Situating mobile health: a qualitative study of mHealth expectations in the rural health district of Nouna, Burkina Faso

Duclos, Vincent; Yé, Maurice; Kagoné, Moubassira; Sanou, Hamidou; Sawadogo, Natéwindé; Bibeau, Gilles; Sié, Ali

doi:10.1186/s12961-017-0211-y

Cited by 49 publications

(55 citation statements)

References 64 publications

(60 reference statements)

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“…Interrupted eye contact and passive involvement especially with illiterate and older women impeded trust building and effective engagement. On the other hand, assessment of the mobile santé Nouna intervention in rural Burkina Faso showed expectations of improved relationships between the health facility and the community with mHealth as an intermediary [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Pregnant women’s experiences with an integrated diagnostic and decision support device for antenatal care in Ghana

Abejirinde

Douwes²,

Bardají

et al. 2018

BMC Pregnancy Childbirth

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BackgroundQuality antenatal care (ANC) is recognised as an opportunity for screening and early identification of pregnancy-related complications. In rural Ghana, challenges with access to diagnostic services demotivate women from ANC attendance and referral compliance, leading to absent or late identification and management of high-risk women. In 2016, an integrated diagnostic and clinical decision support system tagged ‘Bliss4Midwives’ (B4M), was piloted in Northern Ghana. The device facilitated non-invasive screening of pre-eclampsia, gestational diabetes and anaemia at the point-of-care. This study aimed to explore the experiences of pregnant women with B4M, and its influence on service utilisation (“pull effect”) and woman-provider relationships (“woman engagement”).MethodsThrough an embedded study design, qualitative methods including individual semi-structured interviews and non-participant observation were employed. Interviews were conducted with 20 pregnant women and 10 health workers, supplemented by ANC observations in intervention facilities. Secondary data on ANC registrations over a one-year period were extracted from health facility records to support findings on the perceived influence of B4M on service utilisation.ResultsWomen’s first impressions of the device were mostly emotive (excitement, fear), but sometimes neutral. Although it is inconclusive whether B4M increased ANC registration, pregnant women generally valued the availability of diagnostic services at the point-of-care. Additionally, by fostering some level of engagement, the intervention made women feel listened to and cared for. Process outcomes of the B4M encounter also showed that it was perceived as improving the skills and knowledge of the health worker, which facilitated trust in diagnostic recommendations and was therefore believed to motivate referral compliance.ConclusionsThis study suggests that mHealth diagnostic and decision support devices enhance woman engagement and trust in health workers skills. There is need for further inquiry into how these interventions influence maternal health service utilization and women’s expectations of pregnancy care.Electronic supplementary materialThe online version of this article (10.1186/s12884-018-1853-7) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Pregnant women’s experiences with an integrated diagnostic and decision support device for antenatal care in Ghana

Abejirinde

Douwes²,

Bardají

et al. 2018

BMC Pregnancy Childbirth

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“…This is especially interesting for LMICs, as mobile phone usage outperforms other communication infrastructure usage [ 98 ]. In total, 70% of the 7.4 billion users of cellular phones reside in LMICs, and especially in sub-Saharan Africa, mHealth had a rapid expansion, making this approach hugely promising [ 20 , 99 , 100 ]. The response to Ebola PoC in the last epidemic might serve as an example, as it was very fast as a result of the effective surveillance systems in place.…”

Section: The Usagementioning

confidence: 99%

“…This is starting to change as mHealth is more utilized. In a review of 255 studies of mHealth applications, 93 studies fell into the realm of health monitoring and surveillance, the second largest group with 88 publications concerned themselves with raising health awareness [ 98 ]; another study found the most used context to be increased patient follow-up, as well as patient compliance [ 100 ].…”

Section: The Usagementioning

confidence: 99%

Point of Care Diagnostics in Resource-Limited Settings: A Review of the Present and Future of PoC in Its Most Needed Environment

et al. 2020

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Point of care (PoC) diagnostics are at the focus of government initiatives, NGOs and fundamental research alike. In high-income countries, the hope is to streamline the diagnostic procedure, minimize costs and make healthcare processes more efficient and faster, which, in some cases, can be more a matter of convenience than necessity. However, in resource-limited settings such as low-income countries, PoC-diagnostics might be the only viable route, when the next laboratory is hours away. Therefore, it is especially important to focus research into novel diagnostics for these countries in order to alleviate suffering due to infectious disease. In this review, the current research describing the use of PoC diagnostics in resource-limited settings and the potential bottlenecks along the value chain that prevent their widespread application is summarized. To this end, we will look at literature that investigates different parts of the value chain, such as fundamental research and market economics, as well as actual use at healthcare providers. We aim to create an integrated picture of potential PoC barriers, from the first start of research at universities to patient treatment in the field. Results from the literature will be discussed with the aim to bring all important steps and aspects together in order to illustrate how effectively PoC is being used in low-income countries. In addition, we discuss what is needed to improve the situation further, in order to use this technology to its fullest advantage and avoid “leaks in the pipeline”, when a promising device fails to take the next step of the valorization pathway and is abandoned.

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“…Other projects using health ICTs in low-income countries have encountered similar challenges. 16,19,28 It is also essential to study the economic context in order to understand variations in the intervention’s effects and their dependencies on contextual factors. 36 We believe it is imperative that mHealth projects invest in suitable premises and equipment (quality of Internet service, ventilation, air-conditioning, relay generator, etc) to mitigate technological hazards, and ensure regular maintenance to ensure the service is uninterrupted.…”

Section: Discussionmentioning

confidence: 99%

“…16,25-27 Often, studies have narrowed in on issues of acceptability and people’s capacity to use the technology, but without examining their complex health behaviors and the processes involved in adopting the technology. 28…”

Section: Introductionmentioning

confidence: 99%

Relevance of a Toll-Free Call Service Using an Interactive Voice Server to Strengthen Health System Governance and Responsiveness in Burkina Faso

Lechat

Bonnet

Queuille³

et al. 2019

Int J Health Policy Manag

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Background: In Africa, health systems are poorly accessible, inequitable, and unresponsive. People rarely have either the confidence or the opportunity to express their opinions. In Burkina Faso, there is a political will to improve governance and responsiveness to create a more relevant and equitable health system. Given their development in Africa, information and communication technologies (ICTs) offer opportunities in this area. Methods: This article presents the results of an evaluation of a toll-free call service coupled with an interactive voice server (TF-IVS) tested in Ouagadougou, Burkina Faso, to assess its relevance for improving health systems governance. The approach consisted of a 2-phased action research project to test 2 technologies: recorded messages and touch keypad. Using a concurrent mixed approach, we assessed the technological, social, and instrumental relevance of the service. Results: The call service is available everywhere, 24 hours per day, seven days per week. The equipment and its physical location were not adequately protected against technological hazards. Of the 278 days of operation, 49 were non-functional. In 8 months, there were 13 877 calls, which demonstrated the popularity of ICTs and the ease of access to telephone networks and mobile technologies. The TF-IVS was free, anonymous, and multilingual, which fostered the expression of public opinion. However, cultural context (religion, ethnic culture) and fear of reprisals may have had a negative influence. In the end, questions remained regarding people’s capacity to use this innovative service. In the first trial, 49% of callers recorded their message and in the second, 48%. Touch key technology appeared more relevant for automated and real-time data collection and analysis, but there was no comprehensive strategy for translating the information collected into a response from healthcare actors or the government. Conclusion: This study showed the relevance and feasibility of implementing a TF-IVS to strengthen health system responsiveness in one of the world’s poorest countries. Public opinion expressed through data collected in real-time is helpful for improving system responsiveness to meet care needs and enhance equity. However, the strategy for developing this tool must take into account the implementation context and the activities needed to influence the mechanisms of social responsibility (eg, information provision, citizen action, and state response).

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Situating mobile health: a qualitative study of mHealth expectations in the rural health district of Nouna, Burkina Faso

Cited by 49 publications

References 64 publications

Pregnant women’s experiences with an integrated diagnostic and decision support device for antenatal care in Ghana

Pregnant women’s experiences with an integrated diagnostic and decision support device for antenatal care in Ghana

Point of Care Diagnostics in Resource-Limited Settings: A Review of the Present and Future of PoC in Its Most Needed Environment

Relevance of a Toll-Free Call Service Using an Interactive Voice Server to Strengthen Health System Governance and Responsiveness in Burkina Faso

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