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Jonayed M, Rumi MH. Towards women's digital health equity: A qualitative inquiry into attitude and adoption of reproductive mHealth services in Bangladesh. PLOS DIGITAL HEALTH 2024; 3:e0000637. [PMID: 39405293 PMCID: PMC11478865 DOI: 10.1371/journal.pdig.0000637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2024] [Accepted: 09/10/2024] [Indexed: 10/19/2024]
Abstract
Health equity in Bangladesh faces a large chasm over the economic conditions, socio-cultural factors and geographic location despite the push for digitalization of the health sector. While some research has been conducted assessing the viability of digital health solutions in Bangladesh, gender dynamics of digital healthcare have been absent. This study dived into healthcare equity for women with a focus on reproductive health services delivered through mobile devices. This paper reported the findings of a qualitative study employing in-depth interviews conducted among 26 women about their behavioral intention to use mHealth services for reproductive health and the underlying factors influencing this intention with the help of the Integrative Model of Planned Behavior (IMPB). A snowball sampling technique were used to interview those university educated women, aged 21-31, based on their familiarity and exposure of mHealth services from seven universities in Bangladesh. The findings suggested that users of mHealth services find it more convenient and secure compared to visiting healthcare facilities, especially for trivial issues and inquiries regarding their reproductive health. Although promoting such services is lagging behind traditional healthcare, the attitude toward reproductive health services in Bangladesh is generally favorable resulting increasing adoption and use. Because such information-related mobile services (apps, websites, and social media) served as a first base of knowledge on reproductive health among many young girls and women in Bangladesh, who are generally shy to share or talk about their menstruation or personal health problems with family members, peers, or even health professionals due to socio-cultural factors and stigmatization. Conversely, urban centric services, availability of experts, quality management, security of privacy, authenticity of the information, digital divide, lack of campaign initiatives, lack of equipment and technology, lack of sex education, and outdated apps and websites were identified as obstacles that constrain the widespread use of reproductive mHealth services in Bangladesh. This study also concluded that promotion will be crucial in reforming conservative norms, taboos, and misconceptions about women's health and recommended such endeavors to be initiated by the policy makers as there is a substantive need for a specific policy regulating emerging digital health market in Bangladesh. Notwithstanding, women-only sample, low sample size, narrow focus on mHealth users and absence of perspectives from healthcare providers were among shortcomings of this study which could be addressed in future research. Further quantitative explorations are must to determine the usage patterns of reproductive mHealth services and their effectiveness that would identify implementation challenges in terms of customization and personalization in reproductive healthcare in a developing country like Bangladesh.
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Affiliation(s)
- M. Jonayed
- Department of Public Administration, University of Dhaka, Dhaka, Bangladesh
| | - Maruf Hasan Rumi
- Department of Public Administration, University of Dhaka, Dhaka, Bangladesh
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Bhuiyan MI, Haque MA. NGOs' initiatives and grassroots approach for accessing to health care services for the slum people in Dhaka. FRONTIERS IN HEALTH SERVICES 2024; 4:1386698. [PMID: 39364142 PMCID: PMC11446876 DOI: 10.3389/frhs.2024.1386698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 08/23/2024] [Indexed: 10/05/2024]
Abstract
Objective This study holds significant importance as it aims to delve into the impactful NGOs' initiatives and grassroots approaches instrumental in providing healthcare services to Dhaka's underserved slum people. It focuses on understanding how these factors influence the use and access to health services, which is a crucial aspect for researchers, policymakers, and healthcare professionals. Study design This study was meticulously designed, utilizing a comprehensive cross-sectional mixed-methods design. By incorporating qualitative and quantitative data collection methods, we ensured a thorough understanding of NGOs' initiatives and grassroots approaches to providing healthcare services to slum dwellers in Dhaka, thereby instilling confidence in the validity of our research for the audience. Methods A face-to-face interview was used to survey the participants (n = 722) using semi-structured questionnaires, following a systematic sampling technique. Four focus group discussions (FGDs) were also conducted with the slum people. Binary logistic regression was performed to know NGOs' initiatives, roles, and grassroots approach as predictors or independent variables and healthcare services as an outcome or dependent variable. The quantitative data were analyzed using SPSS version 23.0. At the same time, thematic analysis was conducted following Philip Adu's Qualitative data analysis process and Braun and Clarke's six steps of the thematic analysis system, integrating the 11 subthemes with the quantitative findings to highlight the interpretative findings of the qualitative data. Findings Major findings revealed that NGOs' initiative roles and grassroots approach had a significant impact on slum dwellers' use and access to healthcare services. The initiatives included affordable health services (OR = 22.86, 95% CI = 3.87, 35.00, P = 0.01), special health services (OR = 5.63, 95% CI = 3.36, 9.42, P = 0.00), engagement of responsible community leaders (OR = 1.72, 95% CI = 1.14, 2.59, P = 0.01), distribution of health and medicine items (OR = 1.92, 95% 2 CI = 1.40, 2.63, P = 0.01), provision of updated information to slum dwellers (OR = 1.37, 95% CI = .99, 1.90, P = 0.05), telehealth and telemedicine (OR = 1.82, 95% CI = 1.55, 2.13, P = 0.01), BCC strategy (OR = 1.26, 95% CI = 1.00, 1.57, P = 0.05), and doorstep services as NGOs' grassroots approach (OR = 1.84, 95% CI = 1.00, 3.38, P = 0.05). Qualitative findings supported the quantitative findings through 2 main themes and 11 sub-themes, which were integrated with quantitative findings to highlight the interpretative findings of qualitative data. Conclusions Health services and other facilities for urban slum people through NGOs' initiatives and grassroots approaches are highly affordable and practical, special health services with the involvement of special exceptional health professionals, community supportive services, BCC strategies, and doorstep health services may trigger the use and access to health services for slum dwellers. Results suggest and recommend capitalizing and investing in such initiatives and grassroots approaches from the government, policymakers, and donors with NGOs to find accessible, affordable health services for the unprivileged slum people.
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Affiliation(s)
| | - Md Aminul Haque
- Department of Population Sciences, University of Dhaka, Dhaka, Bangladesh
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De P, Pradhan MR. Effectiveness of mobile technology and utilization of maternal and neonatal healthcare in low and middle-income countries (LMICs): a systematic review. BMC Womens Health 2023; 23:664. [PMID: 38082424 PMCID: PMC10714653 DOI: 10.1186/s12905-023-02825-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 12/01/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Maternal and neonatal mortality are important indicators of the development of a nation and pose a severe health concern, especially in developing and Low and Middle-Income Countries (LMICs). Healthcare providers use various mobile technologies as tools to provide antenatal, delivery, and postnatal care and thereby promote maternal and child health. We conducted a systematic review to critically assess the existing literature on the effectiveness of mobile phone technology in maternal and neonatal healthcare (MNH) utilization, especially in LMICs in Asia and Africa. METHODS A systematic search strategy was developed, and Boolean combinations of relevant keywords were utilized to search relevant literature on three electronic databases (PubMed/Medline, Scopus, and Google Scholar) from 2012 to 2022. After assessing the inclusion and exclusion criteria, 25 articles were selected for systematic review. A narrative synthesis strategy was applied to summarise the information from the included literature. RESULTS This review reveals that research and evaluation studies on mobile phone or Mobile Health (mHealth) and MNH service utilization substantially varied by research designs and methodology. Most studies found that mobile phone technology is highly appreciable in improving several MNH indicators, especially in LMICs. Despite the identified benefits of mobile technology in MNH utilization, some studies also mentioned challenges related to technology use and misuse, rich-poor discrimination, and disparity in phone ownership need to be addressed. CONCLUSION There is constantly increasing evidence of mobile counseling and the use of digital technology in the MNH care system. Public health practitioners and policymakers need to make efforts to smooth the functioning of technology-based healthcare services, considering all the issues related to the confidentiality and safety of health-related data on the Internet.
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Affiliation(s)
- Prasenjit De
- Department of Fertility and Social Demography, International Institute for Population Sciences (IIPS), Govandi Station Road, Deonar, Mumbai, 400088, Maharashtra, India.
| | - Manas Ranjan Pradhan
- Department of Fertility and Social Demography, International Institute for Population Sciences (IIPS), Govandi Station Road, Deonar, Mumbai, 400088, Maharashtra, India
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Kibria GMA, Hashan MR, Hanif AAM, Maniar V, Shawon MSR. Mobile phone use for pregnancy-related healthcare utilization and its association with optimum antenatal care and hospital delivery in Bangladesh. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001762. [PMID: 37022996 PMCID: PMC10079009 DOI: 10.1371/journal.pgph.0001762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 03/07/2023] [Indexed: 06/19/2023]
Abstract
Pregnancy-related healthcare utilization is inadequate in Bangladesh, where more than half of pregnant women do not receive optimum number of antenatal care (ANC) visits or do not deliver child in hospitals. Mobile phone use could improve such healthcare utilization; however, limited evidence exists in Bangladesh. We investigated the pattern, trends, and factors associated with mobile phone use for pregnancy-related healthcare and how this can impact at least 4 ANC visits and hospital delivery in the country. We analyzed cross-sectional data from Bangladesh Demographic and Health Survey (BDHS) 2014 (n = 4,465) and 2017-18 (n = 4,903). Only 28.5% and 26.6% women reported using mobile phones for pregnancy-related causes in 2014 and 2017-18, respectively. Majority of the time, women used mobile phones to seek information or to contact service providers. In both survey periods, women with a higher education level, more educated husbands, a higher household wealth index, and residence in certain administrative divisions had greater likelihoods of using mobile phones for pregnancy-related causes. In BDHS 2014, proportions of at least 4 ANC and hospital delivery were, respectively, 43.3% and 57.0% among users, and 26.4% and 31.2% among non-users. In adjusted analysis, the odds of utilizing at least 4 ANC were 1.6 (95% confidence interval (CI): 1.4-1.9) in BDHS 2014 and 1.4 (95% CI: 1.3-1.7) in BDHS 2017-18 among users. Similarly, in BDHS 2017-18, proportions of at least 4 ANC and hospital delivery were, respectively, 59.1% and 63.8% among users, and 42.8% and 45.1% among non-users. The adjusted odds of hospital delivery were also high, 2.0 (95% CI: 1.7-2.4) in BDHS 2014 and 1.5 (95% CI: 1.3-1.8) in BDHS 2017-18. Women with history of using mobile phones for pregnancy-related causes were more likely to utilize at least 4 ANC visits and deliver in health facilities, however, most women were not using mobile phones for that.
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Affiliation(s)
| | - Mohammad Rashidul Hashan
- Bangladesh Civil Service, Ministry of Health and Family Welfare, Government of Bangladesh, Dhaka, Bangladesh
- Central Queensland University, Rockhampton, Australia
| | | | - Vidhi Maniar
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
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Sumankuuro J, Domapielle MK, Derbile EK. The what's, where's and why's of miscarriage: evidence from the 2017 Ghana Maternal Health Survey. Public Health 2022; 213:34-46. [PMID: 36334582 DOI: 10.1016/j.puhe.2022.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 08/31/2022] [Accepted: 09/16/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Miscarriage remains a significant public health challenge in most low- and middle-income settings, including Ghana. We thus examined the sociodemographic and maternal characteristics associated with miscarriage in Ghana using the 2017 Maternal Health Survey dataset. STUDY DESIGN This was a cross-sectional quantitative study. METHODS We quantitatively analysed Ghana Maternal and Health Survey dataset. Demographic and Health Survey (DHS) collected the data using survey techniques. Approximately 25,062 women within the active reproductive ages of 15-49 years were involved in the survey. We analysed the data using binary and multivariate logistic regression models at a 95% confidence level. The findings were reported using the World Health Organisation's Conceptual Social Determinants of Health framework. RESULTS We found that the prevalence of miscarriage was 15.6%. Education, religion and ethnicity were the most significant structural factors associated with miscarriage. We also found that women of all ages (20-49 years), starting antenatal care (ANC) in the fifth month of gestation, residing in rural area, having history of abortion (aOR = 0.622, 95% CI = 0.570-0.679, P < 0.001), and not using mobile phone during complications (adjusted odds ratio = 0.601, 95% confidence interval = 0.556-0.651, P < 0.001) were key intermediary determinants of miscarriage. The analysis found increased odds of miscarriage among women who had no mobile phone and could not access the same during obstetric complications. CONCLUSIONS The study concludes that country-policy frameworks on maternal and neonatal health care do not go far enough in providing specific solutions for preventing miscarriage. To reverse this trend, we recommend targeted ANC, including enhanced twenty-four-hour primary emergency obstetric care within 5 km, advocacy, and education as a lever to increasing utilisation of ANC, and removal of indirect financial barriers to maternal health care. We further recommend a qualitative research to understand some of the findings and explore the feasibility of promoting mobile phone technology to address maternal health problems, particularly obstetric care for women in hard-to-reach rural communities.
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Affiliation(s)
- J Sumankuuro
- Faculty of Public Policy and Governance, SD Dombo University of Business and Integrated Development Studies, Wa, Ghana; Centre for Health Policy, School of Public Health, Faculty of Science, University of Witwatersrand, Johannesburg, South Africa; School of Community Health, Faculty of Science, Charles Sturt University, NSW, Australia; School of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, South Africa.
| | - M K Domapielle
- Faculty of Public Policy and Governance, SD Dombo University of Business and Integrated Development Studies, Wa, Ghana.
| | - E K Derbile
- Faculty of Planning and Land Management, SD Dombo University of Business and Integrated Development Studies, Wa, Ghana.
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Parajuli R, Bohara D, KC M, Shanmuganathan S, Mistry SK, Yadav UN. Challenges and opportunities for implementing digital health interventions in Nepal: A rapid review. Front Digit Health 2022; 4:861019. [PMID: 36120714 PMCID: PMC9480345 DOI: 10.3389/fdgth.2022.861019] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 08/01/2022] [Indexed: 11/13/2022] Open
Abstract
Background In recent times, digital technologies in health care have been well recognized in Nepal. It is crucial to understand what is works well and areas that need improvements in the digital health ecosystem. This rapid review was carried out to provide an overview of Nepal's challenges and opportunities for implementing digital health interventions. Methods This study is reported according to PRISMA guidelines and used telehealth, telemedicine, e-health, mobile health, digital health, implementation, opportunities, challenges and Nepal as key search terms to identify primary studies published between 1 January 2010 and 30 December 2021 in four databases, namely PubMed, Google Scholar, Scopus, and CINAHL. Initially, identified studies were screened against predetermined selection criteria, and data were extracted, and the findings were narratively synthesized. Result The review identified various challenges, opportunities, and benefits of implementing digital health initiatives in Nepal. The most expressed challenge was inadequate technical facilities (lack of electricity and internet) and rugged geographical distribution, which makes transportation difficult in hilly and mountain areas. Shortage of skilled workforce and supportive policies were also notable challenges documented. Meanwhile, major opportunities identified were education and training of the students and health practitioners and increasing awareness among the general population. Conclusion This review identified various factors associated with the successful implementation of digital health initiatives in Nepal. Our findings may guide the formulation of digital health policy and interventions to improve mass health outcomes using digital health services.
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Affiliation(s)
- Rojina Parajuli
- Department of Public Health, Torrens University, Sydney, Australia
| | - Dipak Bohara
- Department of Public Health, Torrens University, Sydney, Australia
| | - Malati KC
- Department of Public Health, Torrens University, Sydney, Australia
| | - Selvanaayagam Shanmuganathan
- Department of Public Health, Torrens University, Sydney, Australia
- Menzies Centre for Health Policy and Economics, The University of Sydney, New South Wales, Sydney, Australia
| | - Sabuj Kanti Mistry
- Centre for Primary Health Care and Equity, Faculty of Medicine,, University of New South Wales, NSW, Sydney, Australia
- Department of Public Health, Daffodil International University, Dhaka, Bangladesh
| | - Uday Narayan Yadav
- Department of Public Health, Torrens University, Sydney, Australia
- Centre for Primary Health Care and Equity, Faculty of Medicine,, University of New South Wales, NSW, Sydney, Australia
- National Centre for Epidemiology and Population Health, The Australian National University, ACT, Canberra, Australia
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Kalinga A, Munga M, Ngenya A, John W, Kisoka W, Oriyo N, Mutalemwa P, Mandara W, Masagati L, Ogondiek J, Korir P, Klarmann-Schulz U, Horn S, Kroidl I, Debrah A, Hoerauf A, Mwingira U. The viability of utilising phone-based text messages in data capture and reporting morbidities due to lymphatic Filariasis by community health workers: a qualitative study in Kilwa district, Tanzania. BMC Health Serv Res 2022; 22:924. [PMID: 35854308 PMCID: PMC9295502 DOI: 10.1186/s12913-022-08256-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 06/20/2022] [Indexed: 11/10/2022] Open
Abstract
Background Globally, there is recognition of the value of using mobile phones among health providers in improving health systems performance. However, in many Low- and Middle-income countries where there is shortage of health providers, Community Health Workers have assumed some responsibilities especially relating to identifying and reporting on health problems within their communities. Despite the known benefits of using mobile phone technology to deliver health services, there is limited information on the extent to which Community Health Workers are able to effectively use the technology in data collection and reporting. The aim of this study was to determine the feasibility of utilizing phone-based text messages on Lymphatic Filariasis morbidity surveillance by Community Health Workers. Methods This was a cross sectional study whose data was collected through key informant interviews and focused group discussions among community health workers, health providers and staff of neglected tropical diseases control program. Collected transcripts were analysed through Thematic content analysis as it allowed for the identification of data codes through inductive reasoning. Results The use of mobile phone-based text messages in data collection and reporting lymphatic filariasis morbidity cases by Community Health Workers was perceived by study participants to be a relevant tool and feasible due to the ease of use of the technology. The tool was reported by end-users to significantly increase their performance and efficiency was gained in terms of reduced paper work, increased the number of patients accessing health care services and the ability to report in real-time. All respondents were confident that Community Health Workers were the right persons to interact with communities in tracking and reporting morbidity cases using mobile technology. Conclusion Mobile phone-based text messages have proven to be effective in routine workflows such as, data collection and reporting on Lymphatic Filariasis morbidity cases, patient to provider communication, decision making and supportive supervision. Mobile phones have also improved efficiency and general performance of end users in terms of increased number of cases identified and efficiency gained in terms of reduced paper work and the ability to collect and report in real-time.
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Affiliation(s)
- Akili Kalinga
- National Institute for Medical Research (NIMR), Headquarters, Dar es Salaam, Tanzania.
| | - Michael Munga
- National Institute for Medical Research (NIMR), Headquarters, Dar es Salaam, Tanzania
| | - Abdallah Ngenya
- National Institute for Medical Research (NIMR), Headquarters, Dar es Salaam, Tanzania
| | - Winfrida John
- National Institute for Medical Research (NIMR), Headquarters, Dar es Salaam, Tanzania
| | - William Kisoka
- National Institute for Medical Research (NIMR), Headquarters, Dar es Salaam, Tanzania
| | - Ndekya Oriyo
- National Institute for Medical Research (NIMR), Headquarters, Dar es Salaam, Tanzania
| | - Prince Mutalemwa
- National Institute for Medical Research (NIMR), Headquarters, Dar es Salaam, Tanzania
| | - Wilfred Mandara
- National Institute for Medical Research (NIMR), Headquarters, Dar es Salaam, Tanzania
| | - Leonard Masagati
- National Institute for Medical Research (NIMR), Headquarters, Dar es Salaam, Tanzania
| | - John Ogondiek
- National Institute for Medical Research (NIMR), Headquarters, Dar es Salaam, Tanzania
| | - Patricia Korir
- Institute for Medical Microbiology, Immunology and Parasitology (IMMIP), Bonn, Germany
| | - Ute Klarmann-Schulz
- Institute for Medical Microbiology, Immunology and Parasitology (IMMIP), Bonn, Germany
| | - Sacha Horn
- Division of Infectious Diseases and Tropical Medicine, University Hospital Munich, Ludwig-Maximilians-Universität (LMU), Munich, Germany.,German Centre for Infection Research (DZIF), Neglected Tropical Diseases, Partner Site, Munich, Germany
| | - Inge Kroidl
- Division of Infectious Diseases and Tropical Medicine, University Hospital Munich, Ludwig-Maximilians-Universität (LMU), Munich, Germany.,German Centre for Infection Research (DZIF), Neglected Tropical Diseases, Partner Site, Munich, Germany
| | - Alex Debrah
- Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Achim Hoerauf
- Institute for Medical Microbiology, Immunology and Parasitology (IMMIP), Bonn, Germany
| | - Upendo Mwingira
- National Institute for Medical Research (NIMR), Headquarters, Dar es Salaam, Tanzania.,Research Triangle Institute (RTI), International, Washington DC, USA
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Mistry SK, Akter F, Hossain MB, Huda MN, Irfan NM, Yadav UN, Storisteanu DML, Arora A. Exploring Factors Associated with Women's Willingness to Provide Digital Fingerprints in Accessing Healthcare Services: A Cross-Sectional Study in Urban Slums of Bangladesh. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:40. [PMID: 35010299 PMCID: PMC8751190 DOI: 10.3390/ijerph19010040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/17/2021] [Accepted: 12/18/2021] [Indexed: 06/14/2023]
Abstract
Digital fingerprints are increasingly used for patient care and treatment delivery, health system monitoring and evaluation, and maintaining data integrity during health research. Yet, no evidence exists about the use of fingerprinting technologies in maternal healthcare services in urban slum contexts, globally. The present study aimed to explore the recently delivered women's willingness to give digital fingerprints to community health workers to access healthcare services in the urban slums of Bangladesh and identify the associated factors. Employing a two-stage cluster random sampling procedure, we chose 458 recently delivered women from eight randomly selected urban slums of Dhaka city, Bangladesh. Chi-square tests were performed for descriptive analyses, and binary logistic regression analyses were performed to explore the factors associated with willingness to provide fingerprints. Overall, 78% of the participants reported that they were willing to provide digital fingerprints if that eased access to healthcare services. After adjusting for potential confounders, the sex of the household head, family type, and household wealth status were significantly associated with the willingness to provide fingerprints to access healthcare services. The study highlighted the potentials of using fingerprints for making healthcare services accessible. Focus is needed for female-headed households, women from poor families, and engaging husbands and in-laws in mobile health programs.
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Affiliation(s)
- Sabuj Kanti Mistry
- BRAC James P Grant School of Public Health, BRAC University, Dhaka 1212, Bangladesh; (S.K.M.); (F.A.); (M.B.H.)
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW 2052, Australia
- Department of Health Research, ARCED Foundation, 13/1, Pallabi, Mirpur-12, Dhaka 1216, Bangladesh
- Department of Public Health, Daffodil International University, Dhaka 1207, Bangladesh
| | - Fahmida Akter
- BRAC James P Grant School of Public Health, BRAC University, Dhaka 1212, Bangladesh; (S.K.M.); (F.A.); (M.B.H.)
| | - Md. Belal Hossain
- BRAC James P Grant School of Public Health, BRAC University, Dhaka 1212, Bangladesh; (S.K.M.); (F.A.); (M.B.H.)
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Md. Nazmul Huda
- School of Health Sciences, Western Sydney University, Campbeltown, NSW 2560, Australia;
- School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia
| | - Nafis Md. Irfan
- Institute of Nutrition and Food Science, University of Dhaka, Dhaka 1000, Bangladesh;
- Interdisciplinary Graduate Program in Human Toxicology, University of Iowa, Iowa City, IA 52242, USA
| | - Uday Narayan Yadav
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, ACT 0200, Australia;
| | | | - Amit Arora
- Translational Health Research Institute, Campbelltown Campus, Western Sydney University, Penrith, NSW 2751, Australia
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Penrith, NSW 2751, Australia
- Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, NSW Health, Surry Hills, NSW 2010, Australia
- Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia
- Health Equity Laboratory, Campbelltown, NSW 2560, Australia
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