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

Abstract Background: 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. Material and Methods: 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. Results: 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. Conclusions: 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.