A17044 Community health workers for non-communicable disease interventions in the digital age

Objectives: In this study, we review the evidence and discuss how the digitalization affects the CHWs programs for tackling non-communicable diseases (NCDs) in low-and-middle income countries (LMICs).

Methods: We conducted a review of literature covering two databases: PubMED and Embase. A total of 97 articles were abstracted for full text review of which 21 are included in the analysis. Existing theories were used to construct a conceptual framework for understanding how digitalization affects the prospects of CHW programs for NCDs.

Results: We identified three benefits and three challenges of digitalization. Firstly, it will help improve the access and quality of services, notwithstanding its higher establishment and maintenance costs. Secondly, it will add efficiency in training and personnel management. Thirdly, it will leverage the use of data generated across grass-roots platforms to further research and evaluation. The challenges posed are related to funding, health literacy of CHWs, and systemic challenges related to motivating CHWs. More than 60 digital platforms were identified, including mobile based networking devices (used for behavioral change communication), Web-applications (used for contact tracking, reminder system, adherence tracing, data collection, and decision support), videoconference (used for decision support) and mobile applications (used for reminder system, supervision, patients’ management, hearing screening, and tele-consultation).

Conclusion: The digitalization efforts of CHW programs are afflicted by many challenges, yet the rapid technological penetration and acceptability coupled with the gradual fall in costs constitute encouraging signals for the LMICs. Both CHWs interventions and digital technologies are not inexpensive, but they may provide better value for the money.