Evaluation of mHealth Usage Logs for Health Provider Performance in HIV Care in Zambézia Province, Mozambique

Community health workers (CHWs) offer essential services for people living with HIV (PLHIV) in low-resource settings. However, understanding and optimizing CHW performance is challenging as CHWs work remotely and over large geographical areas. A mobile health (mHealth) application, mUzima, was introduced in one district in Mozambique to support CHWs during patient visits. Usefulness of mUzima-derived logs to inform CHW performance and work patterns was evaluated. Derived from 113,893 cleaned log records, the 29 CHWs who used mUzima for 8,896 distinct encounters worked an average 2.65 days per week, with encounter documentation length within mUzima taking 3.6 minutes (SD 5.8). Mean length of mUzima usage was 2.7 hours per day (SD 4.0), with 30.7% of encounter data entered outside of regular work hours. Roughly 83% of CHWs entered visit data into mUzima on weekends. mHealth-usage logs offer novel insights into work patterns by CHWs, informing approaches to best support them.