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Mobile phone use and the welfare of community health nurses in Ghana: An analysis of unintended costs

Robson, Elsbeth; Hampshire, Kate; Abane, Albert; Kasim, Adetayo; Owusu, Samuel; Mariwah, Simon


Kate Hampshire

Albert Abane

Adetayo Kasim

Samuel Owusu

Simon Mariwah


The use of mobile phones is fast transforming the healthcare delivery landscape in Ghana. A substantial number of health facilities are now dependent on mobile phones to facilitate their work. Evidence of the use of mobile phones in Ghana's healthcare is however limited. In order to contribute to the evidence of the value of using mobile phones to promote healthcare, we interrogated and highlighted unexpected costs imposed on community health nurses who use their personal mobile phones for healthcare delivery in the country. Data for the study were derived from 598 completed questionnaires and extracts from focus group discussions with community health nurses who were sampled from three regions across the three main ecological zones of Ghana. The results show that over 90% of nurses bear the cost of paying for airtime, bundles and chargers used for work-related activities, yet less than 10% of them receive direct compensation. This costly burden has the potential to demotivate the nurses and threaten the country's progress towards the achievement of universal health coverage. More significantly, the data strongly suggest that physical distance, regional location and gender are the main factors triggering extra costs incurred by the nurses. We conclude that the use of personal mobile phones for healthcare delivery imposed huge financial burden on community health workers in Ghana. A suggested intervention to forestall negative consequences on performance is to offer incentive packages to nurses as a compensation for the financial and non-physical costs of using personal mobile phones for work-related activities.


Robson, E., Hampshire, K., Abane, A., Kasim, A., Owusu, S., & Mariwah, S. (2021). Mobile phone use and the welfare of community health nurses in Ghana: An analysis of unintended costs. World Development Perspectives, 23, Article 100317.

Journal Article Type Article
Acceptance Date May 12, 2021
Online Publication Date Jun 4, 2021
Publication Date 2021-09
Deposit Date May 17, 2021
Publicly Available Date Oct 27, 2022
Journal World Development Perspectives
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 23
Article Number 100317
Keywords Mobile phones; Healthcare; mhealth; Community health nurses; Ghana
Public URL


Published article (3 Mb)

Copyright Statement
© 2021 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (

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