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Walter YO, Atim P, Amone D, Peter AS, Tabo GO. Attitudes of female market vendors of reproductive age towards use of mobile phones and access to family planning self-care interventions in Northern Uganda: a cross-sectional study. BMC Med Inform Decis Mak 2024; 24:164. [PMID: 38867227 PMCID: PMC11167777 DOI: 10.1186/s12911-024-02565-5] [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: 09/30/2023] [Accepted: 06/04/2024] [Indexed: 06/14/2024] Open
Abstract
BACKGROUND Mobile phones are potential digital technologies for accessing family planning self-care interventions. However, their utilization could be possible if women of reproductive age have positive attitudes towards the use of this technology for healthcare purposes. This study aimed to examine the relationship between attitudes towards the use of mobile phones and access to family planning self-care interventions among female market vendors of reproductive age in northern Uganda. METHODS A cross-sectional survey design was used. Two hundred and five randomly selected female vendors from the Gulu city main market participated. A structured researcher-administered questionnaire was used to collect the data. Descriptive statistics and standard multiple regression were performed, and the data were analysed using SPSS software version 15. RESULTS Of the 205 participants, 112 (54.6%) reported using smartphones, and 147 (71.7%) were aware of family planning self-care interventions. Participants had moderate attitudes towards access to family planning self-care interventions (mean = 3.18), positive attitudes towards ease of use (mean = 3.31) and usefulness of mobile phones (mean = 3.30), strong positive attitudes towards privacy (mean = 4.04), and skills associated with using mobile phones (mean = 4.04). Furthermore, significant positive relationships existed between ease of use (p value = 0.000), skills (p value = 0.001), privacy (p value = 0.002) and access to family planning self-care interventions. There was, however, an insignificant positive relationship between mobile phone usefulness and access to family planning self-care interventions (p value = 0.189). CONCLUSIONS Participants' positive attitudes towards the use of mobile phones could lead to access to FP self-care interventions, although uncertainty about the usefulness of the use of mobile phones for accessing FP self-care interventions exists. It is therefore important for healthcare practitioners, health development partners and the government to encourage and integrate the use of mHealth into regular FP self-care services and promotional activities while targeting underserved communities in Uganda.
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Affiliation(s)
- Yagos Onen Walter
- Department of Library and Information Service, Medical Library, Gulu University, Kampala, Uganda.
| | - Pamela Atim
- Department of Public Health, Faculty of Medicine, Gulu University, Kampala, Uganda
| | - Derrick Amone
- Department of Surgery, Faculty of Medicine, Gulu University, Gulu, Kampala, Uganda
| | - Alarakol Simon Peter
- Department of Biochemistry, Faculty of Medicine, Gulu University, Kampala, Uganda
| | - Geoffrey Olok Tabo
- Department of Computer Science, Faculty of Science, Gulu University, Kampala, Uganda
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Mwanzia L, Baliddawa J, Biederman E, Perkins SM, Champion VL. Promoting childbirth in a rural health facility: A quasi-experimental study in western Kenya. Birth 2024; 51:319-325. [PMID: 37902183 DOI: 10.1111/birt.12788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 10/04/2023] [Accepted: 10/05/2023] [Indexed: 10/31/2023]
Abstract
BACKGROUND The high maternal and neonatal mortality rate in sub-Saharan Africa could be reduced by using navigation by means of mobile devices to increase the number of women who choose to give birth in a health center (HC) with a skilled healthcare practitioner. METHODS A quasi-experimental design was used to test a midwife-delivered navigation by means of mobile phone. A total of 208 women were randomized to two groups (intervention and control). Women in the intervention group received up to three navigation calls from midwives. Women in the control group received usual antenatal education during prenatal visits. Data were collected using semistructured questionnaires. Childbirth location was determined through medical records. RESULTS Overall, 180 (87%) women gave birth in a HC with a 3% advantage for the intervention group. A total of 86% (88/102) of the control group gave birth in a HC versus 89% (92/103) for the intervention group (Χ2 = 0.44, p-value = 0.51), with an unadjusted odds ratio of 1.33 (95% CI: 0.57, 3.09). Among those with personal phones, 91% (138/152) had a birth in a HC versus 79% (42/53) in those without a personal phone (Χ2 = 4.89, p-value = 0.03). CONCLUSIONS The results of this study indicate that it is feasible to deliver phone-based navigation to support birth in a HC; personal phone ownership may be a factor in the success of this strategy.
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Affiliation(s)
- Lydia Mwanzia
- Department of Midwifery and Gender, College of Health Sciences, Moi University, Eldoret, Kenya
| | - Joyce Baliddawa
- Department of Behavioural Sciences and Mental Health, School of Medicine, Moi University, Eldoret, Kenya
| | - Erika Biederman
- The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Susan M Perkins
- Department of Biostatistics and Health Data Science, School of Medicine and Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana, USA
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Shannon K, Burridge J, Franklin B, Bhushan S, Hilsenbeck S, Petrova EV, N’Dow J, Iwuh I, Anandasabapathy S, Wilkinson JP. Gambian Mothers Lack Obstetric Danger Sign Knowledge, But Educational Intervention Shows Promise. Ann Glob Health 2024; 90:31. [PMID: 38800705 PMCID: PMC11122691 DOI: 10.5334/aogh.3930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 01/02/2024] [Indexed: 05/29/2024] Open
Abstract
Background The Gambia has the 12th highest maternal mortality rate in the world, with 80% of deaths resulting from avoidable causes. Unawareness of pregnancy danger signs (DS) has been shown to be a barrier to seeking obstetric care, while app-based education intervention has shown promise. Objective We aim to assess patient awareness of DS, identify barriers to awareness, and evaluate potential for implementing smartphone-based technologies for education. Methods A cross-sectional semi-structured survey was administered to Gambian women (n = 100) across five hospitals/health centers. Data and informed consent were collected via an online survey portal. Analysis included bivariate analysis and descriptive statistics with p < 0.05 significance level. Recall of 0-2 DS per category was classified as "low" knowledge, 3-5 as "moderate" knowledge, and 6+ as "sufficient" knowledge. Cross-category recall was quantified for overall awareness level (0-6 = "low", 7-12 = "moderate", 13+ = "sufficient". N = 28 total DS). Findings Although 75% of participants (n = 100) self-perceived "sufficient" knowledge of DS, the average recall was only two (SD = 2, n = 11) pregnancy DS, one labor and delivery DS (SD = 1, n = 8), and one postpartum DS (SD = 1, n = 9). Twenty-one women were unable to recall any danger signs. "Low" awareness was identified in 77% of women, while 23%, and 0% of women showed "moderate" and "sufficient" overall awareness, respectively. Education level was significantly correlated with overall danger sign recall (ρ(98) = .243, p = .015) and awareness level (ρ(98) = .265, p = .008). Monthly income was significantly correlated with awareness level (ρ(97) = .311, p = .002). Smartphone ownership was reported by 76% of women, and 97% expressed interest in using app-based video (94%) or provider (93%) teaching. Conclusions Women had low knowledge of obstetric danger signs, and true awareness of danger signs was remarkably lower than self-perceived knowledge. However, patients exhibited proper healthcare-seeking behavior when danger signs arose. Findings suggest that video- or messaging-based education from local healthcare providers may be effective DS educational interventions.
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Affiliation(s)
- Kara Shannon
- School of Medicine, Baylor College of Medicine, Houston, TX, USA
| | | | | | | | - Susan Hilsenbeck
- Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA
| | | | - James N’Dow
- Baylor Global Health, Houston, TX, USA
- Horizons Trust Gambia, The Gambia
| | - Ibezimako Iwuh
- Academic Urology Unit, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA
| | | | - Jeffrey P. Wilkinson
- Academic Urology Unit, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA
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Nagraj S, Kennedy S, Jha V, Norton R, Hinton L, Billot L, Rajan E, Mohammed Abdul A, Phalswal A, Arora V, Praveen D, Hirst J. A Mobile Clinical Decision Support System for High-Risk Pregnant Women in Rural India (SMARThealth Pregnancy): Pilot Cluster Randomized Controlled Trial. JMIR Form Res 2023; 7:e44362. [PMID: 37471135 PMCID: PMC10401191 DOI: 10.2196/44362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 06/01/2023] [Accepted: 06/13/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is the leading cause of death in women in India. Early identification is crucial to reducing deaths. Hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM) carry independent risks for future CVD, and antenatal care is a window to screen and counsel high-risk women. In rural India, community health workers (CHWs) deliver antenatal and postnatal care. We developed a complex intervention (SMARThealth Pregnancy) involving mobile clinical decision support for CHWs and evaluated it in a pilot cluster randomized controlled trial (cRCT). OBJECTIVE The aim of the study is to co-design a theory-informed intervention for CHWs to screen, refer, and counsel pregnant women at high risk of future CVD in rural India and evaluate its feasibility and acceptability. METHODS In phase 1, we used qualitative methods to explore community priorities for high-risk pregnant women in rural areas of 2 diverse states in India. In phase 2, informed by behavior change theory and human-centered design, we used these qualitative data to develop the intervention components and implementation strategies for SMARThealth Pregnancy in an iterative process with end users. In phase 3, using mixed methods, we evaluated the intervention in a cRCT with an embedded qualitative substudy across 4 primary health centres: 2 in Jhajjar district, Haryana, and 2 in Guntur district, Andhra Pradesh. RESULTS SMARThealth Pregnancy embedded a total of 15 behavior change techniques and included (1) community awareness programs; (2) targeted training, including point-of-care blood pressure and hemoglobin measurement; and (3) mobile clinical decision support for CHWs to screen women in their homes. The intervention focused on 3 priority conditions: anemia, HDP, and GDM. The evaluation involved a total of 200 pregnant women, equally randomized to intervention or enhanced standard care (control). Recruitment was completed within 5 months, with minimal loss to follow-up (4/200, 2%) at 6 weeks postpartum. A total of 4 primary care doctors and 54 CHWs in the intervention clusters took part in the study. Fidelity to intervention practices was 100% prepandemic. Over half the study population was affected by moderate to severe anemia at baseline. The prevalence of HDP (2.5%) and GDM (2%) was low in our study population. Results suggest a possible improvement in mean hemoglobin (anemia) in the intervention group, although an adequately powered trial is needed. The model of home-based care was feasible and acceptable for pregnant or postpartum women and CHWs, who perceived improvements in quality of care, self-efficacy, and professional recognition. CONCLUSIONS SMARThealth Pregnancy is an innovative model of home-based care for high-risk pregnant women during the transitions between antenatal and postnatal care and adult health services. The use of theory and co-design during intervention development facilitated acceptability of the intervention and implementation strategies. Our experience has informed the decision to initiate a larger-scale cRCT. TRIAL REGISTRATION ClinicalTrials.gov NCT03968952; https://clinicaltrials.gov/ct2/show/NCT03968952. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.3389/fgwh.2021.620759.
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Affiliation(s)
- Shobhana Nagraj
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, United Kingdom
- The George Institute for Global Health, Imperial College London, London, United Kingdom
- Health Systems Collaborative, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Oxford University Global Surgery Group, University of Oxford, Oxford, United Kingdom
| | - Stephen Kennedy
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - Vivekananda Jha
- The George Institute for Global Health, Imperial College London, London, United Kingdom
- The George Institute for Global Health, New Delhi, India
- University of New South Wales, Sydney, Australia
- Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
| | - Robyn Norton
- The George Institute for Global Health, Imperial College London, London, United Kingdom
- The George Institute for Global Health, UNSW Sydney, Kensington, Australia
| | - Lisa Hinton
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Laurent Billot
- The George Institute for Global Health, UNSW Sydney, Kensington, Australia
| | - Eldho Rajan
- The George Institute for Global Health, New Delhi, India
| | | | - Anita Phalswal
- The George Institute for Global Health, New Delhi, India
| | - Varun Arora
- Post Graduate Institute of Medical Science, Rohtak, India
| | - Devarsetty Praveen
- The George Institute for Global Health, New Delhi, India
- University of New South Wales, Sydney, Australia
- Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
| | - Jane Hirst
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, United Kingdom
- The George Institute for Global Health, Imperial College London, London, United Kingdom
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Systematic review on the cost and cost-effectiveness of mHealth interventions supporting women during pregnancy. Women Birth 2023; 36:3-10. [PMID: 35339412 DOI: 10.1016/j.wombi.2022.03.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 03/14/2022] [Accepted: 03/16/2022] [Indexed: 01/28/2023]
Abstract
OBJECTIVES The increased integration of digital health into maternity care-alongside growing use of, and access to, personal digital technology among pregnant women-warrants an investigation of the cost-effectiveness of mHealth interventions used by women during pregnancy and the methodological quality of the cost-effectiveness studies. METHODS A systematic search was conducted to identify peer-reviewed studies published in the last ten years (2011-2021) reporting on the costs or cost-effectiveness of mHealth interventions used by women during pregnancy. Available data related to program costs, total incremental costs and incremental cost-effectiveness ratios (ICERs) were reported in 2020 United States Dollars. The quality of cost-effectiveness studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS). FINDINGS Nine articles reporting on eight studies met the inclusion criteria. Direct intervention costs ranged from $7.04 to $86 per woman, total program costs ranged from $241,341 to $331,136 and total incremental costs ranged from -$21.16 to $1.12 million per woman. The following ICERs were reported: $2168 per DALY averted, $203.44 per woman ceasing smoking, and $3475 per QALY gained. The full economic evaluation studies (n = 4) were moderate to high in quality and all reported the mHealth intervention as cost-effective. Other studies (n = 4) were low to moderate in quality and reported low costs or cost savings associated with the implementation of the mHealth intervention. CONCLUSIONS FOR PRACTICE Preliminary evidence suggests mHealth interventions may be cost-effective and "low-cost" but more evidence is needed to ascertain the cost-effectiveness of mHealth interventions regarding positive maternal and child health outcomes and longer-term health service utilisation.
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Katusiime J, Tumuhimbise W, Rwambuka Mugyenyi G, Kobutungi P, Mugaba A, Zender R, Pinkwart N, Musiimenta A. The role of mobile health technologies in promoting COVID-19 prevention: A narrative review of intervention effectiveness and adoption. Digit Health 2022; 8:20552076221131146. [PMID: 36276182 PMCID: PMC9585560 DOI: 10.1177/20552076221131146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 09/20/2022] [Indexed: 11/15/2022] Open
Abstract
Background Researchers have found innovative ways of using mobile health (mHealth) technologies to prevent the spread of coronavirus disease 2019 (COVID-19). However, fewer studies have been done to determine their adoption and effectiveness. Objective This review summarises the published evidence on the effect of mHealth technologies on the adoption of COVID-19 preventive measures, prevention knowledge acquisition and risk perception as well as technology adoption features for COVID-19 prevention. Methods PubMed, IEEE and Google Scholar databases were searched for peer-reviewed literature from 1 January 2020 to 31 March 2022 for studies that evaluated the effect of mHealth technologies on COVID-19 preventive measures adoption, prevention knowledge acquisition and risk perception. Thirteen studies met the inclusion criteria and were included in this review. All the included studies were checked for quality using the mHealth evidence reporting and assessment (mERA) checklist. Results The review found out that the utilisation of mHealth interventions such as alert text messages, tracing apps and social media platforms was associated with adherence behaviour such as wearing masks, washing hands and using sanitisers, maintaining social distance and avoiding crowded places. The use of contact tracing was linked to low-risk perception as users considered themselves well informed about their status and less likely to pose transmission risks compared to non-users. Privacy and security issues, message personalisation and frequency, technical issues and trust concerns were identified as technology adoption features that influence the use of mHealth technologies for promoting COVID-19 prevention. Conclusion Utilisation of mHealth may be a feasible and effective way to prevent the spread of COVID-19. However, the small study samples and short study periods prevent generalisation of the findings and calls for larger, longitudinal studies that encompass diverse study settings.
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Affiliation(s)
- Jane Katusiime
- Department of Computer Science, Humboldt Universität zu Berlin, Berlin, Germany,Faculty of Computing and Informatics, Mbarara University of Science and Technology, Mbarara, Uganda,Jane Katusiime, Department of Computer Science, Humboldt Universität zu Berlin, Unter den Linden 6, 10099 Berlin, Germany.
| | - Wilson Tumuhimbise
- Faculty of Computing and Informatics, Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - Phionah Kobutungi
- Faculty of Computing and Informatics, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Aaron Mugaba
- Faculty of Computing and Informatics, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Raphael Zender
- Department of Computer Science, Humboldt Universität zu Berlin, Berlin, Germany
| | - Niels Pinkwart
- Department of Computer Science, Humboldt Universität zu Berlin, Berlin, Germany
| | - Angella Musiimenta
- Faculty of Computing and Informatics, Mbarara University of Science and Technology, Mbarara, Uganda
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Musiimenta A, Tumuhimbise W, Atukunda EC, Mugaba AT, Asasira J, Katusiime J, Zender R, Pinkwart N, Mugyenyi GR, Haberer JE. A mobile health app may improve maternal and child health knowledge and practices among rural women with limited education in Uganda: a pilot randomized controlled trial. JAMIA Open 2022; 5:ooac081. [PMID: 36225894 PMCID: PMC9542753 DOI: 10.1093/jamiaopen/ooac081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 08/24/2022] [Accepted: 09/21/2022] [Indexed: 11/06/2022] Open
Abstract
Objective This article describes the impact of a mobile health app (MatHealth App) on maternal and child health knowledge and practices among women with limited education. Materials and methods Pregnant women initiating antenatal care (ANC) were randomized (1:1) to the MatHealth App versus routine care. Participants were followed until 6 weeks after delivery. Questionnaires for assessing knowledge and practices were administered to participants from both arms at baseline and endline. Using logistic regression, we estimated the difference in odds of having maternal health knowledge. We reviewed clinic records to capture maternal health practices. Results Of the 80 enrolled participants, 69 (86%) completed the study with a median follow-up of 6 months. Women in the MatHealth arm had 8.2 (P = .19), 3.6 (P = .14), and 6.4 (P = .25), respectively higher odds of knowing (1) the recommended gestation period for starting ANC, (2) the recommended number of ANC visits, and (3) the timing and frequency of recommended human immunodeficiency virus (HIV) testing, respectively, compared to those in the routine care arm. All women in the MatHealth App arm exclusively breastfed their babies, and brought them at 6 weeks for HIV testing, compared to the routine care arm. Just over half of the women attended at least 4 prenatal visits across the 2 arms. The main reason for noncompliance to ANC appointments was a lack of transport to the clinic. Discussion and conclusion The app increased knowledge and practices although not reaching statistical significance. Future efforts can focus on addressing social and economic issues and assessing clinical outcomes.
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Affiliation(s)
- Angella Musiimenta
- Corresponding Author: Angella Musiimenta, PhD, Department of Information Technology, Mbarara University of Science and Technology, P.O. Box 653, Mbarara, Uganda;
| | - Wilson Tumuhimbise
- Department of Information Technology, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Esther C Atukunda
- Department of Information Technology, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Aaron T Mugaba
- Department of Information Technology, Mbarara University of Science and Technology, Mbarara, Uganda,Angels Compassion Research and Development Initiative, Mbarara, Uganda
| | - Justus Asasira
- Department of Information Technology, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Jane Katusiime
- Department of Information Technology, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Raphael Zender
- Department of Computer Science, Humboldt Universitat zu Berlin, Berlin, Germany
| | - Niels Pinkwart
- Department of Computer Science, Humboldt Universitat zu Berlin, Berlin, Germany
| | | | - Jessica E Haberer
- Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts, USA,Medicine Department, Harvard Medical School, Boston, Massachusetts, USA
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Musiimenta A, Tumuhimbise W, Atukunda EC, Ayebaza S, Kobutungi P, Mugaba AT, Asasira J, Mugyenyi GR, Katusiime J, Zender R, Pinkwart N, Haberer JE. Challenges in accessing maternal and child health services during COVID-19 and the potential role of social networking technologies. Digit Health 2022; 8:20552076221086769. [PMID: 35401999 PMCID: PMC8984853 DOI: 10.1177/20552076221086769] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 12/09/2021] [Accepted: 02/16/2022] [Indexed: 01/29/2023] Open
Abstract
Background The COVID-19 pandemic causes new challenges to women and their babies who still need to access postnatal care amidst the crisis. The novel application of social network technologies (SNTs) could potentially enhance access to healthcare during this difficult time. Objectives This study describes the challenges experienced in accessing maternal and child health services by women with limited or no education during this COVID-19 pandemic and discusses the potential of SNTs to support maternal and child health amidst this crisis. Methods We administered surveys to women who had recently given birth in a rural setting and interviewed a purposively selected subset to ascertain their experiences of accessing maternal and child health services during the COVID-19 pandemic. Our analysis involved descriptive analysis of quantitative data using STATA 13 to describe study participants' characteristics, and content analysis of qualitative data to derive categories describing maternal health challenges. Results Among 50 women, the median age was 28 years (interquartile range 24-34), 42 (84%) completed upper primary education. Access to the health facility was constrained by transport challenges, fear of contracting COVID-19, and delays at the facility. Due to the COVID-19 crisis, 42 (84%) women missed facility visits, 46 (92%) experienced financial distress, 43 (86%) had food insecurity, and 44 (88%) felt stressed. SNTs can facilitate remote and timely access to health services and information, and enable virtual social connections and support. Conclusion SNTs have the potential to mitigate the challenges faced in accessing maternal and child health services amidst the ongoing COVID-19 pandemic.
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Affiliation(s)
- Angella Musiimenta
- Mbarara University of Science and
Technology, Uganda,Angels Compassion Organization, Uganda,Angella Musiimenta, Department of
Information Technology, Mbarara University of Science and Technology, P.O. Box
653, Mbarara, Uganda.
| | | | | | | | | | - Aaron T Mugaba
- Mbarara University of Science and
Technology, Uganda,Angels Compassion Organization, Uganda
| | | | | | | | | | | | - Jessica E Haberer
- Harvard Medical School, USA,Massachusetts General
Hospital Center for Global Health, USA
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9
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Tumuhimbise W, Musiimenta A. A review of mobile health interventions for public private mix in tuberculosis care. Internet Interv 2021; 25:100417. [PMID: 34401376 PMCID: PMC8350595 DOI: 10.1016/j.invent.2021.100417] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 06/04/2021] [Accepted: 06/11/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The World Health Organization (WHO) recommends the use of mobile health (mHealth) technologies as emerging opportunities to closing the gaps in Tuberculosis (TB) care through enhancing Public Private Mix (PPM). However, little is known about mHealth interventions that have been used for enhancing PPM in TB care, those that worked and those that did not. OBJECTIVE This review summarizes the published evidence on the utilization and effectiveness of mHealth interventions for public private mix in TB care from literature. METHODS Google scholar, PUBMED, IEEE Xplore and ScienceDirect databases were searched for peer reviewed literature from 1st January 2003 to 31st December 2020 for studies about the mHealth interventions for public private mix in TB care. This was guided by the scoping review methodology proposed by Arksey and O' Malley. In order to assess the quality of the selected studies, mHealth evidence reporting and assessment (mERA) checklist was utilized. Studies that discussed the utilization of mHealth interventions for implementing PPM in TB care were included. Nine studies met the inclusion criteria and were analyzed for review. RESULTS The review found out the application of mHealth in Public Private Mix in TB care through the following ways; 1) TB screening, 2) TB case notification 3) TB treatment adherence 4) data collection and management 5) patient referral and follow up, and 6) education. This resulted into high user experience, significant time reduction in data aggregation, increased case notification and referrals and proactive tracking and provision of follow up care hence reduced treatment and completion gaps. One study yielded suboptimal utilization due to the technical and operational challenges encountered by the healthcare workers. CONCLUSION Although this scoping review highlights the role of mHealth technologies in enhancing PPM in TB care, its utilization is still limited in African settings. No Africa-based study was identified by this review. Future studies should focus on assessing the utilization of mHealth for PPM in Africa.
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Affiliation(s)
| | - Angella Musiimenta
- Mbarara University of Science and Technology, Mbarara, Uganda
- Angels Compassion Research and Development Initiative, Mbarara, Uganda
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10
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Musiimenta A, Tumuhimbise W, Pinkwart N, Katusiime J, Mugyenyi G, Atukunda EC. A mobile phone-based multimedia intervention to support maternal health is acceptable and feasible among illiterate pregnant women in Uganda: Qualitative findings from a pilot randomized controlled trial. Digit Health 2021; 7:2055207620986296. [PMID: 33717497 PMCID: PMC7917428 DOI: 10.1177/2055207620986296] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 12/11/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Uganda's maternal mortality rate remains unacceptably high. Mobile phones can potentially provide affordable means of accessing maternal health services even among the otherwise hard-to-reach populations. Evidence about the acceptability and feasibility of mobile phone-based interventions targeting illiterate women, however, is limited. OBJECTIVE To assess the acceptability and feasibility of a mobile phone-based multimedia application (MatHealth app) to support maternal health amongst illiterate pregnant women in rural southwestern Uganda. METHODS 80 pregnant women initiating antenatal care from Mbarara regional referral hospital were enrolled in a pilot randomized controlled trial and followed until six weeks after delivery. The 40 women in the intervention group received a MatHealth app composed of educational videos/audios, clinic appointment reminders, and the calling function. Qualitative interviews on acceptability of this technology were carried out with 30 of the intervention participants. An inductive, content analytic approach was used to analyze qualitative data. Quantitative feasibility data were recorded and summarized descriptively. RESULTS Participants reported that the intervention is acceptable as it enabled them adopt good maternal health practices, enhanced social support from spouses, provided clinic appointment reminders, and facilitated communication with healthcare providers. Challenges included: phone sharing (74%), accidental deletion of the application 15 (43%), lack of electricity 15 (43%), and inability to set up a reminder function 20 (57%). CONCLUSION The MatHealth app is an acceptable and feasible intervention among illiterate women, in a resource limited setting. Future efforts should focus on optimized application design, spouse orientation, and incorporating economic support to overcome the challenges we encountered.
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Affiliation(s)
- Angella Musiimenta
- Department of Information Technology, Mbarara, Mbarara University of Science and Technology, Uganda
- Angels Compassion Organisation, Mbarara, Uganda
| | - Wilson Tumuhimbise
- Department of Information Technology, Mbarara, Mbarara University of Science and Technology, Uganda
| | - Niels Pinkwart
- Computer Science Department, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Jane Katusiime
- Department of Information Technology, Mbarara, Mbarara University of Science and Technology, Uganda
| | - Godfrey Mugyenyi
- Department of Information Technology, Mbarara, Mbarara University of Science and Technology, Uganda
| | - Esther C Atukunda
- Department of Information Technology, Mbarara, Mbarara University of Science and Technology, Uganda
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