Assessing the feasibility of eHealth and mHealth: a systematic review and analysis of initiatives implemented in Kenya

Njoroge, Martin; Zurovac, Dejan; Ogara, Esther A. A.; Chuma, Jane; Kirigia, Doris

doi:10.1186/s13104-017-2416-0

Cited by 83 publications

(80 citation statements)

References 35 publications

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“…A unique aspect of this study was the use of the MAPS Toolkit, which allowed for comprehensive evaluation of the major components needed to introduce and adopt the EIRs as part of the scale-up plan. The EIRs deployed in Tanzania and Zambia were planned for scale prior to piloting the systems; this is a rare occurrence in LMICs where limited numbers of DHIs are scaled following a pilot or "proof-of-concept" deployment [6,7,17]. The variability in the success of EIR adoption is seen by the range of use amongst districts across each country.…”

Section: Discussionmentioning

confidence: 99%

“…Findings from this study help to provide needed context to understand the degree of sustained use, which in turn influences the resulting immunization coverage. Successfully scaling up of a DHI is contingent on the intervention demonstrating an impact on health outcomes, which continues to remain a challenge as there are few studies that assess impact on clinical outcomes in LMICs [6,17,24]. Researchers and policy makers have recognized that an implementation science agenda is needed to help expand the breadth of relevant evidence available for DHIs, this includes conducting more mixed methods and quasi-experimental studies that can help understand the influence of contextual factors on implementation of an intervention [26].…”

Section: Discussionmentioning

confidence: 99%

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Perceptions of factors influencing the introduction and adoption of electronic immunization registries in Tanzania and Zambia: a mixed methods study

Dolan

Alao

Mwansa

et al. 2020

Implement Sci Commun

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Background: As technology has become cheaper and more accessible, health programs are adopting digital health interventions (DHI) to improve the provision of and demand for health services. These interventions are complex and require strong coordination and support across different health system levels and government departments, and they need significant capacities in technology and information to be properly implemented. Electronic immunization registries (EIRs) are types of DHI used to capture, store, access, and share individual-level, longitudinal health information in digitized records. The BID Initiative worked in partnership with the governments of Tanzania and Zambia to introduce an EIR at the sub-national level in both countries within 5 years as part of a multi-component complex intervention package focusing on data use capacity-building. Methods: We aimed to gather and describe learnings from the BID experience by conducting a framework-based mixed methods study to describe perceptions of factors that influenced scale-up of the EIR. Data were collected through key informant interviews, a desk review, EIRs, and health management information systems. We described how implementation of the EIRs fulfilled domains described in our conceptual framework and used cases to illustrate the relationships and relative influence of domains for scale-up and adoption of the EIR. Results: We found that there was no single factor that seemed to influence the introduction or sustained adoption of the EIR as many of the factors were interrelated. For EIR introduction, strong strategic engagement among partners was important, while EIR adoption was influenced by adequate staffing at facilities, training, use of data for supervision, internet and electricity connectivity, and community sensitization. Conclusions: Organizations deploying DHIs in the future should consider how best to adapt their intervention to the existing ecosystem, including human resources and organizational capacity, as well as the changing technological landscape during planning and implementation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Perceptions of factors influencing the introduction and adoption of electronic immunization registries in Tanzania and Zambia: a mixed methods study

Dolan

Alao

Mwansa

et al. 2020

Implement Sci Commun

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“…Also, Gorski et al (2016) found from their meta-analysis that globally, most mHealth projects are located in sub-Saharan Africa [ 16 ]. According to Njoroge et al (2017), the growth of mHealth in sub-Saharan Africa is particularly outstanding in Kenya [ 17 ]. However, former studies have not attempted to quantitatively and systematically assess the mHealth and mobile penetrations in sub-Saharan Africa region.…”

Section: Introductionmentioning

confidence: 99%

Mapping mHealth (mobile health) and mobile penetrations in sub-Saharan Africa for strategic regional collaboration in mHealth scale-up: an application of exploratory spatial data analysis

2017

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BackgroundMobile health (mHealth), a term used for healthcare delivery via mobile devices, has gained attention as an innovative technology for better access to healthcare and support for performance of health workers in the global health context. Despite large expansion of mHealth across sub-Saharan Africa, regional collaboration for scale-up has not made progress since last decade.MethodsAs a groundwork for strategic planning for regional collaboration, the study attempted to identify spatial patterns of mHealth implementation in sub-Saharan Africa using an exploratory spatial data analysis. In order to obtain comprehensive data on the total number of mHelath programs implemented between 2006 and 2016 in each of the 48 sub-Saharan Africa countries, we performed a systematic data collection from various sources, including: the WHO eHealth Database, the World Bank Projects & Operations Database, and the USAID mHealth Database. Additional spatial analysis was performed for mobile cellular subscriptions per 100 people to suggest strategic regional collaboration for improving mobile penetration rates along with the mHealth initiative. Global Moran’s I and Local Indicator of Spatial Association (LISA) were calculated for mHealth programs and mobile subscriptions per 100 population to investigate spatial autocorrelation, which indicates the presence of local clustering and spatial disparities.ResultsFrom our systematic data collection, the total number of mHealth programs implemented in sub-Saharan Africa between 2006 and 2016 was 487 (same programs implemented in multiple countries were counted separately). Of these, the eastern region with 17 countries and the western region with 16 countries had 287 and 145 mHealth programs, respectively. Despite low levels of global autocorrelation, LISA enabled us to detect meaningful local clusters. Overall, the eastern part of sub-Saharan Africa shows high-high association for mHealth programs. As for mobile subscription rates per 100 population, the northern area shows extensive low-low association.ConclusionsThis study aimed to shed some light on the potential for strategic regional collaboration for scale-up of mHealth and mobile penetration. Firstly, countries in the eastern area with much experience can take the lead role in pursuing regional collaboration for mHealth programs in sub-Saharan Africa. Secondly, collective effort in improving mobile penetration rates for the northern area is recommended.Electronic supplementary materialThe online version of this article (doi:10.1186/s12992-017-0286-9) contains supplementary material, which is available to authorized users.

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“…Thus, health system experts emphasize more on the maintenance and evaluation (23) . Currently, more research has been done to know the user acceptance and use of IT across the world as the key component of health IT lifecycle (24,25) . The latest model "Unified Theory of Acceptance and Use of Technology (UTAUT)" proposed by the researchers included all the possible determinants of user acceptance.…”

Section: Discussionmentioning

confidence: 99%

Perceptions and experiences with District Health Information System software to collect and utilize health data in Bangladesh: A qualitative exploratory study

Begum

Khan

Adamou

et al. 2019

Preprint

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Background: Accurate and high-quality data are important for improving program effectiveness and informing policy. Bangladesh’s health management information system adopted the District Health Information Software, Version 2 (DHIS2) in 2009 to capture real-time health service utilization data. However, routinely collected data are being underused because of poor data quality. We aimed to understand the facilitators and barriers of implementing DHIS2 as a way to retrieve meaningful and accurate data for reproductive, maternal and child health (RMCAH) services. Methods: This qualitative study was conducted in two districts of Bangladesh from September 2017 to 2018. Data collection included key informant interviews (n=11), in-depth interviews (n=23), and focus group discussions (n=2). The study participants were individuals involved with DHIS2 implementation from the community level to the national level. The data were analyzed thematically. Results: DHIS2 could improve the timeliness and completeness of data reporting over time. The reported facilitating factors were strong government commitment, extensive donor support, and positive attitudes toward the technology among staffs. Quality checks and feedback loops at multiple levels of data gathering points were helpful to minimize data errors. Introducing a dashboard makes DHIS2 compatible to use as monitoring tool. However, the barriers to effective DHIS2 implementation were lack of human resources, slow Internet connectivity, frequent changes to of DHIS2 versions, and maintaining both manual and electronic system side-by-side. Data in DHIS2 remains incomplete because it does not capture data from private health facilities. Having two parallel management information systems reporting the same RMNCAH indicators threatens data quality and increases the reporting workload. Conclusion: The overall insights from this study are expected to contribute to the development of effective strategies for successful DHIS2 implementation and building responsive health management information system. Focused strategic direction is needed to sustain the achievements of digital data culture. Periodic refresher trainings, incentives for increased performance, and an automated single reporting system for multiple stakeholders could make the system more user-friendly. A national electronic health strategy and implementation framework can facilitate creating a culture of DHIS2 use for planning, setting priorities, and decision making among stakeholder groups.

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Assessing the feasibility of eHealth and mHealth: a systematic review and analysis of initiatives implemented in Kenya

Cited by 83 publications

References 35 publications

Perceptions of factors influencing the introduction and adoption of electronic immunization registries in Tanzania and Zambia: a mixed methods study

Perceptions of factors influencing the introduction and adoption of electronic immunization registries in Tanzania and Zambia: a mixed methods study

Mapping mHealth (mobile health) and mobile penetrations in sub-Saharan Africa for strategic regional collaboration in mHealth scale-up: an application of exploratory spatial data analysis

Perceptions and experiences with District Health Information System software to collect and utilize health data in Bangladesh: A qualitative exploratory study

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