JMIR Publications

ABSTRACT

Background:

The reach and proliferation of the Internet and mobile phones has expanded rapidly across LMICs enabling broader access to educational opportunities and an attitude shift in how content can be successfully delivered, but reaching specific audiences in low resource settings to influence working practice is a multi-layered challenge. Materials need to be contextually appropriate, interesting and formatted to engage the user on their chosen device, but they must also be easy to access with minimal barriers. Understanding how healthcare workers in resource poor settings can access online training has been the focus of a study by Interburns, a UK charity twinned with the Centre for Global Burns Injury and Policy Research (CGBIPR) at Swansea University. Since 2006, Interburns has worked with partners in Asia, the Middle East and Africa, to develop tailor made training programmes to tackle the global burden of burn injuries. Burns affect more than 11 million people annually, with 95% occurring in poor countries and the majority of those affected are children. Interburn’s training materials reflect the reality of burns care services on the ground in low resource or conflict settings and focus on increasing the rate at which ‘knowledge is turned to action’. The research focused on understanding barriers to accessing online content and has been used to inform the digital strategy for all Interburn’s training resources.

Objective:

To understand barriers to access of online educational materials for healthcare workers in low resource or conflict settings in order to inform a digital strategy for a leading NGO working in burn treatment and care in Asia, Africa and the Middle East.

Methods:

Literature review. Survey.

Results:

Technological improvements have opened the way to reaching specific populations in low resource settings, but it is vital to understand the context within which the individual lives, works and accesses digital information so that materials can be tailored to the setting and the device, and delivered with minimal barriers to access. The majority of Learning Management System (LMS) software relies on inputting a functioning email address for sign up and verification as well as passwords for course and email access. This can be a significant barrier if healthcare workers are not used to using email in their daily lives. Healthcare workers in low resource settings increasingly use mobile messaging both personally and professionally. 7.5% of participants thought that educational materials should be accessible only by computer, against 21% only on mobile phone. 70% felt that educational information on burns should be made available on both computer and mobile device.

Conclusions:

Digital content needs to be contextually appropriate, formatted to be interesting while not losing the educational message, and accessible by computer and mobile phone with an increasingly ‘mobile first’ approach to developing content. This includes functional aspects to fit the smaller screen, but also ensuring that content is light in terms of data as cost is a significant barrier to use. Blended programmes of face to face and online training can help to encourage greater use of online resources, with digital skills introduced alongside face to face training. Findings from this research have fed directly into Interburn’s digital strategy for increasing engagement with healthcare workers in low resource and conflict settings, informing the development of a mobile friendly online platform for contextually appropriate content and also setting up active WhatsApp groups for sharing learning and contributing to education and research in burns.