mHealth for Safer Deliveries: A mixed methods evaluation of the effect of an integrated mobile health intervention on maternal care utilization

Battle, Julia D.; Farrow, Leonie; Tibaijuka, Jalia; Mitchell, M. D.

doi:10.1016/j.hjdsi.2015.10.011

Cited by 37 publications

(38 citation statements)

References 3 publications

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“…17,16 In the present study, 101 women out of 102 in study group (one woman aborted at 12 weeks) and 102 in control group had institutional deliveries which were high when compared to study done by Battle et al where 75% delivered at a facility and 78% delivered under skilled care. 18 In our study, a significant difference was noted in Hb% in last visit in study group [p-0.004] when compared to a study done by Khorshid et al where no effect on anaemia was found, as there were no significant differences in hemoglobin and hematocrit in study group. 19 There was no significant difference noted in both groups in this study in terms of age, risk factors, literacy status which is similar to study done by Lund et al 16 The limitations of m-health are that compliance of health workers for handling the software application may be low.…”

Section: Discussioncontrasting

confidence: 54%

The role of m-health in providing antenatal care in rural areas

Menaka¹,

Kamineni²,

Sree³

2017

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONGlobally about 800 women die every day of preventable causes related to pregnancy and childbirth and 20 % of such deaths are from India. It is estimated that per year, 55,000 women die due to preventable pregnancy-related causes in India.1 The United Nations' Millennium Development Goal (MDG5) was to reduce maternal mortality rate (MMR) by 75% between 1990 and 2015. 2 In order to achieve these goals and accelerate their progress, newer strategies like m-Health are required. India faces several challenges in meeting the needs of pregnant women, particularly those related to complications of pregnancy and obstetric emergencies. Besides medical causes, other factors that may contribute to maternal deaths are delay in care-seeking due to delay in identifying the complication, deciding to seek care, transportation to a health facility, and delay in receiving appropriate treatment.3 Mobile health (m-Health) denotes using small portable and wireless communication devices like mobile phones, personal digital assistants, based on web applications to facilitate the health needs of health care providers and consumers. The basic idea of m-health application for expectant mothers is that community health workers collect data about pregnant women and send to a specialist. The specialist views the patient information and provides feedback to the mobile of community health worker.4 It works as a good support system and is operated by rural health workers to improve point of care diagnostic support. It is also useful for screening of patients who need specialist care and to provide advice for routine cases. ABSTRACT Background:The maternal mortality rate is high in India and many deaths are due to preventable causes related to pregnancy. Mobile-health is an innovative strategy wherein, mobile phones are used for pregnancy tracking and giving support during the antenatal period. Aims and objectives of the study was to know the role of m-Health in providing antenatal care in rural areas. Methods: This was a prospective, comparative study carried out at Kamineni Hospital, LB Nagar, Hyderabad and the Primary Health Centres (PHC) of Uppal and Narapally, Ranga Reddy district over a period of one year nine months and consisted of 204 registered antenatal cases divided into study and control groups. Both groups received routine antenatal support and the study group, in addition received mobile health support also. Various parameters were compared in both the groups. Results: The study group had more antenatal visits, better correction of anemia, less number of patients who were lost to follow-up, and more number of Caesarean deliveries. Conclusions: Mobile health helps in pregnancy tracking and increasing the antenatal visits. It helps in timely referrals for high-risk pregnancies in remote areas and it has the potential to provide obstetric care and consultations to both low risk and at-risk women in rural areas where specialist care is not always available.

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Section: Discussioncontrasting

confidence: 54%

The role of m-health in providing antenatal care in rural areas

Menaka¹,

Kamineni²,

Sree³

2017

Int J Reprod Contracept Obstet Gynecol

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“…In Zanzibar, technology has been introduced by a nongovernmental organization but ownership is being transferred to the government. 3 In Malawi, the government has been working with funders and consultants to develop a digital health strategy. 35 What is common to these three models and most other examples is that the government has a central role in defining the policies and strategies for digital health, whereas implementation is often led by outside private groups.…”

Section: Challengesmentioning

confidence: 99%

“…A recent project in Zanzibar, Tanzania, has shown how the use of digital technology has been able to significantly increase the ability of women to access safer delivery services. 3 In India, Uganda, and Tanzania, ambulance services focused on the use of digital protocols and access have replaced the largely nonexistent public system. In South Africa, two million young women have access to accurate information about sex, health, and motherhood through a national online service run by the government.…”

mentioning

confidence: 99%

Digital Technology and the Future of Health Systems

Mitchell

Kan

2019

Health Systems & Reform

Self Cite

171

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Digital health is having a profound effect on health systems, changing the balance of power between provider and patient, enabling new models of care, and shifting the focus of health systems toward client-centered health care within low-and middle-income countries. Though many of these changes are just being felt due to resistance by organizations and individuals reluctant to change the status quo, the explosive growth of digital technology globally means that these changes are inevitable. We can expect to see increasing use of telemedicine for remote diagnostics and treatment, protocol-driven health care to improve quality of care, and better access to goods and services through changes in the organization of transportation and delivery services. Data will become central to health systems, whether big data and artificial intelligence tools for surveillance, planning, and management or "personalized data" in the form of universal electronic record systems and customized treatment protocols. As with any disruptive innovation, the growth of digital health will also bring challenges, including who owns, controls, and manages the data being collected and how to maintain privacy and confidentiality in this data-rich world.

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“…Undertaking a comprehensive implementation science study is particularly important when studying mHealth interventions, as the health care system itself is complex, includes multiple interacting components, and interventions must be adapted to fit the needs of a practice setting and patients with different views and expectations [ 19 , 20 ]. However, to our knowledge there is no tested tool that can be continuously used to evaluate, monitor, and inform mHealth implementation processes as they unfold.…”

Section: Introductionmentioning

confidence: 99%

Identifying Barriers and Facilitators of 13 mHealth Projects in North America and Africa: Protocol for a 5-Year Implementation Science Study

et al. 2018

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BackgroundAlthough many mHealth interventions have shown efficacy in research, few have been effectively implemented and sustained in real-world health system settings. Despite this programmatic gap, there is limited conclusive evidence identifying the factors that affect the implementation and successful integration of mHealth into a health system.ObjectiveThe aim of this study is to examine the individual, organizational, and external level factors associated with the effective implementation of WelTel, an mHealth intervention designed to support outpatient medication adherence and engagement in care in Africa and North America.MethodsWe will adopt the Consolidated Framework for Implementation Research (CFIR) constructs for evaluation of mHealth implementation including a scoring and monitoring system. We will apply the adapted tool to identify facilitators and barriers to implementation of the WelTel mHealth intervention in order to determine how the technology platform is perceived, diffused, adapted, and used by different mHealth project teams and health system actors in Africa and North America. We will use a mixed-methods approach to quantitatively test whether the factors identified in the CFIR framework are associated with the successful uptake of the mHealth intervention toward implementation goals. We will triangulate these data through interviews and focus group discussion with project stakeholders, exploring factors associated with successful implementation and sustainment of these interventions.ResultsThe development of the customized CFIR is finalized and currently is in pilot testing. The initial results of the use of the tool in those 13 implementations will be available in 2019. Continuous conference and peer- reviewed publications will be published in the coming years.ConclusionsThe results of this study will provide an in-depth understanding of individual, organizational, and external level factors that influence the successful implementation of mHealth in different health systems and geographic contexts over time. Via the tool’s unique scoring system connected to qualitative descriptors, these data will inform the most critical implementation targets and contribute to the tailoring of strategies that will assist the health system in overcoming barriers to implementation, and ultimately, improve treatment adherence and engagement in care.Registered Report IdentifierRR1-10.2196/9633

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mHealth for Safer Deliveries: A mixed methods evaluation of the effect of an integrated mobile health intervention on maternal care utilization

Cited by 37 publications

References 3 publications

The role of m-health in providing antenatal care in rural areas

The role of m-health in providing antenatal care in rural areas

Digital Technology and the Future of Health Systems

Identifying Barriers and Facilitators of 13 mHealth Projects in North America and Africa: Protocol for a 5-Year Implementation Science Study

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