Moving mountains with mobiles: Spatiotemporal perspectives on mHealth in Nepal

Abstract

Community healthcare workers (CHW) are an important component of rural healthcare service delivery to remote rural communities in developing countries. The field of mHealth proposes that mobile technologies will have a beneficial impact on rural healthcare development. Current analyses advance the proposition that the utilization of mobile technologies leads to the shifting of space and time (Ling & Campbell, 2009). The current research examined the potential for a sustainable mHealth system for CHW in Achham, Nepal. The community aspect of mobile usage was overlaid with a spatio-temporal lens to examine the information and communication needs and practices of stakeholders within the healthcare infrastructure. Fieldwork was conducted in conjunction with Nyaya Health, at the Bayalpata Hospital, in Accham, Nepal. Qualitative research methods, focus group discussions, and in-depth interviews included 57 respondents. The findings revealed that limited relevance and information-sharing, limited access due to individual ownership and low income, and ineffective training programs were key barriers to the delivery of rural healthcare services. The spatio-temporal perspective, particularly community communicative practices, revealed technological mHealth design solutions to alleviate the problems identified. The potential shifts in power relationships by using mobile technologies and hybrid fixed wireless technologies provide opportunities for further theoretical investigation.