As digital health interventions are adopted at scale, it is important to monitor the impact of these programs on health care accessibility and understand communities’ readiness to adopt new digital interventions. WEE-Connect-funded study, Empowering Women through Digital Connectivity: Advancing Community Health in Kenya, is studying an interactive text messaging intervention known as CHV-NEO, which enables two-way communication between pregnant women and their community health workers in Western Kenya. CHV-NEO is integrated into Kenya’s electronic community health information system (eCHIS) which is used by community health workers throughout the country to manage their service provision. The team is exploring digital access by community health workers and perinatal women to shed light on which groups are best served vs. left behind by digital health interventions. The study’s preliminary data on the nature of technology access and control shed light on women’s digital empowerment and connectivity.
Most women are able and willing to receive health information on their mobile devices: among 2238 perinatal women in the study, 84% of women have their own phone, 99% make decisions about their own phone use, and 68-93% are willing to receive health information on their personal phone, depending on the content of messages. Internet access is also high: 81% have ever used the internet, of whom 69% used it in the last 24 hours. Phone type is evenly split between feature phones and brick phones, and only 8% of women have a smartphone. While only 12% of women have a bank account, 99% have used ePay (M-Pesa) to send and receive funds.
Similarly, community health workers are poised to adopt digital tools, with all 322 community health workers in the study having been issued smartphones by the Ministry of Health and most health workers reporting high digital autonomy and experience with various digital tools, as well as overall positive attitudes towards artificial intelligence (AI). Over 99% of health workers make decisions about their own phone use, 98% have used the internet (85% in the last 24 hours), over 99% have used ePay, and 75% can access their bank account by phone. Preliminary data on attitudes towards AI suggest that approximately half know what AI means and 43% have ever used an AI tool. Over 75% of respondents believe that AI can be beneficial, for example, in creating jobs and improving the quality of life. However, approximately half of community health workers believe that AI is used to secretly watch or monitor people and may affect them negatively. Additionally, 25% are concerned that AI is dangerous, untrustworthy, being used in a wrong or harmful way, or making mistakes. Overall, these findings suggest an emerging awareness of and interaction with AI, mostly positive attitudes toward its capabilities, but also some concerns about risks. In the era of rapid AI growth, these insights are valuable in understanding the level of AI preparedness among the community health workforce in Kenya.
The study’s preliminary findings suggest that women and community health workers largely have the ability to implement and utilize text message-based health interventions. However, the data also suggest limited access to smartphone-based programs and highlight the need to more deeply understand appropriate and trustworthy use cases for AI.
This blog is funded by the WEE-Connect initiative in support of the study “Empowering Women through Digital Connectivity: Advancing Community Health in Kenya”
Authors:
Dr. Ronen is Assistant Professor of Global Health at the University of Washington
Dr. Unger is Associate Professor of Obstetrics and Gynecology at Women and Infants Hospital and Brown University
Dr. Kinuthia is Director of Training, Research and Innovation at Kenyatta National Hospital
Photo Credit: Paul J. Brown Photography
