Using Mobile Health to Support Clinical Decision-Making to Improve Maternal and Neonatal Health Outcomes in Ghana: Insights of Frontline Health Worker Information Needs

Amoakoh, Hannah Brown; Klipstein‐Grobusch, Kerstin; Grobbee, Diederick E.; Amoakoh-Coleman, Mary; Oduro‐Mensah, Ebenezer; Sarpong, Charity; Frimpong, Edith; Kayode, Gbenga A; Agyepong, Irène Akua; Ansah, Evelyn

doi:10.2196/12879

Cited by 19 publications

(17 citation statements)

References 36 publications

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“…Methodologically, 7 studies were randomized controlled trials (RCTs), 21 were observational cohorts with control groups, and 18 were observational pre/post studies. Of the four prespecified categories of mHealth interventions delineated in this systematic review, 8 studied data collection interventions [ 15 - 22 ], 9 studied decision support interventions [ 14 , 23 - 30 ], 15 studied direct patient care interventions [ 31 - 45 ], and 14 studied health training interventions [ 46 - 59 ]. Table 2 provides detailed study characteristics.…”

Section: Resultsmentioning

confidence: 99%

The effects of mobile health on emergency care in low- and middle-income countries: A systematic review and narrative synthesis

et al. 2021

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Background In resource-constrained settings, mobile health (mHealth) has varied applications. While there is strong evidence for its use in chronic disease management, the applications of mHealth for management of acute illness in low- and middle-income countries (LMICs) are not as well described. This review systematically explores current available evidence on the effectiveness of mHealth interventions at improving health outcomes in emergency care settings in LMICs. Methods A systematic search of the literature was performed in accordance with PRISMA guidelines, utilizing seven electronic databases and manual searches to identify peer-reviewed literature containing each of three search elements: mHealth, emergency care (EC), and LMICs. Articles quality was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. Results After removing duplicates, 6498 studies met initial search criteria; 108 were eligible for full text review and 46 met criteria for inclusion. Thirty-six pertained to routine emergency care, and 10 involved complex humanitarian emergencies. Based on the GRADE criteria, 15 studies were rated as “Very Low” quality, 24 as “Low” quality, 6 as “Moderate” quality, and 1 as “High” quality. Eight studied data collection, 9 studied decision support, 15 studied direct patient care, and 14 studied health training. All 46 studies reported positive impacts of mHealth on EC in LMICs. Conclusions Mobile health interventions can be effective in improving provider-focused and patient-centered outcomes in both routine and complex EC settings. Future investigations focusing on patient-centered outcomes are needed to further validate these findings.

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Section: Resultsmentioning

confidence: 99%

The effects of mobile health on emergency care in low- and middle-income countries: A systematic review and narrative synthesis

et al. 2021

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“…The USSD technology provides an interactive, user-friendly and simple tool for delivering health information using mobile phones. This technology has been used to build highly promising mobile phone-based clinical decision support systems for healthcare providers [ 39 ], USSD was also used to pilot a well-received mobile app enabling users to locate healthcare facilities in their vicinity [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

Developing an Unstructured Supplementary Service Data-based mobile phone app to provide adolescents with sexual reproductive health information: a human-centered design approach

Macharia

Pérez-Navarro

Inwani

et al. 2022

BMC Med Res Methodol

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Background Adolescent pregnancies and sexually-transmitted infections continue to impact 15 – 19-year-olds across the globe. The lack of sexual reproductive health information (SRH) in resource-limited settings due to cultural and societal attitudes towards adolescent SRH could be contributing to the negative outcomes. Innovative approaches, including mobile phone technologies, are needed to address the need for reliable adolescent SRH information. Objective The study aimed to co-design a Unstructured Supplementary Service Data (USSD) based mobile app prototype to provide confidential adolescent SRH information on-demand and evaluate the mobile app’s usability and user experience. Methods A human-centered design methodology was applied. This practice framework allowed the perspectives and feedback of adolescent users to be included in the iterative design process. To participate, an adolescent must have been 15 to 19 years old, resided in Kibra and would be able to access a mobile phone. Adolescents were enrolled for the alpha and field testing of the app prototype at different time-points. The Mobile Application Rating Scale (MARS) a multidimensional mobile phone evaluation tool was used to access the functionality, engagement, aesthetics and quality of information in the app. Responses from the MARS were reported as mean scores for each category and a mean of the aggregate scores making the app’s quality score. The MARS data was also evaluated as categorical data, A Chi square test of independence was carried out to show significance of any observed differences using cumulative and inverse cumulative distribution functions. Results During the usability test, 62/109 (54.9%) of the adolescents that were followed-up had used the app at least once, 30/62 (48.4%) of these were male participants and 32/62 (51.6%) female. On engagement, the app had a mean score of 4.3/5 (SD 0.44), 4.6/5 (SD 0.38) on functionality, 4.3/5 (SD 0.57) on aesthetics and 4.4/5 (SD 0.60) on the quality of information. The overall app quality mean score was 4.4/5 (SD 0.31). The app was described as ‘very interesting’ to use by 44/62 (70.9%) of the participants, 20/44 males and 24/44 females. The content was deemed to be either ‘perfectly’ or ‘well targeted’ on sexual reproductive health by 60/62 (96.7%) adolescents, and the app was rated ‘best app’ by 45/62 (72.6%) adolescents, 27/45 females and 18/45 males, with a p-value = 0.011. Conclusions Adolescents need on-demand, accurate and trusted SRH information. A mobile phone app is a feasible and acceptable way to deliver adolescent SRH information in resource-limited settings. The USSD mobile phone technology shows promise in the delivery of much needed adolescent SRH information on-demand..

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“…41 With this increasing penetration of Internet connectivity, mHealth has been a valuable tool in global health research, especially in areas of communication, education, clinical care, and disaster response. [17][18][19][42][43][44][45] We endeavored to offer open access to this resource to maximize uptake among researchers and policymakers worldwide so that comparative analyses can be made at the local, regional, national, and international level. The survey will continue to be developed and piloted through the Pediatric Sepsis Data CoLaboratory's (Sepsis CoLab) Environmental Scan Working Group.…”

Section: Discussionmentioning

confidence: 99%

A 2-Phase Survey to Assess a Facility's Readiness for Pediatric Essential Emergency and Critical Care in Resource-Limited Settings

et al. 2022

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ObjectiveInfectious diseases, including pneumonia, malaria, and diarrheal diseases, are the leading causes of death in children younger than 5 years worldwide. The vast majority of these deaths occur in resource-limited settings where there is significant variation in the availability and type of human, physical, and infrastructural resources. The ability to identity gaps in healthcare systems that may hinder their ability to deliver care is an important step to determining specific interventions for quality improvement. Our study objective was to develop a comprehensive, digital, open-access health facility survey to assess facility readiness to provide pediatric critical care in resource-limited settings (eg, low- and lower middle–income countries).MethodsA literature review of existing facility assessment tools and global guidelines was conducted to generate a database of survey questions. These were then mapped to one of the following 8 domains: hospital statistics, services offered, operational flow, facility infrastructure, staff and training, medicines and equipment, diagnostic capacity, and quality of clinical care. A 2-phase survey was developed and an iterative review process of the survey was undertaken with 12 experts based in low- and middle-income countries. This was built into the REDCap Mobile Application for electronic data capture.ResultsThe literature review process yielded 7 facility assessment tools and 7 global guidelines for inclusion. After the iterative review process, the final survey consisted of 11 sections with 457 unique questions in the first phase, “environmental scan,” focusing on the infrastructure, availability, and functionality of resources, and 3 sections with 131 unique questions in the second phase, “observation scan,” focusing on the level of clinical competency.ConclusionsA comprehensive 2-phase survey was created to evaluate facility readiness for pediatric critical care. Results will assist hospital administrators and policymakers to determine priority areas for quality improvement, enabling them to implement a Plan-Do-Study-Act cycle to improve care for the critically ill child.

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Using Mobile Health to Support Clinical Decision-Making to Improve Maternal and Neonatal Health Outcomes in Ghana: Insights of Frontline Health Worker Information Needs

Cited by 19 publications

References 36 publications

The effects of mobile health on emergency care in low- and middle-income countries: A systematic review and narrative synthesis

The effects of mobile health on emergency care in low- and middle-income countries: A systematic review and narrative synthesis

Developing an Unstructured Supplementary Service Data-based mobile phone app to provide adolescents with sexual reproductive health information: a human-centered design approach

A 2-Phase Survey to Assess a Facility's Readiness for Pediatric Essential Emergency and Critical Care in Resource-Limited Settings

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