Josefien van Olmen1,2, Erica Erwin3,4, Ana Cristina García-Ulloa5, Bruno Meessen6, J Jaime Miranda7,8, Kirsty Bobrow9,10, Juliet Iwelunmore11, Ucheoma Nwaozuru11, Chisom Obiezu Umeh12, Carter Smith13, Chris Harding14, Pratap Kumar15, Clicerio Gonzales5, Sergio Hernández-Jiménez5, Karen Yeates12,16. 1. Primary and Interdisciplinary Care, University of Antwerp, Antwerpen, 1000, Belgium. 2. Department of Public Health, Institute of Tropical Medicine, Antwerp, Antwerpen, 1000, Belgium. 3. Global Health Research Office, Queen's University, Ontario, Canada. 4. Pamoja Tunaweza Research Center, Moshi, Tanzania. 5. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico. 6. Collectivity, Brussels, Belgium. 7. CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru. 8. School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru. 9. University of CapeTown, Capetown, South Africa. 10. Oxford University, Oxford, UK. 11. Department of Behavioral Science and Health Education, St. Louis University Salus Center, Sint Louis, USA. 12. College of Global Public Health, New York University, New York, USA. 13. Faculty of Health Sciences, Queen's University, Ontario, Canada. 14. ConnectMed, Nairobi, Kenya. 15. Strathmore Business School, Institute of Healthcare Management, Nairobi, Kenya. 16. Medicine, Queen's University, Ontario, Canada.
Abstract
Background: Mobile health (mHealth) has been hailed as a potential gamechanger for non-communicable disease (NCD) management, especially in low- and middle-income countries (LMIC). Individual studies illustrate barriers to implementation and scale-up, but an overview of implementation issues for NCD mHealth interventions in LMIC is lacking. This paper explores implementation issues from two perspectives: information in published papers and field-based knowledge by people working in this field. Methods: Through a scoping review publications on mHealth interventions for NCDs in LMIC were identified and assessed with the WHO mHealth Evidence Reporting and Assessment (mERA) tool. A two-stage web-based survey on implementation barriers was performed within a NCD research network and through two online platforms on mHealth targeting researchers and implementors. Results: 16 studies were included in the scoping review. Short Message Service (SMS) messaging was the main implementation tool. Most studies focused on patient-centered outcomes. Most studies did not report on process measures and on contextual conditions influencing implementation decisions. Few publications reported on implementation barriers. The websurvey included twelve projects and the responses revealed additional information, especially on practical barriers related to the patients' characteristics, low demand, technical requirements, integration with health services and with the wider context. Many interventions used low-cost software and devices with limited capacity that not allowed linkage with routine data or patient records, which incurred fragmented delivery and increased workload. Conclusion: Text messaging is a dominant mHealth tool for patient-directed of quality improvement interventions in LMIC. Publications report little on implementation barriers, while a questionnaire among implementors reveals significant barriers and strategies to address them. This information is relevant for decisions on scale-up of mHealth in the domain of NCD. Further knowledge should be gathered on implementation issues, and the conditions that allow universal coverage. Copyright:
Background: Mobile health (mHealth) has been hailed as a potential gamechanger for non-communicable disease (NCD) management, especially in low- and middle-income countries (LMIC). Individual studies illustrate barriers to implementation and scale-up, but an overview of implementation issues for NCD mHealth interventions in LMIC is lacking. This paper explores implementation issues from two perspectives: information in published papers and field-based knowledge by people working in this field. Methods: Through a scoping review publications on mHealth interventions for NCDs in LMIC were identified and assessed with the WHO mHealth Evidence Reporting and Assessment (mERA) tool. A two-stage web-based survey on implementation barriers was performed within a NCD research network and through two online platforms on mHealth targeting researchers and implementors. Results: 16 studies were included in the scoping review. Short Message Service (SMS) messaging was the main implementation tool. Most studies focused on patient-centered outcomes. Most studies did not report on process measures and on contextual conditions influencing implementation decisions. Few publications reported on implementation barriers. The websurvey included twelve projects and the responses revealed additional information, especially on practical barriers related to the patients' characteristics, low demand, technical requirements, integration with health services and with the wider context. Many interventions used low-cost software and devices with limited capacity that not allowed linkage with routine data or patient records, which incurred fragmented delivery and increased workload. Conclusion: Text messaging is a dominant mHealth tool for patient-directed of quality improvement interventions in LMIC. Publications report little on implementation barriers, while a questionnaire among implementors reveals significant barriers and strategies to address them. This information is relevant for decisions on scale-up of mHealth in the domain of NCD. Further knowledge should be gathered on implementation issues, and the conditions that allow universal coverage. Copyright:
Authors: Fakir M Amirul Islam; Elisabeth A Lambert; Sheikh Mohammed Shariful Islam; M Arzan Hosen; Bruce R Thompson; Gavin W Lambert Journal: BMC Public Health Date: 2021-12-30 Impact factor: 3.295
Authors: Joanna Morrison; Kohenour Akter; Hannah Jennings; Naveed Ahmed; Sanjit Kumer Shaha; Abdul Kuddus; Tasmin Nahar; Carina King; Hassan Haghparast-Bidgoli; A K Azad Khan; Anthony Costello; Kishwar Azad; Edward Fottrell Journal: Glob Public Health Date: 2021-05-08