One Message, Many Voices: Mobile Audio Counselling in Health Education

Health workers' use of counselling information on their mobile phones for health education is a central but little understood phenomenon in numerous mobile health (mHealth) projects in Sub-Saharan Africa. Drawing on empirical data from an interpretive case study in the setting of the Millennium Villages Project in rural Malawi, this research investigates the ways in which community health workers (CHWs) perceive that audio-counselling messages support their health education practice. Three main themes emerged from the analysis: phone-aided audio counselling (1) legitimises the CHWs' use of mobile phones during household visits; (2) helps CHWs to deliver a comprehensive counselling message; (3) supports CHWs in persuading communities to change their health practices. The findings show the complexity and interplay of the multi-faceted, sociocultural, political, and socioemotional meanings associated with audio-counselling use. Practical implications and the demand for further research are discussed.