abstract: 'Africa''s recent communications `revolution'' has generated optimism that

  using mobile phones for health (mhealth) can help bridge healthcare

  gaps, particularly for rural, hard-to-reach populations. However, while

  scale-up of mhealth pilots remains limited, health-workers across the

  continent possess mobile phones. This article draws on interviews from

  Ghana and Malawi to ask whether/how health-workers are using their

  phones informally and with what consequences. Healthworkers were found

  to use personal mobile phones for a wide range of purposes: obtaining

  help in emergencies; communicating with patients/colleagues;

  facilitating community-based care, patient monitoring and medication

  adherence; obtaining clinical advice/information and managing logistics.

  However, the costs were being borne by the health-workers themselves,

  particularly by those at the lower echelons, in rural communities, often

  on minimal stipends/salaries, who are required to `care'' even at

  substantial personal cost. Although there is significant potential for

  `informal mhealth'' to improve (rural) healthcare, there is a risk that

  the associated moral and political economies of care will reinforce

  existing socioeconomic and geographic inequalities.'
affiliation: 'Hampshire, K (Corresponding Author), Univ Durham, Dept Anthropol, Durham
  DH1 3LE, England.

  Hampshire, Kate; Porter, Gina, Univ Durham, Dept Anthropol, Durham DH1 3LE, England.

  Mariwah, Simon; Abane, Albert, Univ Cape Coast, Dept Geog \& Reg Planning, Cape
  Coast, Ghana.

  Munthali, Alister; Milner, James, Univ Malawi, Ctr Social Res, Zomba, Malawi.

  Robson, Elsbeth, Univ Hull, Dept Geog Environm \& Earth Sci, Kingston Upon Hull,
  N Humberside, England.

  Owusu, Samuel Asiedu, Univ Cape Coast, Dept Populat \& Hlth, Cape Coast, Ghana.'
author: Hampshire, Kate and Porter, Gina and Mariwah, Simon and Munthali, Alister
  and Robson, Elsbeth and Owusu, Samuel Asiedu and Abane, Albert and Milner, James
author-email: K.R.Hampshire@durham.ac.uk
author_list:
- family: Hampshire
  given: Kate
- family: Porter
  given: Gina
- family: Mariwah
  given: Simon
- family: Munthali
  given: Alister
- family: Robson
  given: Elsbeth
- family: Owusu
  given: Samuel Asiedu
- family: Abane
  given: Albert
- family: Milner
  given: James
da: '2023-09-28'
doi: 10.1093/heapol/czw095
eissn: 1460-2237
files: []
issn: 0268-1080
journal: HEALTH POLICY AND PLANNING
keywords: 'Care work; community health-workers; mobile phones; moral economy;

  political economy; Sub-Saharan Africa; task shifting'
keywords-plus: 'INCOME COUNTRIES; COMMUNITY; VOLUNTEER; SUPPORT; IMPLEMENTATION; AFRICA;

  SUSTAINABILITY; INTERVENTIONS; COMMUNICATION; PERCEPTIONS'
language: English
month: FEB
number: '1'
number-of-cited-references: '60'
orcid-numbers: 'Owusu, Samuel Asiedu/0000-0002-9249-6036

  Mariwah, Simon/0000-0003-0803-9746

  Hampshire, Kate/0000-0003-4184-849X'
pages: 34-42
papis_id: 91f0dc6a1ae713c05371c523b4763529
ref: Hampshire2017whobears
researcherid-numbers: 'Owusu, Samuel Asiedu/AIC-6915-2022

  Mariwah, Simon/Q-5636-2018

  Owusu, Samuel Asiedu/T-8212-2019

  '
times-cited: '41'
title: Who bears the cost of `informal mhealth'? Health-workers' mobile phone practices
  and associated political-moral economies of care in Ghana and Malawi
type: article
unique-id: WOS:000397104500004
usage-count-last-180-days: '1'
usage-count-since-2013: '8'
volume: '32'
web-of-science-categories: Health Care Sciences \& Services; Health Policy \& Services
year: '2017'