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Smartphones: Curse or blessing to patient care?

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CONCERNED—Bulayindi

Jennifer Tilindiyani, 36, lives at Lumbadzi in Traditional Authority (T/A) Mkukula’s area in Dowa District but travels over 13 Kilometres to access antenatal and postnatal healthcare services at M’bang’ombe Health Centre under T/A Chitukula in Lilongwe.

Tilindiyani alleged that nurses and midwives at Lumbadzi Health Centre are negligent whilst on duty, claiming that, instead of providing care to patients, they spend most of their time chatting and playing on their smartphones.

“It hurts to see a nurse or midwife using their cellphones for personal reasons such as texting their friends or chatting on social media when patients under their care are groaning and rolling on the floor with pain,” she said.

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Tilindiyani’s sentiments came out during an interface, which the Catholic Commission for Justice and Peace (CCJP) organised at Chitukula Traditional Court on Saturday.

The Organisation is implementing a six-month Covid-19 response and recovery project, with funding from UN Women through the Episcopal Conference of Malawi (ECM) in collaboration with the dioceses of Blantyre, Lilongwe and Mzuzu.

Currently, it is being implemented in Blantyre, Mulanje, Mwanza, Lilongwe and Mzimba.

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Community leaders at Chitukula also alleged that delivery of healthcare services have collapsed at Lumbadzi Health Centre because nurses and midwives spend most of their times surfing social media such as WhatsApp or Facebook.

In November 2020, community leaders from T/A Mkukula in Dowa also raised similar concerns and had gone as far as pleading with member of Parliament (MP) for Dowa South East Constituency, Halima Daud, to intervene.

A 2017 report by the World Bank estimated that the mobile phone infrastructure is the most advanced infrastructural development in Africa, far surpassing roads and water, with many rural households having access to mobile phone services, but not piped water.

Thus, it is evident that digital technologies such as mobile phones could be handy in providing solutions for improving access to healthcare information and services in low- and middle-income countries such as Malawi.

But while technology has potentially improved patient care and safety, it is not without risks. Technology has been accounted for bringing a solution and added problems for safer health care.

Problems may arise based on the sheer number of new devices, the complexity and careless introduction in using them.

ECRI Institute – an independent body that conducts medical device evaluations, with labs located in North America and Asia Pacific, found that failure to adequately safeguard patient data stored on the phone or to prevent unauthorized access to the healthcare facility’s systems could lead to security breaches or violation of patients’ rights.

“Caregivers may also become distracted by incoming personal messages or by the temptation to surf the web or conduct other personal business during patient care activities. And they may be unaware that their smartphones carry pathogens that can be transmitted to patients if proper cleaning and handwashing protocols are not followed,” it says.

One of the community leaders in Chitukula, Annie Bulayindi, said it was unfair and unethical for nurses and midwives to abandon patients under their care to attend to non-work-related chats.

Bulayindi, however, disclosed that through various forums, they learned modern smartphones are embedded with apps that provide health care workers with access to information about diseases and treatments, as well as information about their patients’ drugs and laboratory tests.

“But is it right for the nurse assigned to your care to use their phones to text or scroll through social media? Then what is the essence of seeking antenatal and neonatal care services at a facility whose doctors do not have time for you?” she charged.

Facitliy in-charge at Lumbadzi Health Centre Maureen Magombo-Kadzanja said she was not aware about the use of smartphones for non-work-related purposes by the staff at the facility.

However, Magombo- Kadzanja pointed out that the facility will investigate the matter and that disciplinary action will be taken against the members found guilty of the misconduct.

CCJP (Lilongwe) Head of Programmes, Patrick Chima, said the major objective of the project is to seek a commitment from authorities to prioritise access to Sexual and Reproductive Health Rights (SRHR) services and ensure populations’ ability to seek care amidst restricted mobility.

Chima disclosed that the project is looking at three dimensions: Gender Based Violence (GBV), SRHR and list of mechanisms in the community itself.

“This intervention came about because of Covid-19 whereby it was discovered that women were not accessing health services due to fear of contracting the disease. During the implementation of the project, it has come out clear that women are complaining about the treatment they receive from their nurses and midwives and it is the wish of the Commission that they be addressed as a matter of urgency,” he said.

Another 2017 study by Beratarrechea et al confirmed that mobile phones have the potential to improve access to healthcare information and services in low-resourced settings.

The study investigated the use of mobile phones among patients with chronic diseases, pregnant women, and health workers to enhance primary healthcare in rural South Africa.

It found that the use of mobile health for long-term conditions in sub-Saharan Africa can address the lack of capacity at the point at which people access healthcare as staff can use them to communicate with one another, to access clinical guidance materials and tools, and to facilitate patient care.

Patients and visitors, meanwhile, can use them to keep in touch with loved ones and to continue to participate in their normal lives.

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