Abstract:BackgroundWith the exponential increase in mobile phone users in India, a large number of public health initiatives are leveraging information technology and mobile devices for health care delivery. Given the considerable financial and human resources being invested in these initiatives, it is important to ascertain their role in strengthening health care systems.ObjectiveWe undertook this review to identify the published mobile health (mHealth) or telemedicine initiatives in India in terms of their current ro… Show more
“…Digital health interventions (DHIs) have become more prolific across health programs in low-and middleincome countries (LMICs) in recent years [1][2][3][4]. As technology has become cheaper and more accessible, health programs are adopting DHI to improve the provision of and demand for health services.…”
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.
“…Digital health interventions (DHIs) have become more prolific across health programs in low-and middleincome countries (LMICs) in recent years [1][2][3][4]. As technology has become cheaper and more accessible, health programs are adopting DHI to improve the provision of and demand for health services.…”
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.
“…mHealth initiatives have been on rise in India with diabetes being the most researched in Indian context. 10 As per, ""mHealth and ICT Framework"" developed by World Health Organization (WHO), Johns Hopkins University Global mHealth Initiative, the United Nations Children"s Fund (UNICEF), and Frog Designs, to describe mHealth innovations health systems. 7 Our initiative falls under two mHealth ICT framework, Electronic decision support and Data collection and reporting.…”
Background: Diabetes forms huge burden of non-communicable diseases that is affecting health care systems in India. India has large number undiagnosed and undetected cases. mHealth initiatives are cost effective, quick and less resource intensive technology assisted initiatives which help to strengthen the health system. High mobile penetration and availability of cheap and high-speed data network across India has been conducive to implement mHealth initiatives in Indian health system. We present our experience in using mHealth initiative to improve the diabetes screening and diagnosis in rural Indian settings.Methods: The study is a descriptive analysis of all the tasks undertaken as part of “Disease free Village” Initiative of our organization. The study data is operational data from our organizational health information management systems. The study is divided into three phase. Phase 1, was dedicated to enrolling entire village population using android smartphone and ODK collect application; phase 2 used clinical decision support system for screening of high risk individuals and phase 3 used traditional door to door campaign to motivating the high risk individuals to get their fast and post prandial blood glucose levels checked at health care facility.Results: Phase 1 was to set a baseline, with 3624 base population, 2651 was target adult population. Rapid screening in phase 2, screened 2204 (83.14%). Out of 2204 screened cases 1307 were high risk cases. 1307 high risk cases were followed in Phase 3, and blood glucose screening was carried out 1156 (88.44%) high and moderate risk individuals out of 1307 (100%).Conclusions: We concluded that the mHealth initiatives for screening and diagnosis of diabetes in rural India, combined with traditional techniques could help to improve screening and diagnosis rate and help to reduce the hidden burden of disease.
“…India sees promise in mHealth innovations to improve rural healthcare due to the broad geographical coverage of communications infrastructure and the low cost and availability of mobile handsets [3,8,17]. According to a report from Telecom Regulatory authority of India, of the 1203.77 million number of telephone subscribers in January 2019, 45% (530.86 million) were rural telephone subscribers [31], opening the landscape to develop mHealth interventions that could reduce health disparities, improve healthcare outcomes, while leaving no one behind and achieving universal health coverage.…”
Mobile health interventions are an innovative way to improve health outcomes and may play a powerful role in mitigating health disparities. However, their use poses special challenges and few articles have reported specifically on digital technology interventions for vulnerable populations. This article shares our experience from the Tika Vaani ("vaccine voice") Intervention which uses a combined face-to-face and mHealth strategy to educate and empower beneficiaries to improve immunization uptake and child health for a poor, low-literate population in rural Uttar Pradesh, India. Based on the mERA checklist, a guide to improve the completeness of reporting mHealth interventions, we provide information about the process of development, implementation and lessons for scaling up the Tika Vaani intervention. This study contributes to the literature to improve reporting on mHealth interventions and provide researchers with key points and actions to take during intervention development to serve hard-to-reach communities and improve health outcomes. CCS CONCEPTS • Human-centered computing~Interaction design • Humancentered computing~Human computer interaction (HCI)
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