ABSTRACT
Background
Limited literature exists in India on WhatsApp use for health communication among frontline health workers like Auxiliary Nurse Midwives (ANM). We conducted this study to assess the adoption of WhatsApp among ANMs and identify factors influencing its adoption. In addition, the study explored the perceptions of ANMs on WhatsApp use for sharing health information.
Methods
We employed a mixed-method sequential explanatory design. We surveyed 259 ANMs, followed by in-depth interviews with 19 purposively sampled ANMs. We conducted multinomial logistic regression to identify factors associated with WhatsApp adoption and employed thematic analysis to analyze interviews.
Results
257 ANMs responded to the survey questionnaire, of which 18.3%, 48.2%, and 33.5% had low, mid, and high levels of WhatsApp adoption, respectively. Education (AOR = 2.87 [95% CI = 1.20–6.85]), motivation (AOR = 6.31 [95% CI = 1.43–27.80]), and technical awareness (AOR = 2.91 [95% CI = 1.11–7.62]) were significantly associated with WhatsApp adoption. Thematic analysis of the interviews resulted in six themes describing perceptions and experiences of ANMs on WhatsApp use. They are: (i) a way of instant communication, (ii) provision for multimedia messaging, (iii) a quick fix tool for queries and concerns, (iv) make attendance and reporting easy (v) a way of reaching higher officials, and (vi) a cost-saving mechanism.
Conclusion
WhatsApp facilitated ANMs’ communication and service delivery at the grassroots level. Measures to improve motivation, technical awareness, and digital education will likely improve WhatsApp adoption among health workers.
Additional information
Notes on contributors
Devaganesh Kadhuluri
Devaganesh Kadhuluri is an MPH candidate at the Department of Public Health and Community Medicine, Central University of Kerala. He is involved in conception, development of the study, data collection, analysis, and manuscript preparation of the article.
Sibasis Hense
Sibasis Hense is an Assistant Professor at the Department of Public Health and Community Medicine, Central University of Kerala. He is involved in development of the study, data analysis, and revision of the manuscript.
Prakash Babu Kodali
Prakash Babu Kodali is an Assistant Professor at the Department of Public Health and Community Medicine, Central University of Kerala. He supervised the development of the study, data analysis, development of initial draft and revision of the manuscript.
Kavumpurathu Raman Thankappan
Kavumpurathu Raman Thankappan is Professor at the Department of Public Health and Community Medicine, Central University of Kerala. He provided necessary technical inputs, manuscript revision and approval of final submission documents.