Healthcare workers’ perceptions and experience on using mHealth technologies to deliver primary healthcare services: qualitative evidence synthesis

Odendaal, Willem; Goudge, Jane; Griffiths, Frances; Tomlinson, Mark; Leon, Natalie; Daniels, Karen

doi:10.1002/14651858.cd011942

Cited by 100 publications

(30 citation statements)

References 45 publications

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“…We used the CERQual (Confidence in the Evidence from Reviews of Qualitative research) approach to assess our confidence in the review findings (Colvin 2018; Glenton 2018; Lewin 2018a; Lewin 2018b; Munthe‐Kaas 2018; Noyes 2018). This approach, building on the GRADE approach (Schünemann 2017), and the Cochrane tool for assessing risk of bias (Higgins 2017), for Cochrane systematic reviews of interventions, is becoming the standard to assess confidence in the findings from qualitative evidence syntheses (Ames 2017; Bohren 2015a; Colvin 2013; Lewin 2015; Munabi‐Babigumira 2017; Odendaal 2015). The CERQual approach assesses the following four concepts (Lewin 2018a).…”

Section: Methodsmentioning

confidence: 99%

Perceptions and experiences of labour companionship: a qualitative evidence synthesis

Bohren

Berger

Munthe‐Kaas

et al. 2019

Cochrane Database of Systematic Reviews

198

197

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BackgroundLabour companionship refers to support provided to a woman during labour and childbirth, and may be provided by a partner, family member, friend, doula or healthcare professional. A Cochrane systematic review of interventions by Bohren and colleagues, concluded that having a labour companion improves outcomes for women and babies. The presence of a labour companion is therefore regarded as an important aspect of improving quality of care during labour and childbirth; however implementation of the intervention is not universal. Implementation of labour companionship may be hampered by limited understanding of factors affecting successful implementation across contexts.ObjectivesThe objectives of the review were to describe and explore the perceptions and experiences of women, partners, community members, healthcare providers and administrators, and other key stakeholders regarding labour companionship; to identify factors affecting successful implementation and sustainability of labour companionship; and to explore how the findings of this review can enhance understanding of the related Cochrane systematic review of interventions.Search methodsWe searched MEDLINE, CINAHL, and POPLINE K4Health databases for eligible studies from inception to 9 September 2018. There were no language, date or geographic restrictions.Selection criteriaWe included studies that used qualitative methods for data collection and analysis; focused on women’s, partners’, family members’, doulas', providers', or other relevant stakeholders' perceptions and experiences of labour companionship; and were from any type of health facility in any setting globally.Data collection and analysisWe used a thematic analysis approach for data extraction and synthesis, and assessed the confidence in the findings using the GRADE‐CERQual approach. We used two approaches to integrate qualitative findings with the intervention review findings. We used a logic model to theorise links between elements of the intervention and health and well‐being outcomes. We also used a matrix model to compare features of labour companionship identified as important in the qualitative evidence synthesis with the interventions included in the intervention review.Main resultsWe found 51 studies (52 papers), mostly from high‐income countries and mostly describing women's perspectives. We assessed our level of confidence in each finding using the GRADE‐CERQual approach. We had high or moderate confidence in many of our findings. Where we only had low or very low confidence in a finding, we have indicated this.Labour companions supported women in four different ways. Companions gave informational support by providing information about childbirth, bridging communication gaps between health workers and women, and facilitating non‐pharmacological pain relief. Companions were advocates, which means they spoke up in support of the woman. Companions provided practical support, including encouraging women to move around, providing massage, and holding her hand. Finally, companions...

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Section: Methodsmentioning

confidence: 99%

Perceptions and experiences of labour companionship: a qualitative evidence synthesis

Bohren

Berger

Munthe‐Kaas

et al. 2019

Cochrane Database of Systematic Reviews

198

197

View full text Add to dashboard Cite

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“…mHealth technologies used in LMIC include portable wireless devices, including mobile phones and tablets. 15 mHealth can involve one-way or two-way communication between the health worker and patient, using any digital channel that allows the users to be mobile. Vasudevan et al 16 suggest that strides are being made in strengthening the global mHealth evidence base along with the key ‘best practices’ in scaling mHealth for achieving universal health coverage.…”

Section: Introductionmentioning

confidence: 99%

mHealth text and voice communication for monitoring people with chronic diseases in low-resource settings: a realist review

et al. 2018

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BackgroundRoutine monitoring by patients and healthcare providers to manage chronic disease is vital, though this can be challenging in low-resourced health systems. Mobile health (mHealth) has been proposed as one way to improve management of chronic diseases. Past mHealth reviews have proposed the need for a greater understanding around how the theoretical constructs in mHealth interventions actually work. In response, we synthesised evidence from primary studies on monitoring of chronic diseases using two-way digital text or voice communication between a patient and health worker. We did this in order to understand the important considerations for the design of mHealth interventions.MethodArticles retrieved were systematically screened and analysed to elicit explanations of mHealth monitoring interventions. These explanations were consolidated into programme theory and compared with existing theory and frameworks. We identified variation in outcomes to understand how context moderates the outcome.ResultsFour articles were identified—monitoring of hypertension and HIV/AIDS from: Kenya, Pakistan, Honduras and Mexico and South Africa. Six components were found in all four interventions: reminders, patient observation of health state, motivational education/advice, provision of support communication, targeted actions and praise and encouragement. Intervention components were mapped to existing frameworks and theory. Variation in outcome identified in subgroup analysis suggests greater impact is achieved with certain patient groups, such as those with low literacy, those with stressful life events or those early in the disease trajectory. There was no other evidence in the included studies of the effect of context on the intervention and outcome.ConclusionmHealth interventions for monitoring chronic disease in low-resource settings, based on existing frameworks and theory, can be effective. A match between what the intervention provides and the needs or social factors relevant to specific patient group increases the effect. It was not possible to understand the impact of context on intervention and outcome beyond these patient-level measures as no evidence was provided in the study reports.

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“…Despite this, many CHWs receive inconsistent supervision, monitoring and training beyond their initial appointment (Bhutta et al, 2010;Hill et al, 2014). The high variability in programme quality complicates the extent to which CHW effectiveness is assessed across various settings (Odendaal et al, 2015). Efforts to maximise the impact of CHWs in the absence of this support has led to the application of new technologies to enhance the quality of care and broaden the scope of services that CHWs provide (Braun et al, 2013;Labrique, Kirk, Westergaard, & Merritt, 2013).…”

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confidence: 99%

Community health workers’ experiences of using video teaching tools during home visits—A pilot study

Coetzee

Kohrman

Tomlinson

et al. 2017

Health Soc Care Community

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Innovations in health, such as the use of tablet computers, show promise in broadening the scope of work of community health workers (CHWs), and play an important role in keeping CHWs and their clients up to date with advancements in health. While the use of mobile phones and tablets is innovative, the applicability of these technologies in different contexts remains poorly understood. Furthermore, little is known about the acceptability and feasibility of the use of video teaching tools on such devices across diverse contexts. In this study, we aimed to explore the acceptability and feasibility of using tablets with teaching videos (about HIV, alcohol, nutrition and breastfeeding) to support the health promotion efforts of 24 CHWs who work with pregnant mothers and mothers of young children in an urban township in South Africa. Between November 2015 and May 2016, we conducted focus groups and identified four key themes (with several sub-themes) that demonstrated factors related to the acceptability and feasibility of these devices and their content. Focus group transcripts were analysed thematically using qualitative data analysis software. The findings indicated that while the devices contained several supportive features (such as lightening the workload, and stimulating interest in their work), they also contained several restrictive features (safety and confidentiality). CHWs considered the video content an important tool to engage not only their clients but also family members and the community at large. Issues surrounding safety, privacy and confidentiality of using these devices require careful consideration prior to implementation in large-scale studies. Furthermore, stigma associated with household visits by CHWs and the nature of their work also need to be addressed by researchers and programme implementers. Overall, CHWs deemed the devices and the video content an acceptable and feasible means with which to provide health promotion and education among their clients.

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Healthcare workers’ perceptions and experience on using mHealth technologies to deliver primary healthcare services: qualitative evidence synthesis

Cited by 100 publications

References 45 publications

Perceptions and experiences of labour companionship: a qualitative evidence synthesis

Perceptions and experiences of labour companionship: a qualitative evidence synthesis

mHealth text and voice communication for monitoring people with chronic diseases in low-resource settings: a realist review

Community health workers’ experiences of using video teaching tools during home visits—A pilot study

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