Healthcare workers' and managers' uses of mobile phone messaging applications (apps) in their daily work in South Africa: a survey.

Mobile health (mHealth) technologies are important for supporting health service delivery and enhancing workforce performance in low- and middle-income countries. Alongside mHealth technologies endorsed by Departments of Health, healthcare workers are using messaging applications (apps), such as WhatsApp, informally on their personal mobile phones to fulfil work tasks. Our objective was to explore the use of mobile phone messaging apps for daily work among healthcare workers and managers in South Africa. We conducted a cross-sectional anonymous online survey with public and private sector healthcare workers, recruited via the Health and Welfare Sector Education and Training Authority database from February 2022 to May 2022. A total of 2174 healthcare workers participated and data were analysed using Stata SE. Most participants were female (73.8%), Caucasian (70.4%), English-speaking (53.7%), and had a postgraduate degree (58%). Over two-thirds of participants (67.5%) worked in the private sector, 81.4% were urban-based and doctors were the largest group (35%). Most participants (90%) reported using a messaging app for work-related communication, mostly WhatsApp (84%). Participants reported using messaging apps for contacting colleagues (52.1%), patient referrals (50.6%) and clinical management information (47.5%). Apps were also used for sharing appointment times and reminders (44.7%) with patients. App use across the public and private sectors and healthcare facility types was similar. Most healthcare workers (79.3%) did not receive a mobile phone data allowance. The survey shows that informal use of messaging apps by healthcare workers in South Africa is widespread and needs to be considered in digital health strategies.