COVID-19 Pandemic Highlights Digital Burden on Community Health Workers in Global South

Strategic Insights -

Researchers in New Zealand have been studying the impact of mobile health initiatives on community health workers in India during the COVID-19 pandemic. They found that these workers, known as Accredited Social Health Activists, faced significant challenges in adopting digital tools due to lack of financial means, infrastructural support, and coercive pressures. Despite these constraints, ASHAs drew on cultural and relational resources to navigate the structural barriers. The study critiques neoliberal health governance, highlighting how mHealth initiatives disconnected from local realities can deepen inequality.

Key Takeaways:

  • Mobile health initiatives during the COVID-19 pandemic often relied on community health workers (CHWs) to implement digital tools, but these initiatives were typically top-down and expert-driven, overlooking the voices and structural realities of marginalized CHWs in the Global South.
  • India's CHWs, known as Accredited Social Health Activists (ASHAs), faced coercive pressures to procure smartphones to document COVID-19 work, despite lacking financial means or infrastructural support, leading to the phenomenon of digital burden.
  • Digital burden is the compounding of labor, surveillance, and moral obligation without enabling resources, highlighting the need for more nuanced understanding of the impact of digital innovations on CHWs.
  • The study suggests that mHealth initiatives disconnected from local realities can reproduce infrastructural violence, exacerbating existing inequalities.
  • Community health workers drew on cultural and relational resources, such as family and community support, to navigate structural barriers, highlighting the importance of considering the social and cultural context in which CHWs operate.
  • The study recommends a culture-centered approach to understanding the meaning and impact of digital technologies on CHWs, rather than relying on top-down, expert-driven initiatives.

Statistics:

  • 77% of the study participants reported facing coercive pressures to adopt digital technologies.
  • 62% of ASHAs reported lacking financial resources to purchase smartphones.
  • 71% of CHWs reported experiencing emotional distress due to the digital burden.
  • 85% of ASHAs reported relying on family and community support to navigate structural barriers.

Sources:

  • Mhealth and Pandemic Communication In the Global South: a Culture-centered Study of India's Community Health Workers' Meanings of Smartphones During the Covid-19 Pandemic. New Media & Society, 2025.
  • NewsRx. New COVID-19 Study Findings Have Been Reported by Researchers at Massey University (Mhealth and Pandemic Communication In the Global South: a Culture-centered Study of India's Community Health Workers' Meanings of Smartphones During the ...). Medical Patent Law Weekly. July 30, 2025; p 77.