Hope of India : an evaluation of information communication technologies in rural Indian healthcare.

Abstract

This research paper evaluates issues faced by rural community healthcare workers under India's National Rural Health Mission scheme, in particular Accredited Social Health Activists (ASHAs), primarily women whose main role is to aid pregnant women in childbirth. In November-December 2008, we conducted a series of in-depth interviews with ASHAs (13), other rural healthcare workers (14), patients (10) and doctors (18). Their usage of information and communication technologies (ICTs) within the healthcare system was investigated. The Value of ICTs model (Chib, Lwin, Santoso, Hsu & Ang, 2008) and Technology-Community-Management Vulnerabilities model (Chib & Komathi, in press) covered the four main benefits of using ICTs in healthcare: opportunity production, capabilities enhancement, social enabling and knowledge generator, as well as obstacles to the usage of ICTs that include economic, technological, socio-cultural and infrastructural barriers. Findings showed that the models were applicable in the Indian rural healthcare situation. The dominant form of ICT used was mobile phones, which allowed ASHAs to reach their fellow colleagues and doctors easily. During emergencies, they were able to call the ambulance service, which greatly increased their work efficiency and service quality. Organizational barriers turned out to be significant issues. These include the low ASHA job satisfaction, inadequate job training, and systemic inaccessibility, particularly to Public Health Centers (PHCs) in areas with difficult access. Recommendations are provided on improving the current healthcare situation via ICTs to bridge the gap between rural healthcare workers and higher authorities, and to improve the welfare of healthcare workers through better job training and stable benefits. ASHAs can play a significant role in the health of rural communities, particularly in providing maternal and infant healthcare, through programmatic measures administered in collaboration with the health authorities.