Perception and Experiences of Auxiliary Nurse Midwives in using the ANMOL Application: A Qualitative Study Based on...

Currently, auxiliary nurse midwife (ANM), a crucial public health functionary in rural India, uses health-related mobile-based applications for their routine activities. The study aims to explore the facilitators and barriers of ANMs in using the ANMOL applications.

A sequential exploratory study was conducted among all 24 ANMs in the Salon block of Raebareli district, India. The ANMs were categorized into low- and high-performing ANMs using an adapted Hennessy-Hicks Training Needs Analysis questionnaire. In-depth interviews (IDIs) in their language using a structured interview guide were conducted among six ANMs from each category. An inductive thematic analysis was performed to identify domains, themes, and subthemes.

The mean (SD) age of the ANMs was 37.25 (9.9) years with a median (IQR) experience of 5.5 (2.75,8.50) years. Around 13 (54.17%) were categorized as low-performing and 11 (45.83%) as high-performing ANMs. The key themes identified were internet-related issues, technical issues, easy information tracking, increased work, one-point availability of data, and monitoring of the activities. The high-performing ANMs not only reported technical challenges along with increased workload in using the application, but also provided technical suggestions, like ASHA-wise classification of data in the application. However, low-performing ANMs focused mainly on ease in routine immunization.

More than half of the ANMs were perceived to have a high need for training in the ANMOL application. Poor internet coverage, technical glitches in the application, and duplication in data entry affect the holistic utilization of these applications.