Isabella Rega

What do community health workers have to say about their work, and how can this inform improved programme design? A case study with CHWs within Kenya

Background Community health workers (CHWs) are used increasingly in the world to address shortages of health workers and the lack of a pervasive national health system. However, while their role is often described at a policy level, it is not clear how these ideals are instantiated in practice, how best to support this work, or how the work is interpreted by local actors. CHWs are often spoken about or spoken for, but there is little evidence of CHWs’ own characterisation of their practice, which raises questions for global health advocates regarding power and participation in CHW programmes. This paper addresses this issue. Design A case study approach was undertaken in a series of four steps. Firstly, groups of CHWs from two communities met and reported what their daily work consisted of. Secondly, individual CHWs were interviewed so that they could provide fuller, more detailed accounts of their work and experiences; in addition, community health extension workers and community health committee members were interviewed, to provide alternative perspectives. Thirdly, notes and observations were taken in community meetings and monthly meetings. The data were then analysed thematically, creating an account of how CHWs describe their own work, and the tensions and challenges that they face. Results The thematic analysis of the interview data explored the structure of CHWs work, in terms of the frequency and range of visits, activities undertaken during visits (monitoring, referral, etc.) and the wider context of their work (links to the community and health service, limited training, coordination and mutual support through action and discussion days, etc.), and provided an opportunity for CHWs to explain their motivations, concerns and how they understood their role. The importance of these findings as a contribution to the field is evidenced by the depth and detail of their descriptive power. One important aspect of this is that CHWs’ accounts of both successes and challenges involved material elements: leaky tins and dishracks evidenced successful health interventions, whilst bicycles, empty first aid kits and recruiting stretcher bearers evidenced the difficulties of resourcing and geography they are required to overcome. Conclusion The way that these CHWs described their work was as healthcare generalists, working to serve their community and to integrate it with the official health system. Their work involves referrals, monitoring, reporting and educational interactions. Whilst they face problems with resources and training, their accounts show that they respond to this in creative ways, working within established systems of community power and formal authority to achieve their goals, rather than falling into a ‘deficit’ position that requires remedial external intervention. Their work is widely appreciated, although some households do resist their interventions, and figures of authority sometimes question their manner and expertise. The material challenges that they face have both practical and community aspects, since coping with scarcity brings community members together. The implication of this is that programmes co-designed with CHWs will be easier to implement because of their relevance to their practices and experiences, whereas those that assume a deficit model or seek to use CHWs as an instrument to implement external priorities are likely to disrupt their work.

Investigating perception changes in teachers attending ICT curricula through self-efficacy

This paper introduces the construct of Self-Efficacy as a method to measure the impact that ICT-enhanced teacher training has on teachers. Firstly, Self-Efficacy and its related sub-constructs, Computer Self-Efficacy and Teacher Self-Efficacy, are presented. Secondly, three research settings where the construct have been tested are introduced: two related to BET K-12 (Brazilian Elearning Teacher training in K-12) project and one related to MELISSA (Measuring ELearning Impact in primary Schools in South African disadvantaged areas). Finally, results of the three experiments are presented and discussed.

Using Photo-Elicitation to Explore Social Representations of Community Multimedia Centers in Mozambique

Ten Mozambican Community Multimedia Centers (CMCs) were investigated by analyzing Social Representations of users and staff members. Photo‐elicitation, an underexplored methodological approach in the domain of Information and Communication Technologies for Development (ICT4D), was employed to conduct the study, and a three‐step qualitative content analysis was performed on both visual and textual data. Results tend to confirm and build upon outcomes from the existing literature on Public Access Venues (PAVs). Local communities value these centers because they bring social recognition to people working or learning there. The venues are associated with a symbolism that extends from the social recognition of the individual to the development and social inclusion of the whole community, which, because of the presence of the venue, does not feel left behind. In this vein, the study also shows that the importance of CMCs is often not related to the newest technology available, but to the technology that reaches the most of the community. The study also highlights neglected dimensions of CMCs, such as the importance of the exterior appearance of the venue, and the perception of a switch in their nature from static centers funded by third parties towards more entrepreneurial‐driven ones. The presented research also contributes to the ICT4D field by proposing a promising research protocol, which is able to elicit representations otherwise difficult to obtain.

eLearning and Teacher Training in a Disadvantaged Brazilian Area: a Project to Assess Access, Impact and Quality

This paper shows the importance of information and communication technologies in the field of education for developing countries. The opportunities they provide for teacher training in disadvantaged areas are outlined and some examples, specific of the Brazilian context, are reported to show the importance of three main issues access, impact and quality. The paper also outlines the BET-K12 project structure stressing how it embeds the above mentioned issues, relevant not only for producing sound researches but also and above all for the effectiveness, the efficiency and the sustainability of activities aimed at promoting development

The Rise of eTourism for Development

This paper presents the conceptualization of eTourism For Development (eT4D), an emerging and still underexplored field of research. eT4D can be defined as the use of tourism technologies in developing and emerging contexts to foster socio-economic development. eT4D is a new concept that integrates three distinct disciplines: development studies, tourism studies and information and communication technologies. The paper describes and defines the eT4D field from a theoretical point of view. Additionally the research presents an exploratory case study describing current tourism technology usage in a given developing context that is the one of Rocinha, a slum in Rio de Janeiro. Results confirm the theoretical conceptualization of the domain and the need of investigating the eT4D field also from a practical perspective.

The representation of voluntourism in search engines: The case of South Africa

This paper responds to the paucity of research on the linkages between voluntourism and digital technology and seeks to understand the online representation of the phenomenon in a developing context. In particular, the researchers investigate the so-called ‘online domain’ of voluntourism in South Africa. The researchers collected a series of web results from search engines and analysed the presence of traditional and social media websites, the most relevant presented topics, and the type of argumentation found. Results identify the context and representation of voluntourism as it transpires virtually. This will contribute to the understanding of the interplay between voluntourism and digital technology, with specific emphasis on web presence. Ultimately, results will shed light on how digitally accessible voluntourism is in South Africa and will set the basis for future investigations.

Public access venues and community empowerment in Mozambique: a social representation study

Abstract This article uses the theoretical construct of Social Representations to investigate how Community Multimedia Centers (CMCs) – venues that offer public access to Information and Communication Technologies (ICTs) to underserved communities – are perceived by communities in Mozambique, and it discusses how the local population understands these venues as means to foster community empowerment and socio-economic development. In total, 113 participants took part in the study, from six CMCs in different towns of Mozambique. Participants were represented from three different social groups, according to their use of the CMC: staff members, users of both CMC components – telecenter and radio – and radio-only users. The article analyses the Social Representations’ structure, using a Prototypical approach. Findings show that CMCs are seen by local communities as places at which they can receive and exchange information, and also as learning spaces, with the telecenter part focused on the delivery of ICT training and the radio component engaging with educational activities and services in a broader sense. Furthermore, CMCs are perceived as places dedicated almost exclusively to children and young people. The results of this study can help policy makers, practitioners, funding agencies and other relevant stakeholders to improve Mozambican CMCs and leverage their community empowerment potential.

Tourism, Development and Digital Technologies: Insights from Malaysian Homestays

Rooted in the Sustainable Livelihood Approach, this paper contributes to the current debate on e-tourism for development by analysing the use of ICTs in community-based tourism micro enterprises. Using a qualitative case study approach with semi structured interviews, observations and documentary evidence, this study sheds light on the importance of ICTs in homestays and analyses its impact on the five livelihood assets (i.e. human, natural, financial, physical, social) as perceived by Malaysian homestay managers. Results indicate that there are significant direct and indirect impacts of ICTs on the livelihood assets of the community and open the floor for further research in the field.