual use of the maternal health care forms. However, considering health workers’ high use of mobile top ups for voice calls, we recommend implementers of such an interface to solicit a mechanism of securing free airtime for health workers from telecommunication service providers, or putting restrictions on health workers’ mobile top up use in view of long term cost management. 110
Usability of an mHealth application by HEWs and midwives References 1. Singh P, Sachs JD: 1 million community health workers in sub‐Saharan Africa by 2015. Lancet 2013, 382(9889):363‐365. 2. Federal Ministry of Health of Ethiopia: Health Extension Program in Ethiopia Profile. Addis Ababa: Health Extension and Education center. Ministry of Health; 2007. 3. Federal Ministry of Health of Ethiopia: Health Sector Development Programme III. Addis Ababa: Annual performance report, Ministry of health; 2010. 4. Federal Ministry of Health of Ethiopia: Health Sector Development Program IV (2010/11‐2014/15). Addis Ababa: Federal Ministry of Health of Ethiopia Planning and program department; 2010. 5. Federal Ministry of Health (FMOH) of Ethiopia: Health and Health Related Indicators 2010/11. Addis Ababa: Ministry of Health; 2011. 6. Teklehaimanot HD, Teklehaimanot A: Human resource development for a community‐based health extension program: a case study from Ethiopia. Hum Resour Health 2013, 11(1):39. 7. Federal Ministry of Health (FMOH) of Ethiopia: Health and Health Related Indicators 2003/04. Addis Ababa: Ministry of Health; 2004. 8. Medhanyie A, Spigt M, Kifle Y, Schaay N, Sanders D, Blanco R, GeertJan D, Berhane Y: The role of health extension workers in improving utilization of maternal health services in rural areas in Ethiopia: a cross sectional study. BMC Health Serv Res 2012, 12:352. 9. Karim AM, Admassu K, Schellenberg J, Alemu H, Getachew N, Ameha A, Tadesse L, Betemariam W: Effect of ethiopia's health extension program on maternal and newborn health care practices in 101 rural districts: a dose‐response study. PLoS One 2013, 8(6):e65160. 10. Central Statistical Agency [Ethiopia], ORC Macro: Ethiopia Demographic and Health Survey 2005. Addis Ababa, Ethiopia and Calverton, Maryland, USA: Central Statistical Agency and ORC Macro; 2006. 11. Central Statistical Agency and ICF International Ethiopia Demographic and Health Survey 2011. Addis Ababa, Ethiopia and Calverton, MD, USA: Central Statistical Agency and ICF International;2012 12. Medhanyie A, Spigt M, Dinant G, Blanco R: Knowledge and performance of the Ethiopian health extension workers on antenatal and delivery care: a cross‐sectional study. Hum Resour Health 2012, 10(1):44. 13. Koblinsky M, Tain F, Gaym A, Karim A, Carnell M, Tesfaye S: Responding to the challenge‐The Ethiopian Health Extension Programme and back up support for maternal health care. EthiopJHealth Dev 2010, 24(Special Issue 1):105‐109. 14. Teklehaimanot A, Kitaw Y, G/yohannes A, Girma S, Seyoum A, Desta H, Ye‐Ebiyo Y: Study of working conditions of Health Extension Workers in Ethiopia. EthiopJHealth Dev 2007, 21(3):246‐259. 15. Sebastian MS, Lemma H: Efficiency of the health extension programme in Tigray, Ethiopia: a data envelopment analysis. BMC Int Health Hum Rights 2010, 10:16. 16. Earth Institute: Barriers and Gaps Affecting mHealth in Low and Middle Income Countries: A Policy White Paper. Washington, DC: mHealth Alliance; 2010. 17. Vital Wave Consulting: mHealth for development: the opportunity of mobile technology for healthcare in the developing world. UN Foundation‐Vodafone Foundation Partnership; 2009. 18. World Health Organization: mHealth: New horizons for health through mobile technologies, Global Observatory for eHealth series. vol. 3. Geneva: WHO; 2011. 19. Marshall c., Lewis D., Whittaker M.: mHealth technologies in developing countries: a feasibility assessment and a proposed framework. Working paper. The University of Queensland; 2013. 20. Vital Wave Consulting: mHealth in Ethiopia: Strategies for a New Framework. mHealth Ethiopia report. Vital Wave Consulting; 2011. 21. Kallander K, Tibenderana JK, Akpogheneta OJ, Strachan DL, Hill Z, ten Asbroek AH, Conteh L, Kirkwood BR, Meek SR: Mobile health (mHealth) approaches and lessons for increased performance and retention of community health workers in low‐ and middle‐income countries: a review. J Med Internet Res 2013, 15(1):e17. 22. Tamrat T, Kachnowski S: Special delivery: an analysis of mHealth in maternal and newborn health programs and their outcomes around the world. Matern Child Health J 2012, 16(5):1092‐1101. 111
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© Araya Abrha Medhanyie, Maastrich
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Promotor Prof. dr. G.J. Dinant Copr
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Abbreviations AIDS ANC AOR CBRHA CH
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Chapter 1 General introduction 9
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Introduction Maternal health and mo
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Introduction Map 1. Map of Ethiopia
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Introduction Map 2 The Tigray regio
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Introduction In 2010/2011, the Fede
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Introduction Cross‐sectional surv
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Introduction Outline of thesis In C
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Introduction References 1. Hogan MC
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Chapter 2 The role of health extens
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Role of HEWs in improving utilizati
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Chapter 3 Knowledge and performance
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Knowledge and performance of HEWs o
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Chapter 4 Meeting community health
Page 59 and 60: Health Workers Needs and Mobile Tec
Page 83 and 84: Chapter 5 Mobile health data collec
Page 85 and 86: Mobile health data collection Intro
Page 87 and 88: Mobile health data collection summa
Page 89 and 90: Mobile health data collection cente
Page 91 and 92: Mobile health data collection Discu
Page 93 and 94: Mobile health data collection that
Page 95: Mobile health data collection 21. M
Page 98 and 99: Chapter 6 Abstract Background Mobil
Page 100 and 101: Chapter 6 birth attendants increase
Page 102 and 103: Chapter 6 of mobile phone, motivati
Page 104 and 105: Chapter 6 Figure 6.1 Total number o
Page 106 and 107: Chapter 6 was also evident from the
Page 108 and 109: Chapter 6 Five (21.7%) of the healt
Page 112 and 113: Chapter 6 23. Mosa AS, Yoo I, Sheet
Page 114 and 115: Chapter 7 Abstract Background Mobil
Page 116 and 117: Chapter 7 settings [8,9,10]. The ve
Page 118 and 119: Chapter 7 Table 7.1 Selected variab
Page 120 and 121: Chapter 7 in electronic records wer
Page 122 and 123: Chapter 7 and forgetting decimal po
Page 124 and 125: Chapter 7 we compared two separate
Page 127 and 128: Chapter 8 General discussion 127
Page 129 and 130: General discussion General discussi
Page 131 and 132: General discussion birth attendant.
Page 133 and 134: General discussion treatment suppor
Page 135 and 136: General discussion would pose a dif
Page 137 and 138: General discussion Cost implication
Page 139 and 140: General discussion measure any sign
Page 141 and 142: General discussion References 1. Me
Page 143 and 144: Valorisation 143
Page 145 and 146: Valorisation Valorisation: Implicat
Page 147: Valorisation In this research we te
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Page 152 and 153: expansion of the primary health car
Page 154 and 155: analytics and maternal‐newborn pr
Page 156 and 157: poor knowledge and performance of t
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ክ ፍ ል ለ ማዳ ረ ስ ና
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ነ ው፡ ፡ በ መቀ ጠል
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ምዕ ራፍ ሦስ ት፤ የ ጤ
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የ ህ ሙማን መመር መሪ
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ምእ ራፍ ስ ምን ት፤ ይ
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170
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ተግባ ራዊ ይገ ብራ፡
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ኣብ ምምሕያሽ ግልጋሎ
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ም ዕ ራ ፍ ሰ ለ ስ ተ ፤
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ም ዕ ራ ፍ ሽ ዱ ሽ ተ ፤
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ም ዕ ራ ፍ ሸ ሞ ን ተ ፤
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182
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HEWs para priorizar los casos de al
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prenatal, parto y postnatal. Median
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La escalabilidad en la introducció
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190
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to express my heartfelt gratitude t
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Biography 195
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Biography Biography Araya Abrha Med
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