mHealth communication to strengthen postnatal care in rural areas: a systematic review

Mbuthia, Florence; Reid, Marianne; Fichardt, Annali

doi:10.1186/s12884-019-2531-0

Cited by 43 publications

(38 citation statements)

References 43 publications

(74 reference statements)

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“…In addition, utilization of postnatal services varies widely, particularly in low and middle-income countries (LMICs), where barriers to access based largely on socio-economic circumstances and rurality PLOS ONE limit engagement [12]. Innovative approaches like m-health have shown some promise in raising awareness and increasing coverage in some LMIC settings [13] and giving birth in a recognized health facility may enhance further engagement with postnatal services [14]. However, the situation in many under resourced LMICs is hugely variable and, even in hospital settings, many women fail to receive the most basic pre-discharge check-up [15,16].…”

Section: Introductionmentioning

confidence: 99%

What matters to women in the postnatal period: A meta-synthesis of qualitative studies

Finlayson¹,

Crossland²,

Bonet³

et al. 2020

PLoS ONE

146

161

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Introduction The postnatal period is an underserved aspect of maternity care. Guidelines for postnatal care are not usually informed by what matters to the women who use it. This qualitative systematic review was undertaken to identify what matters to women in the postnatal period, to inform the scope of a new World Health Organization (WHO) postnatal guideline. Methods We searched MEDLINE, CINAHL, PsycINFO, POPLINE, Global Index Medicus, EMBASE, LILACS, AJOL, and reference lists of eligible studies published January 2000-July 2019, reporting qualitative data on women's beliefs, expectations, and values relating to the postnatal period. Data collection and analysis Author findings were extracted, coded and synthesised using techniques derived from thematic synthesis. Confidence in the quality, coherence, relevance and adequacy of data underpinning the resulting findings was assessed using GRADE-CERQual. Results We included 36 studies from 15 countries, representing the views of more than 800 women. Confidence in most results was moderate to high. What mattered to women was a positive postnatal experience where they were able to adapt to their new self-identity and develop a sense of confidence and competence as a mother; adjust to changes in their intimate and family relationships, including their relationship to their baby; navigate ordinary physical and emotional challenges; and experience the dynamic achievement of personal growth as they adjust to the 'new normal' of motherhood and parenting in their own cultural context.

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Section: Introductionmentioning

confidence: 99%

What matters to women in the postnatal period: A meta-synthesis of qualitative studies

Finlayson¹,

Crossland²,

Bonet³

et al. 2020

PLoS ONE

146

161

View full text Add to dashboard Cite

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“…One-way mobile phone messaging is the most common type of mHealth communication used in LMICs [8]. However, the limitation of this approach is that clients only receive messages and cannot interact with health care providers in real-time.…”

Section: Introductionmentioning

confidence: 99%

“…However, the limitation of this approach is that clients only receive messages and cannot interact with health care providers in real-time. Factors in uencing mHealth interventions at the individual level include users' intentions, skills, attitudes, perceived norms, self-e cacy, literacy levels and pro ciency in the use of mobile devices such as smartphones [8]. Systems-related factors affecting the use of mHealth interventions include unsuitable implementation context, poor internet infrastructure, unreliable power supplies and frequent power outages [9].…”

Section: Introductionmentioning

confidence: 99%

Explaining the impact of mHealth on maternal and child health care in low- and middle-income countries: A theory-driven scoping review

Kabongo¹,

Mukumbang²,

N³

et al. 2020

Preprint

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Abstract Introduction Despite the growing global application of mobile health (mHealth) technology in maternal and child health, the contextual factors and mechanisms by which interventional outcomes are generated have not been subjected to extensive review. In this study, we sought to identify context, mechanisms and outcome elements from implementation and evaluation studies of mHealth interventions to formulate theories or models explicating how mHealth interventions work (or not) both for health care providers and for pregnant women and new mothers.Method An electronic search of six online databases (Medline, Pubmed, Google Scholar, Scopus, Academic Search Premier and Health Systems Evidence) was performed. Using appropriate MeSH terms and selection procedure, 32 articles were considered for analysis. A theory-driven approach, narrative synthesis, was applied to synthesise the data. Thematic content analysis was used to delineate the elements of the intervention, including its context, actors, mechanism and outcomes. Retroduction was applied to link these elements using a realist evaluation heuristic to form generative theories.Results Mechanisms that promote the implementation of mHealth by community health workers/health care providers include motivation, perceived skill and knowledge improvement, improved self-efficacy, improved confidence, improved relationship between community health workers and clients, perceived support of community health workers, perceived ease of use and usefulness of mHealth, For pregnant women and new mothers, mechanisms that trigger the uptake of mHealth and use of maternal and child health services included: perceived service satisfaction, perceived knowledge acquisition, support and confidence, improved self-efficacy, encouragement, empowerment and motivation. Information overload was identified as a potential negative mechanism for the uptake of maternal and child health services.Conclusion The models developed in this study provide a detailed understanding of the implementation and uptake of mHealth interventions and how they improve maternal and child health services in low and middle income countries. These models provide a foundation for the ‘white box’ or theory-driven evaluation of mHealth intervention and can improve the rollout and implementation where required.

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“…The potential challenges faced by mHealth interventions have been highlighted in previous studies [8,9]. One-way mobile phone messaging is the most common type of mHealth communication used in LMICs [8]. However, the limitation of this approach is that patients only receive messages and cannot interact with health care providers in real-time.…”

Section: Introductionmentioning

confidence: 99%

“…However, the limitation of this approach is that patients only receive messages and cannot interact with health care providers in real-time. Factors in uencing mHealth interventions at the individual level include users' intentions, skills, attitudes, perceived norms, self-e cacy, literacy levels and pro ciency in the use of mobile devices such as smartphones [8]. Systems-related factors affecting the use of mHealth interventions include unsuitable implementation context, poor internet infrastructure, unreliable power supplies and frequent power outages [9].…”

Section: Introductionmentioning

confidence: 99%

Explaining the impact of mHealth on maternal and child health care in low- and middle-income countries: A realist synthesis

Kabongo

Mukumbang

Delobelle

et al. 2020

Preprint

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Background: Despite the growing global application of mobile health (mHealth) technology in maternal and child health, contextual factors, and mechanisms by which interventional outcomes are generated, have not been subjected to a systematic examination. In this study, we sought to uncover context, mechanisms, and outcome elements of various mHealth interventions based on implementation and evaluation studies to formulate theories or models explicating how mHealth interventions work (or not) both for health care providers and for pregnant women and mothers.Method: We undertook a realist synthesis. An electronic search of six online databases (Medline, PubMed, Google Scholar, Scopus, Academic Search Premier, and Health Systems Evidence) was performed. Using appropriate Boolean phrases terms and selection procedures, 32 articles were identified. A theory-driven approach, narrative synthesis, was applied to synthesize the data. Thematic content analysis was used to delineate elements of the intervention, including its context, actors, mechanisms, and outcomes. Abduction and retroduction were applied using a realist evaluation heuristic tool to formulate generative theories.Results: We formulated two configurational models illustrating how and why mHealth impacts the implementation and uptake of maternal and child care services. Implementation-related mechanisms include buy-in from health care providers, perceived support of health care providers’ motivation, and perceived ease of use and usefulness. These mechanisms were influenced by adaptive health system conditions including organization, resource availability, policy implementation dynamics, experience with technology, network infrastructure, and connectivity. For pregnant women and mothers, mechanisms that trigger mHealth use and consequently uptake of maternal and child health care include perceived satisfaction, motivation, and positive psychological support. Information overload was identified as a potential negative mechanism impacting the uptake of maternal and child health care. These mechanisms were influenced by health system conditions, socio-cultural characteristics, socio-economic and demographics characteristics, network infrastructure and connectivity, and awareness.Conclusion: Models developed in this study provide a detailed understanding of the implementation and uptake of mHealth interventions and how and why they impact maternal and child health care in low- and middle-income countries. These models provide a foundation for the ‘white box’ of theory-driven evaluation of mHealth interventions and can improve rollout and implementation where required.

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mHealth communication to strengthen postnatal care in rural areas: a systematic review

Cited by 43 publications

References 43 publications

What matters to women in the postnatal period: A meta-synthesis of qualitative studies

What matters to women in the postnatal period: A meta-synthesis of qualitative studies

Explaining the impact of mHealth on maternal and child health care in low- and middle-income countries: A theory-driven scoping review

Explaining the impact of mHealth on maternal and child health care in low- and middle-income countries: A realist synthesis

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