Using mobile health to strengthen the communication skills for effective delivery of health information in Nepal: A qualitative study of the perspectives of Female Community Health Volunteers

Female Community Health Volunteers (FCHVs) play an important role in linking community members-particularly marginalised and vulnerable women and health facilities in Nepal. There has been increased use of mobile phones amongst FCHVs and their support to improve the quality of health services FCHVs provide, with positive results. Under the leadership of Ministry of Health and Population (MoHP), Department of Health Services (DoHS), and investment by the UK Department for International Development (DFID) via Nepal Health Sector Support Programme 3 (NHSSP 3), BBC Media Action designed and tested an innovative mobile phone-based solution that can best support FCHVs in their work as health promoters in local communities. This study aimed to examine the changes in the FCHVs-beneficiary interaction and communication since the introduction of a mobile-based intervention (Mobile Chautari). A qualitative study was conducted in three districts of Nepal: Tehrathum, Darchula and Rautahat using in-depth interviews, focus group discussions with FCHVs, pregnant women and mothers with children less than 5 years old, mothers-in-law, and health facility staff. In addition, observation of Health Mothers Group (HMG) meeting was also conducted. Data analysis was conducted using thematic analysis. The mHealth intervention was acceptable to the FCHVs and the use of Mobile Chautari helped FCHVs recognise the value of communication aids and facilitate effective discussions in HMG meeting. FCHVs felt more confident when talking about health issues and communicated more effectively with diverse beneficiaries. FCHVs felt that Mobile Chautari improved their status in the communities, which also helped enhance trust between FCHVs and communities. Mobile Chautari has the potential to strengthen the communication skills of FCHVs and bridge the gap between the FCHVs and their beneficiaries. Mobile Chautari appears to be a promising way to communicate health related information and communicate with diverse clients. In the short period the study has been able to show the potential of Mobile Chautari and how it could support positive behaviour change.