1
|
Kaburi BB, Harries M, Hauri AM, Kenu E, Wyss K, Silenou BC, Klett-Tammen CJ, Ressing C, Awolin J, Lange B, Krause G. Availability of published evidence on coverage, cost components, and funding support for digitalisation of infectious disease surveillance in Africa, 2003-2022: a systematic review. BMC Public Health 2024; 24:1731. [PMID: 38943132 PMCID: PMC11214246 DOI: 10.1186/s12889-024-19205-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 06/19/2024] [Indexed: 07/01/2024] Open
Abstract
BACKGROUND The implementation of digital disease surveillance systems at national levels in Africa have been challenged by many factors. These include user applicability, utility of IT features but also stable financial support. Funding closely intertwines with implementations in terms of geographical reach, disease focus, and sustainability. However, the practice of evidence sharing on geographical and disease coverage, costs, and funding sources for improving the implementation of these systems on the continent is unclear. OBJECTIVES To analyse the key characteristics and availability of evidence for implementing digital infectious disease surveillance systems in Africa namely their disease focus, geographical reach, cost reporting, and external funding support. METHODS We conducted a systematic review of peer-reviewed and grey literature for the period 2003 to 2022 (PROSPERO registration number: CRD42022300849). We searched five databases (PubMed, MEDLINE over Ovid, EMBASE, Web of Science, and Google Scholar) and websites of WHO, Africa CDC, and public health institutes of African countries. We mapped the distribution of projects by country; identified reported implementation cost components; categorised the availability of data on cost components; and identified supporting funding institutions outside Africa. RESULTS A total of 29 reports from 2,033 search results were eligible for analysis. We identified 27 projects implemented in 13 countries, across 32 sites. Of these, 24 (75%) were pilot projects with a median duration of 16 months, (IQR: 5-40). Of the 27 projects, 5 (19%) were implemented for HIV/AIDs and tuberculosis, 4 (15%) for malaria, 4 (15%) for all notifiable diseases, and 4 (15%) for One Health. We identified 17 cost components across the 29 reports. Of these, 11 (38%) reported quantified costs for start-up capital, 10 (34%) for health personnel compensation, 9 (31%) for training and capacity building, 8 (28%) for software maintenance, and 7(24%) for surveillance data transmission. Of 65 counts of external funding sources, 35 (54%) were governmental agencies, 15 (23%) foundations, and 7 (11%) UN agencies. CONCLUSIONS The evidence on costing data for the digitalisation of surveillance and outbreak response in the published literature is sparse in quantity, limited in detail, and without a standardised reporting format. Most initial direct project costs are substantially donor dependent, short lived, and thus unsustainable.
Collapse
Affiliation(s)
- Basil Benduri Kaburi
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany.
- PhD Programme "Epidemiology" Braunschweig-Hannover, Helmholtz Centre for Infection Research, Braunschweig, Germany.
- Hannover Medical School, Hannover, Germany.
| | - Manuela Harries
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- Hannover Medical School, Hannover, Germany
| | - Anja M Hauri
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Ernest Kenu
- Ghana Field Epidemiology and Laboratory Training Programme, University of Ghana, Accra, Ghana
| | - Kaspar Wyss
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Bernard Chawo Silenou
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | | | - Cordula Ressing
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- Hannover Medical School, Hannover, Germany
| | - Jannis Awolin
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Berit Lange
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- German Center for Infection Research partner site, Hannover-Braunschweig, Germany
| | - Gérard Krause
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- Hannover Medical School, Hannover, Germany
- German Center for Infection Research partner site, Hannover-Braunschweig, Germany
| |
Collapse
|
2
|
Ibrahim W, Himatt S, Heikal S, Al Shamali M, Jabbar R, Elshareif T, Bakiri A, Mahmoud M, Shami R, Saeed H, Shami GA, Omer D, Barakat E, Mahadoon L, Elshaikh T, Rahma R, Omer E, Elbourdiny A, Al Romaihi H, Al Thani M, Sallam M. Enhancing the notification system for surveillance of infectious diseases in Qatar during the FIFA World Cup 2022: project overview. BMC Public Health 2024; 24:625. [PMID: 38413899 PMCID: PMC10900677 DOI: 10.1186/s12889-024-18016-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 02/06/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND In 2022, the Surveillance Department of the Ministry of Public Health in Qatar adopted an integrated project called the Notification Enhancement Project (NEP) to enhance the infectious disease notification system. Efficient surveillance and notification promote early alerts and allow immediate interference in reducing morbidity and mortality from outbreaks. The project was designed to improve the knowledge, attitudes, practices, and notification processes of healthcare workers in Qatar by increasing their reporting rates. METHODS The strategy for comprehensively enhancing notifications was based on the observation and evaluation of the current notification system, the implementation of interventions, and post-evaluation follow-up. To implement the project, we relied on three aspects: effective methods used in previous relevant studies through a literature review, feedback received from healthcare workers, and suggestions from public health surveillance experts from the Ministry of Public Health, Qatar. A preassessment was conducted through an online survey by the Ministry of Public Health. The effectiveness of the different interventions was assessed by analyzing the data of notified patients reported through the Disease Surveillance and Reporting Electronic System. Pre- and postintervention assessments were performed by comparing the percentage of patients notified by healthcare providers with that of patients confirmed by healthcare providers in the laboratory to compare the notification rates over three time periods between January and December 2022. RESULTS There was significant improvement in the infectious disease notification process. A comparison before and after the implementation of the interventions revealed an increase in the communicable disease notification rate among healthcare workers. Pre- and postintervention data were compared. Infectious disease notification activities by healthcare workers increased from 2.5% between January and May 2022 to 41.4% between November and December 2022. CONCLUSION This study highlights the efficiency of different interventions in correcting the underreporting of infectious diseases. Our findings suggest that implementing the Notification Enhancement Project significantly improves notification rates. We recommend continuing interventions through constant education and training, maintaining solid communication with HCWs through regular reminder emails and feedback, periodic assessment of the electronic notification system, and engagement of healthcare workers and other stakeholders to sustain and expand progress achieved through continuous evaluation.
Collapse
Affiliation(s)
| | | | - Sara Heikal
- School of Medicine, Cairo University, Cairo, Egypt
| | | | | | | | | | | | - Rula Shami
- College of Dental Medicine, Qatar University, Doha, Qatar
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
3
|
Kaburi BB, Wyss K, Kenu E, Asiedu-Bekoe F, Hauri AM, Laryea DO, Klett-Tammen CJ, Leone F, Walter C, Krause G. Facilitators and Barriers in the Implementation of a Digital Surveillance and Outbreak Response System in Ghana Before and During the COVID-19 Pandemic: Qualitative Analysis of Stakeholder Interviews. JMIR Form Res 2023; 7:e45715. [PMID: 37862105 PMCID: PMC10625076 DOI: 10.2196/45715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND In the past 2 decades, many countries have recognized the use of electronic systems for disease surveillance and outbreak response as an important strategy for disease control and prevention. In low- and middle-income countries, the adoption of these electronic systems remains a priority and has attracted the support of global health players. However, the successful implementation and institutionalization of electronic systems in low- and middle-income countries have been challenged by the local capacity to absorb technologies, decisiveness and strength of leadership, implementation costs, workforce attitudes toward innovation, and organizational factors. In November 2019, Ghana piloted the Surveillance Outbreak Response Management and Analysis System (SORMAS) for routine surveillance and subsequently used it for the national COVID-19 response. OBJECTIVE This study aims to identify the facilitators of and barriers to the sustainable implementation and operation of SORMAS in Ghana. METHODS Between November 2021 and March 2022, we conducted a qualitative study among 22 resource persons representing different stakeholders involved in the implementation of SORMAS in Ghana. We interviewed study participants via telephone using in-depth interview guides developed consistent with the model of diffusion of innovations in health service organizations. We transcribed the interviews verbatim and performed independent validation of transcripts and pseudonymization. We performed deductive coding using 7 a priori categories: innovation, adopting health system, adoption and assimilation, diffusion and dissemination, outer context, institutionalization, and linkages among the aspects of implementation. We used MAXQDA Analytics Pro for transcription, coding, and analysis. RESULTS The facilitators of SORMAS implementation included its coherent design consistent with the Integrated Disease Surveillance and Response system, adaptability to evolving local needs, relative advantages for task performance (eg, real-time reporting, generation of case-base data, improved data quality, mobile offline capability, and integration of laboratory procedures), intrinsic motivation of users, and a smartphone-savvy workforce. Other facilitators were its alignment with health system goals, dedicated national leadership, political endorsement, availability of in-country IT capacities, and financial and technical support from inventors and international development partners. The main barriers were unstable technical interoperability between SORMAS and existing health information systems, reliance on a private IT company for data hosting, unreliable internet connectivity, unstable national power supply, inadequate numbers and poor quality of data collection devices, and substantial dependence on external funding. CONCLUSIONS The facilitators of and barriers to SORMAS implementation are multiple and interdependent. Important success conditions for implementation include enhanced scope and efficiency of task performance, strong technical and political stewardship, and a self-motivated workforce. Inadequate funding, limited IT infrastructure, and lack of software development expertise are mutually reinforcing barriers to implementation and progress to country ownership. Some barriers are external, relate to the overall national infrastructural development, and are not amenable even to unlimited project funding.
Collapse
Affiliation(s)
- Basil Benduri Kaburi
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- PhD Programme Epidemiology, Braunschweig-Hannover, Braunschweig, Germany
- Hannover Medical School, Hannover, Germany
| | - Kaspar Wyss
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Ernest Kenu
- Ghana Field Epidemiology and Laboratory Training Programme, University of Ghana, Accra, Ghana
| | | | - Anja M Hauri
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | | | | | - Frédéric Leone
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Christin Walter
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- PhD Programme Epidemiology, Braunschweig-Hannover, Braunschweig, Germany
- Hannover Medical School, Hannover, Germany
| | - Gérard Krause
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- Hannover Medical School, Hannover, Germany
- German Center for Infection Research, Braunschweig, Germany
| |
Collapse
|
4
|
Bogale TN, Teklehaimanot SM, Fufa Debela T, Enyew DB, Nigusse Bedada A, Dufera Kebebew S, Nigusie Weldeab A, Wolde Daka D, Willems HJ, Bekele TA. Barriers, facilitators and motivators of electronic community health information system use among health workers in Ethiopia. Front Digit Health 2023; 5:1162239. [PMID: 37351371 PMCID: PMC10282640 DOI: 10.3389/fdgth.2023.1162239] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 05/26/2023] [Indexed: 06/24/2023] Open
Abstract
Background The electronic community health information system (eCHIS) has been implemented in Ethiopia to support health services delivered by community health workers. Despite the many benefits of digitizing community health information systems, the implementation of the eCHIS is challenged by many barriers resulting in low uptake. This study assessed the barriers, facilitators, and motivators of eCHIS use among health workers with focus on health extension workers (HEWs) in Ethiopia. Methods Phenomenological approach was used to assess the barriers, facilitators and motivators of eCHIS use in Amhara, Harari, Oromia, Sidama, South West Ethiopia and Southern Nation Nationalities and People's regions of Ethiopia. Data were collected from 15-29 May 2022. A total of 54 face-to-face in-depth interviews were conducted among HEWs, HEW supervisors, health information technicians and managers. The interviews were audiotaped using Open Data Kit, transcribed verbatim and translated into English. OpenCode 4.03 software was used for coding and categorizing the data. Thematic analysis was used to analyze the data. Results The HEWs and other eCHIS users reported lack of infrastructure and resources; poor quality of training, follow-up, and supervision; parallel recording using the manual and electronic system; and HEWs' workload as barriers hindering eCHIS use. Data quality, retrievability, and traceability; tablet portability; encouragement from supervisors; and positive image in the community resulting from HEWs using tablets in their routine activities were the main facilitators of eCHIS use. Conclusion The study identified various barriers that adversely affect the use of eCHIS. An integrated and coordinated approach to eCHIS implementation that encompasses removing the barriers, and reinforcing facilitators is required.
Collapse
Affiliation(s)
| | | | - Tilahun Fufa Debela
- Department of Health Service Management, School of Public Health, Jimma University, Jimma, Ethiopia
| | - Daniel Berhanie Enyew
- Department of Health Informatics, School of Public Health, Haramaya University, Haramaya, Ethiopia
| | | | | | - Adane Nigusie Weldeab
- Department of Health Promotion & Health Behavior, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Dawit Wolde Daka
- Department of Health Service Management, School of Public Health, Jimma University, Jimma, Ethiopia
| | | | | |
Collapse
|
5
|
Development and On-Field Deployment of a Mobile-Based Application 'MoSQuIT' for Malaria Surveillance in International Border Districts of Northeast India-Challenges and Opportunities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052561. [PMID: 35270256 PMCID: PMC8909168 DOI: 10.3390/ijerph19052561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 02/12/2022] [Accepted: 02/14/2022] [Indexed: 11/16/2022]
Abstract
The conventional paper-based system for malaria surveillance is time-consuming, difficult to track and resource-intensive. Few digital platforms are in use but wide-scale deployment and acceptability remain to be seen. To address this issue, we created a malaria surveillance mobile app that offers real-time data to stakeholders and establishes a centralised data repository. The MoSQuIT app was designed to collect data from the field and was integrated with a web-based platform for data integration and analysis. The MoSQuIT app was deployed on mobile phones of accredited social health activists (ASHA) working in international border villages in the northeast (NE) Indian states of Assam, Tripura and Arunachal Pradesh for 20 months in a phased manner. This paper shares the challenges and opportunities associated with the use of MoSQuIT for malaria surveillance. MoSQuIT employs the same data entry formats as the NVBDCP's malaria surveillance programme. Using this app, a total of 8221 fever cases were recorded, which included 1192 (14.5%) cases of P. falciparum malaria, 280 (3.4%) cases of P. vivax malaria and 52 (0.6%) mixed infection cases. Depending on network availability, GPS coordinates of the fever cases were acquired by the app. The present study demonstrated that mobile-phone-based malaria surveillance facilitates the quick transmission of data from the field to decision makers. Geospatial tagging of cases helped with easy visualisation of the case distribution for the identification of malaria-prone areas and potential outbreaks, especially in hilly and remote regions of Northeast India. However, to achieve the full operational potential of the system, operational challenges have to be overcome.
Collapse
|
6
|
Carrillo MA, Kroeger A, Cardenas Sanchez R, Diaz Monsalve S, Runge-Ranzinger S. The use of mobile phones for the prevention and control of arboviral diseases: a scoping review. BMC Public Health 2021; 21:110. [PMID: 33422034 PMCID: PMC7796697 DOI: 10.1186/s12889-020-10126-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 12/23/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The rapid expansion of dengue, Zika and chikungunya with large scale outbreaks are an increasing public health concern in many countries. Additionally, the recent coronavirus pandemic urged the need to get connected for fast information transfer and exchange. As response, health programmes have -among other interventions- incorporated digital tools such as mobile phones for supporting the control and prevention of infectious diseases. However, little is known about the benefits of mobile phone technology in terms of input, process and outcome dimensions. The purpose of this scoping review is to analyse the evidence of the use of mobile phones as an intervention tool regarding the performance, acceptance, usability, feasibility, cost and effectiveness in dengue, Zika and chikungunya control programmes. METHODS We conducted a scoping review of studies and reports by systematically searching: i) electronic databases (PubMed, PLOS ONE, PLOS Neglected Tropical Disease, LILACS, WHOLIS, ScienceDirect and Google scholar), ii) grey literature, using Google web and iii) documents in the list of references of the selected papers. Selected studies were categorized using a pre-determined data extraction form. Finally, a narrative summary of the evidence related to general characteristics of available mobile health tools and outcomes was produced. RESULTS The systematic literature search identified 1289 records, 32 of which met the inclusion criteria and 4 records from the reference lists. A total of 36 studies were included coming from twenty different countries. Five mobile phone services were identified in this review: mobile applications (n = 18), short message services (n=7), camera phone (n = 6), mobile phone tracking data (n = 4), and simple mobile communication (n = 1). Mobile phones were used for surveillance, prevention, diagnosis, and communication demonstrating good performance, acceptance and usability by users, as well as feasibility of mobile phone under real life conditions and effectiveness in terms of contributing to a reduction of vectors/ disease and improving users-oriented behaviour changes. It can be concluded that there are benefits for using mobile phones in the fight against arboviral diseases as well as other epidemic diseases. Further studies particularly on acceptance, cost and effectiveness at scale are recommended.
Collapse
Affiliation(s)
- Maria Angelica Carrillo
- Centre for Medicine and Society, Master Programme Global Urban Health, Albert-Ludwigs- University Freiburg, Freiburg im Breisgau, Germany.
| | - Axel Kroeger
- Centre for Medicine and Society, Master Programme Global Urban Health, Albert-Ludwigs- University Freiburg, Freiburg im Breisgau, Germany
| | - Rocio Cardenas Sanchez
- Centre for Medicine and Society, Master Programme Global Urban Health, Albert-Ludwigs- University Freiburg, Freiburg im Breisgau, Germany
| | - Sonia Diaz Monsalve
- Centre for Medicine and Society, Master Programme Global Urban Health, Albert-Ludwigs- University Freiburg, Freiburg im Breisgau, Germany
| | | |
Collapse
|
7
|
Odendaal WA, Anstey Watkins J, Leon N, Goudge J, Griffiths F, Tomlinson M, Daniels K. Health workers' perceptions and experiences of using mHealth technologies to deliver primary healthcare services: a qualitative evidence synthesis. Cochrane Database Syst Rev 2020; 3:CD011942. [PMID: 32216074 PMCID: PMC7098082 DOI: 10.1002/14651858.cd011942.pub2] [Citation(s) in RCA: 102] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Mobile health (mHealth), refers to healthcare practices supported by mobile devices, such as mobile phones and tablets. Within primary care, health workers often use mobile devices to register clients, track their health, and make decisions about care, as well as to communicate with clients and other health workers. An understanding of how health workers relate to, and experience mHealth, can help in its implementation. OBJECTIVES To synthesise qualitative research evidence on health workers' perceptions and experiences of using mHealth technologies to deliver primary healthcare services, and to develop hypotheses about why some technologies are more effective than others. SEARCH METHODS We searched MEDLINE, Embase, CINAHL, Science Citation Index and Social Sciences Citation Index in January 2018. We searched Global Health in December 2015. We screened the reference lists of included studies and key references and searched seven sources for grey literature (16 February to 5 March 2018). We re-ran the search strategies in February 2020. We screened these records and any studies that we identified as potentially relevant are awaiting classification. SELECTION CRITERIA We included studies that used qualitative data collection and analysis methods. We included studies of mHealth programmes that were part of primary healthcare services. These services could be implemented in public or private primary healthcare facilities, community and workplace, or the homes of clients. We included all categories of health workers, as well as those persons who supported the delivery and management of the mHealth programmes. We excluded participants identified as technical staff who developed and maintained the mHealth technology, without otherwise being involved in the programme delivery. We included studies conducted in any country. DATA COLLECTION AND ANALYSIS We assessed abstracts, titles and full-text papers according to the inclusion criteria. We found 53 studies that met the inclusion criteria and sampled 43 of these for our analysis. For the 43 sampled studies, we extracted information, such as country, health worker category, and the mHealth technology. We used a thematic analysis process. We used GRADE-CERQual to assess our confidence in the findings. MAIN RESULTS Most of the 43 included sample studies were from low- or middle-income countries. In many of the studies, the mobile devices had decision support software loaded onto them, which showed the steps the health workers had to follow when they provided health care. Other uses included in-person and/or text message communication, and recording clients' health information. Almost half of the studies looked at health workers' use of mobile devices for mother, child, and newborn health. We have moderate or high confidence in the following findings. mHealth changed how health workers worked with each other: health workers appreciated being more connected to colleagues, and thought that this improved co-ordination and quality of care. However, some described problems when senior colleagues did not respond or responded in anger. Some preferred face-to-face connection with colleagues. Some believed that mHealth improved their reporting, while others compared it to "big brother watching". mHealth changed how health workers delivered care: health workers appreciated how mHealth let them take on new tasks, work flexibly, and reach clients in difficult-to-reach areas. They appreciated mHealth when it improved feedback, speed and workflow, but not when it was slow or time consuming. Some health workers found decision support software useful; others thought it threatened their clinical skills. Most health workers saw mHealth as better than paper, but some preferred paper. Some health workers saw mHealth as creating more work. mHealth led to new forms of engagement and relationships with clients and communities: health workers felt that communicating with clients by mobile phone improved care and their relationships with clients, but felt that some clients needed face-to-face contact. Health workers were aware of the importance of protecting confidential client information when using mobile devices. Some health workers did not mind being contacted by clients outside working hours, while others wanted boundaries. Health workers described how some community members trusted health workers that used mHealth while others were sceptical. Health workers pointed to problems when clients needed to own their own phones. Health workers' use and perceptions of mHealth could be influenced by factors tied to costs, the health worker, the technology, the health system and society, poor network access, and poor access to electricity: some health workers did not mind covering extra costs. Others complained that phone credit was not delivered on time. Health workers who were accustomed to using mobile phones were sometimes more positive towards mHealth. Others with less experience, were sometimes embarrassed about making mistakes in front of clients or worried about job security. Health workers wanted training, technical support, user-friendly devices, and systems that were integrated into existing electronic health systems. The main challenges health workers experienced were poor network connections, access to electricity, and the cost of recharging phones. Other problems included damaged phones. Factors outside the health system also influenced how health workers experienced mHealth, including language, gender, and poverty issues. Health workers felt that their commitment to clients helped them cope with these challenges. AUTHORS' CONCLUSIONS Our findings propose a nuanced view about mHealth programmes. The complexities of healthcare delivery and human interactions defy simplistic conclusions on how health workers will perceive and experience their use of mHealth. Perceptions reflect the interplay between the technology, contexts, and human attributes. Detailed descriptions of the programme, implementation processes and contexts, alongside effectiveness studies, will help to unravel this interplay to formulate hypotheses regarding the effectiveness of mHealth.
Collapse
Affiliation(s)
- Willem A Odendaal
- South African Medical Research CouncilHealth Systems Research UnitCape TownWestern CapeSouth Africa
- Stellenbosch UniversityDepartment of PsychiatryCape TownSouth Africa
| | | | - Natalie Leon
- South African Medical Research CouncilHealth Systems Research UnitCape TownWestern CapeSouth Africa
- Brown UniversitySchool of Public HealthProvidenceRhode IslandUSA
| | - Jane Goudge
- University of the WitwatersrandCentre for Health Policy, School of Public Health, Faculty of Health SciencesJohannesburgSouth Africa
| | - Frances Griffiths
- University of WarwickWarwick Medical SchoolCoventryUK
- University of the WitwatersrandCentre for Health Policy, School of Public Health, Faculty of Health SciencesJohannesburgSouth Africa
| | - Mark Tomlinson
- Stellenbosch UniversityInstitute for Life Course Health Research, Department of Global HealthCape TownSouth Africa
- Queens UniversitySchool of Nursing and MidwiferyBelfastUK
| | - Karen Daniels
- South African Medical Research CouncilHealth Systems Research UnitCape TownWestern CapeSouth Africa
- University of Cape TownHealth Policy and Systems Division, School of Public Health and Family MedicineCape TownWestern CapeSouth Africa7925
| | | |
Collapse
|
8
|
Zinsstag J, Crump L, Schelling E, Hattendorf J, Maidane YO, Ali KO, Muhummed A, Umer AA, Aliyi F, Nooh F, Abdikadir MI, Ali SM, Hartinger S, Mäusezahl D, de White MBG, Cordon-Rosales C, Castillo DA, McCracken J, Abakar F, Cercamondi C, Emmenegger S, Maier E, Karanja S, Bolon I, de Castañeda RR, Bonfoh B, Tschopp R, Probst-Hensch N, Cissé G. Climate change and One Health. FEMS Microbiol Lett 2019; 365:4961133. [PMID: 29790983 PMCID: PMC5963300 DOI: 10.1093/femsle/fny085] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 04/03/2018] [Indexed: 12/19/2022] Open
Abstract
The journal The Lancet recently published a countdown on health and climate change. Attention was focused solely on humans. However, animals, including wildlife, livestock and pets, may also be impacted by climate change. Complementary to the high relevance of awareness rising for protecting humans against climate change, here we present a One Health approach, which aims at the simultaneous protection of humans, animals and the environment from climate change impacts (climate change adaptation). We postulate that integrated approaches save human and animal lives and reduce costs when compared to public and animal health sectors working separately. A One Health approach to climate change adaptation may significantly contribute to food security with emphasis on animal source foods, extensive livestock systems, particularly ruminant livestock, environmental sanitation, and steps towards regional and global integrated syndromic surveillance and response systems. The cost of outbreaks of emerging vector-borne zoonotic pathogens may be much lower if they are detected early in the vector or in livestock rather than later in humans. Therefore, integrated community-based surveillance of zoonoses is a promising avenue to reduce health effects of climate change.
Collapse
Affiliation(s)
- Jakob Zinsstag
- Swiss Tropical and Public Health Institute, PO Box, 4002 Basel, Switzerland.,University of Basel, Petersplatz 1, 4003 Basel, Switzerland
| | - Lisa Crump
- Swiss Tropical and Public Health Institute, PO Box, 4002 Basel, Switzerland.,University of Basel, Petersplatz 1, 4003 Basel, Switzerland
| | - Esther Schelling
- Swiss Tropical and Public Health Institute, PO Box, 4002 Basel, Switzerland.,University of Basel, Petersplatz 1, 4003 Basel, Switzerland
| | - Jan Hattendorf
- Swiss Tropical and Public Health Institute, PO Box, 4002 Basel, Switzerland.,University of Basel, Petersplatz 1, 4003 Basel, Switzerland
| | - Yahya Osman Maidane
- Swiss Tropical and Public Health Institute, PO Box, 4002 Basel, Switzerland.,University of Basel, Petersplatz 1, 4003 Basel, Switzerland.,University of Jigjiga, Jigjiga University One Health Initiative, PO Box 1020, Jigjiga, Ethiopia
| | - Kadra Osman Ali
- Swiss Tropical and Public Health Institute, PO Box, 4002 Basel, Switzerland.,University of Basel, Petersplatz 1, 4003 Basel, Switzerland.,University of Jigjiga, Jigjiga University One Health Initiative, PO Box 1020, Jigjiga, Ethiopia
| | - Abdifatah Muhummed
- Swiss Tropical and Public Health Institute, PO Box, 4002 Basel, Switzerland.,University of Basel, Petersplatz 1, 4003 Basel, Switzerland.,University of Jigjiga, Jigjiga University One Health Initiative, PO Box 1020, Jigjiga, Ethiopia
| | - Abdurezak Adem Umer
- Swiss Tropical and Public Health Institute, PO Box, 4002 Basel, Switzerland.,University of Basel, Petersplatz 1, 4003 Basel, Switzerland.,University of Jigjiga, Jigjiga University One Health Initiative, PO Box 1020, Jigjiga, Ethiopia
| | - Ferzua Aliyi
- Swiss Tropical and Public Health Institute, PO Box, 4002 Basel, Switzerland.,University of Basel, Petersplatz 1, 4003 Basel, Switzerland.,University of Jigjiga, Jigjiga University One Health Initiative, PO Box 1020, Jigjiga, Ethiopia
| | - Faisal Nooh
- Swiss Tropical and Public Health Institute, PO Box, 4002 Basel, Switzerland.,University of Basel, Petersplatz 1, 4003 Basel, Switzerland.,University of Jigjiga, Jigjiga University One Health Initiative, PO Box 1020, Jigjiga, Ethiopia
| | - Mohammed Ibrahim Abdikadir
- Swiss Tropical and Public Health Institute, PO Box, 4002 Basel, Switzerland.,University of Basel, Petersplatz 1, 4003 Basel, Switzerland.,University of Jigjiga, Jigjiga University One Health Initiative, PO Box 1020, Jigjiga, Ethiopia
| | - Seid Mohammed Ali
- Swiss Tropical and Public Health Institute, PO Box, 4002 Basel, Switzerland.,University of Basel, Petersplatz 1, 4003 Basel, Switzerland.,University of Jigjiga, Jigjiga University One Health Initiative, PO Box 1020, Jigjiga, Ethiopia
| | - Stella Hartinger
- Swiss Tropical and Public Health Institute, PO Box, 4002 Basel, Switzerland.,University of Basel, Petersplatz 1, 4003 Basel, Switzerland.,Universidad Peruana Cayetano Heredia, Public Health School, Lima, Peru, 15102
| | - Daniel Mäusezahl
- Swiss Tropical and Public Health Institute, PO Box, 4002 Basel, Switzerland.,University of Basel, Petersplatz 1, 4003 Basel, Switzerland
| | - Monica Berger Gonzalez de White
- Swiss Tropical and Public Health Institute, PO Box, 4002 Basel, Switzerland.,University of Basel, Petersplatz 1, 4003 Basel, Switzerland.,Universidad del Valle, Guatemala City, Guatemala, 01015
| | | | | | | | - Fayiz Abakar
- Institut de Recherches en Elevage pour le Développement, BP 433, N'Djaména, Chad
| | - Colin Cercamondi
- Swiss Federal Institute of Technology (ETH), 8092 Zürich, Switzerland
| | - Sandro Emmenegger
- University of Applied Sciences, Institute for Information and Process Management, 9000 St. Gallen, Switzerland
| | - Edith Maier
- University of Applied Sciences, Institute for Information and Process Management, 9000 St. Gallen, Switzerland
| | - Simon Karanja
- Jomo Kenyatta University, School of Public Health, 00200 Nairobi, Kenya
| | - Isabelle Bolon
- Institute of Global Health, Faculty of Medicine, University of Geneva, 1202 Geneva, Switzerland
| | | | - Bassirou Bonfoh
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, 01 BP 1303 Abidjan 01, Côte d'Ivoire
| | - Rea Tschopp
- Swiss Tropical and Public Health Institute, PO Box, 4002 Basel, Switzerland.,University of Basel, Petersplatz 1, 4003 Basel, Switzerland.,Armauer Hansen Research Institute, PO Box 1005, Addis Ababa, Ethiopia
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, PO Box, 4002 Basel, Switzerland.,University of Basel, Petersplatz 1, 4003 Basel, Switzerland
| | - Guéladio Cissé
- Swiss Tropical and Public Health Institute, PO Box, 4002 Basel, Switzerland.,University of Basel, Petersplatz 1, 4003 Basel, Switzerland
| |
Collapse
|
9
|
Beyene TJ, Asfaw F, Getachew Y, Tufa TB, Collins I, Beyi AF, Revie CW. A Smartphone-Based Application Improves the Accuracy, Completeness, and Timeliness of Cattle Disease Reporting and Surveillance in Ethiopia. Front Vet Sci 2018; 5:2. [PMID: 29387688 PMCID: PMC5776010 DOI: 10.3389/fvets.2018.00002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 01/04/2018] [Indexed: 12/04/2022] Open
Abstract
Accurate disease reporting, ideally in near real time, is a prerequisite to detecting disease outbreaks and implementing appropriate measures for their control. This study compared the performance of the traditional paper-based approach to animal disease reporting in Ethiopia to one using an application running on smartphones. In the traditional approach, the total number of cases for each disease or syndrome was aggregated by animal species and reported to each administrative level at monthly intervals; while in the case of the smartphone application demographic information, a detailed list of presenting signs, in addition to the putative disease diagnosis were immediately available to all administrative levels via a Cloud-based server. While the smartphone-based approach resulted in much more timely reporting, there were delays due to limited connectivity; these ranged on average from 2 days (in well-connected areas) up to 13 days (in more rural locations). We outline the challenges that would likely be associated with any widespread rollout of a smartphone-based approach such as the one described in this study but demonstrate that in the long run the approach offers significant benefits in terms of timeliness of disease reporting, improved data integrity and greatly improved animal disease surveillance.
Collapse
Affiliation(s)
- Tariku Jibat Beyene
- College of Veterinary Medicine and Agriculture, Addis Ababa University, Bishoftu, Ethiopia
- Department of Diagnostic Medicine and Pathobiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS, United States
| | - Fentahun Asfaw
- College of Veterinary Medicine and Agriculture, Addis Ababa University, Bishoftu, Ethiopia
| | - Yitbarek Getachew
- College of Veterinary Medicine and Agriculture, Addis Ababa University, Bishoftu, Ethiopia
| | - Takele Beyene Tufa
- College of Veterinary Medicine and Agriculture, Addis Ababa University, Bishoftu, Ethiopia
| | | | - Ashenafi Feyisa Beyi
- College of Veterinary Medicine and Agriculture, Addis Ababa University, Bishoftu, Ethiopia
- Department of Animal Sciences, University of Florida, Gainesville, FL, United States
| | - Crawford W. Revie
- Department of Health Management, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PEI, Canada
| |
Collapse
|