title: An evaluation of a family planning mobile job aid for community health workers in Tanzania.
abstract: The global rapid growth in mobile technology provides unique opportunities to support community health workers (CHWs) in providing family planning (FP) services. FHI 360, Pathfinder International and D-tree International developed an evidence-based mobile job aid to support CHW counseling, screening, service provision and referrals, with mobile forms for client and service data, and text-message reporting and reminders. The purpose of this study is to evaluate the acceptability and potential benefits to service quality from the perspective of CHWs and their clients.
  
  
  
  The mobile job aid was piloted in Dar es Salaam, Tanzania. Data collection tools included a demographic survey of all 25 CHWs trained to use the mobile job aid, in-depth interviews with 20 of the CHWs after 3 months and a survey of 176 clients who received FP services from a CHW using the mobile job aid after 6 months.
  
  
  
  Both CHWs and their clients reported that the mobile job aid was a highly acceptable FP support tool. CHWs perceived benefits to service quality, including timelier and more convenient care; better quality of information; increased method choice; and improved privacy, confidentiality and trust with clients. Most clients discussed multiple FP methods with CHWs; only 1 in 10 clients reported discussion of all 9 methods.
  
  
  
  This research suggests that mobile phones can be effective tools to support CHWs with FP counseling, screening and referrals, data collection and reporting, and communication. Challenges remain to support informed contraceptive choice. Future research should focus on implementation, including scale-up and sustainability.
  
  
  
  Mobile job aids can uniquely enhance FP service provision at the community level through adherence to standard protocols, real-time feedback and technical assistance, and provision of confidential care. This study can inform future efforts to support and expand the role of CHWs in increasing FP access and informed contraceptive choice.
authors.affiliation: FHI 360, 359 Blackwell Street, Suite 200, Durham, NC 27701, USA. Electronic address: braunr@ipas.org.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Braun
authors.affiliation: FHI 360, 359 Blackwell Street, Suite 200, Durham, NC 27701, USA.
authors.forename: Christine
authors.initials: C
authors.lastname: Lasway
authors.affiliation: FHI 360, 359 Blackwell Street, Suite 200, Durham, NC 27701, USA.
authors.forename: Smisha
authors.initials: S
authors.lastname: Agarwal
authors.affiliation: University of San Francisco, School of Nursing and Health Professions, 2130 Fulton Street, San Francisco, CA 94117, USA.
authors.forename: Kelly
authors.initials: K
authors.lastname: L'Engle
authors.affiliation: D-tree International, PO, Box 31269, Dar es Salaam, Tanzania.
authors.forename: Erica
authors.initials: E
authors.lastname: Layer
authors.affiliation: D-tree International, PO, Box 31269, Dar es Salaam, Tanzania.
authors.forename: Lucy
authors.initials: L
authors.lastname: Silas
authors.affiliation: Pathfinder International, Chato Street, Plot No. 260, Dar es Salaam, Tanzania.
authors.forename: Anna
authors.initials: A
authors.lastname: Mwakibete
authors.affiliation: Pathfinder International, Chato Street, Plot No. 260, Dar es Salaam, Tanzania.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kudrati
mesh_terms: D000328:Adult; D003150:Community Health Workers / Q000193:education*; D003376:Counseling; D003625:Data Collection / Q000379:methods; D005193:Family Planning Services / Q000379:methods*; D005260:Female; D006293:Health Promotion / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation; D011795:Surveys and Questionnaires; D013636:Tanzania; D017216:Telemedicine / Q000379:methods*; D060145:Text Messaging / Q000706:statistics & numerical data
keywords: Community health worker; Family planning; Mobile phone; Tanzania; Text message; mHealth