Mobile phone use and the welfare of community health nurses in Ghana: An analysis of unintended costs

Abane, Albert; Mariwah, Simon; Owusu, Samuel Asiedu; Kasim, Adetayo; Robson, Elsbeth; Hampshire, Kate

doi:10.1016/j.wdp.2021.100317

Cited by 8 publications

(10 citation statements)

References 18 publications

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“…Adequate provision of the human and material resources including mobile phones and call credits are key sustainability measures should precede large-scale adoption. Formalizing this intervention has the potential to reduce undue burden on nurses who have been using their personal phones and call credits informally to support patient care [ 36 , 37 ]. Although a simple intervention which made use of available human resources without additional special training requirements, a cost-effectiveness study is also warranted as a prerequisite for scale-up.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of adjunct telephone-based postnatal care on maternal and infant illness in the Greater Accra Region, Ghana: a randomized controlled trial

Ameme

Akweongo

Afari

et al. 2022

BMC Pregnancy Childbirth

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Introduction Globally, postnatal care (PNC) is fraught with challenges. Despite high PNC coverages in Ghana’s Greater Accra Region (GAR), maternal and newborn health outcomes are of great concern. In 2017, neonatal and post-neonatal mortality rates in GAR were 19 and 13 per 1000 live births respectively despite PNC coverages of 93% for at least one PNC and 87.5% for PNC within 48 hours post-delivery. Telephone follow-up has been used to improve health outcomes in some settings, however, its usefulness in improving maternal and infant health during the postnatal period is not well known in Ghana. We assessed effectiveness of telephone-based PNC on infant and maternal illness in selected hospitals in GAR. Methods An open-label, assessor-blinded, parallel-group, two-arm superiority randomized controlled trial with 1:1 allocation ratio was conducted from September 2020 to March 2021. Mother-baby pairs in intervention arm, in addition to usual PNC, received midwife-led telephone counselling within 48 hours post-discharge plus telephone access to midwife during postnatal period. In control arm, only usual PNC was provided. Descriptive and inferential data analyses were conducted to generate frequencies, relative frequencies, risk ratios and 95% confidence intervals. Primary analysis was by intention-to-treat (ITT), complemented by per-protocol (PP) analysis. Results Of 608 mother-baby pairs assessed for eligibility, 400 (65.8%) were enrolled. During 3 months follow-up, proportion of infants who fell ill was 62.5% in intervention arm and 77.5% in control arm (p = 0.001). Maternal illness occurred in 27.5% of intervention and 38.5% of control participants (p = 0.02). Risk of infant illness was 20% less in intervention than control arm in both ITT analysis [RR = 0.8 (95%CI = 0.71–0.92] and PP analysis [RR = 0.8 (95%CI = 0.67–0.89)]. Compared to controls, risk of maternal illness in intervention arm was 30% lower in both ITT [RR = 0.7 (95%CI = 0.54–95.00)] and PP analysis [RR = 0.7 (95%CI = 0.51–0.94)]. Conclusion Telephone-based PNC significantly reduced risk of maternal and infant illness within first 3 months after delivery. This intervention merits consideration as a tool for adoption and scale up to improve infant and maternal health. Trial registration This trial was retrospectively registered with the International Standard Randomized Controlled Trial Number (ISRCTN) Registry with number ISRCTN46905855 on 09/04/2021.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of adjunct telephone-based postnatal care on maternal and infant illness in the Greater Accra Region, Ghana: a randomized controlled trial

Ameme

Akweongo

Afari

et al. 2022

BMC Pregnancy Childbirth

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“…Given this, International Monetary Fund (IMF) described the country as having bright economic prospects. However, like many African countries, Ghana is challenged in several areas, not least the health sector (Abane et al ., 2021). The history of primary healthcare in Ghana can be traced to the Alma-Ata Declaration of 1978 which was captured as “Health-For-All” by the year 2000 (Appiah-Agyekum et al ., 2022).…”

Section: Literature Reviewmentioning

confidence: 99%

“…It is vital to establish that, Ghana through the Ministry of Health around 1977 introduced trained and produced numerous community health workers to provide support to health delivery in rural communities with some being Community Clinic Attendants and others being Traditional Birth Attendants (Nyonator et al ., 2005). This according to the report, brought health services directly to people in their communities and substantially reduced the referral of cases to secondary health facilities (Abane et al ., 2021) (Baatiema et al ., 2016). Contrary to this, studies have reported that a lack of collaboration, cooperation, coordination and poor supervision led to a collapse of these groups of community health workers in the early 1990s (Abane et al ., 2021) (Agyei-baffour et al ., 2012).…”

Section: Literature Reviewmentioning

confidence: 99%

Determinants of mobile health (M-Health) application adoption, usage and discontinuity among corporate workers diagnosed with hypertension and diabetes

Liashiedzi,

Eto,

Atinga

et al. 2024

JHOM

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PurposeThis study examined the determinants of mobile health (M-Health) application, adoption, usage and discontinuation among corporate workers diagnosed with hypertension and diabetes in Ghana.Design/methodology/approachThe diffusion innovation and reasoned action theories were employed using an exploratory design. Three hundred corporate workers diagnosed with diabetes and hypertension from three health facilities for the past six months were sampled for the study using a multi-stage sampling technique and administered questionnaires. Descriptive statistics and logistic regression tools were employed in the analysis of data.FindingsThe study found a significant number of factors influencing m-health applications adoption, usage and discontinuity. These factors include nature and demand of job, perceived advantage, compatibility, complexity, triability, aesthetics and trust. Aesthetics emerged as the strongest predictive factor for the adoption, usage and discontinuity of use among diabetic and hypertensive corporate workers. With the adoption of M-Health applications, compatibility, as well as nature and demand of job, were significant predictors. With the usage of M-Health applications, complexity, triability, aesthetics and trust were significant predictors. Moreover, perceived advantage, compatibility, complexity and triability influenced significantly the choice to discontinue using M-Health applications. The study concluded that M-Health application functionalities play a valuable role in patients’ intention to adopt, use and discontinue the use of an M-Health application in Ghana.Originality/valueThis exploratory study offers in-depth insight into how major M-Health application features affect its adoption, usage and discontinuity, providing crucial information for future research and the improvement of chronic condition healthcare delivery.

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“…It is assisting in overcoming some challenges posed by long distances to health facilities and engender trust between CHNs and their clients 4. Inversely, it is also associated with some challenges such as infrastructural constraints, financial costs and threats to personal well-being 4 18. For instance, cost of buying airtime and data bundle comes as extra financial burdens to CHNs.…”

Section: Informal Mhealth In Ghanamentioning

confidence: 99%

Ethical implications of the widespread use of informal mHealth methods in Ghana

Owusu

2022

J Med Ethics

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BackgroundInformal mHealth is widely used by community health nurses in Ghana to extend healthcare delivery services to clients who otherwise might have been excluded from formal health systems or would experience significant barriers in their quest to access formal health services. The nurses use their private mobile phones or devices to make calls to their clients, health volunteers, colleagues or superiors. These phone calls are also reciprocal in nature. Besides, the parties exchange or share other health data and information through text messages, pictures, videos or voice clips. There are some ethical dimensions that are inherent in these practices that ought to be critically scrutinised by bioethicists.ObjectiveThe author has argued in this paper that informal mHealth at large scale adoption in Ghana is associated with some bioethical challenges.MethodsThis essay was largely based on an analysis of an empirical study published by Hampshire et al in 2021 on the use of informal mHealth methods in Ghana.ResultsWidespread adoption of Informal mHealth in Ghana is associated with privacy invasion of both the nurses and their clients, breaches confidentiality of the parties, discredits the validity of informed consent processes and may predispose the nurses to some other significant aggregated harms.ConclusionThe author affirms his partial support for a formalised adoption process of informal mHealth in Ghana but has reiterated that the current ethical challenges associated with informal mHealth in Ghana cannot escape all the debilitating bioethical challenges, even if it is formalised.

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Mobile phone use and the welfare of community health nurses in Ghana: An analysis of unintended costs

Cited by 8 publications

References 18 publications

Effectiveness of adjunct telephone-based postnatal care on maternal and infant illness in the Greater Accra Region, Ghana: a randomized controlled trial

Effectiveness of adjunct telephone-based postnatal care on maternal and infant illness in the Greater Accra Region, Ghana: a randomized controlled trial

Determinants of mobile health (M-Health) application adoption, usage and discontinuity among corporate workers diagnosed with hypertension and diabetes

Ethical implications of the widespread use of informal mHealth methods in Ghana

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