Mobile phone–based clinical guidance for rural health providers in India

Abstract

There are few tried and tested mobile technology applications to enhance and standardize the quality of health care by frontline rural health providers in low-resource settings. We developed a media-rich, mobile phone-based clinical guidance system for management of fevers, diarrhoeas and respiratory problems by rural health providers. Using a randomized control design, we field tested this application with 16 rural health providers and 128 patients at two rural/tribal sites in Tamil Nadu, Southern India. Protocol compliance for both groups, phone usability, acceptability and patient feedback for the experimental group were evaluated. Linear mixed-model analyses showed statistically significant improvements in protocol compliance in the experimental group. Usability and acceptability among patients and rural health providers were very high. Our results indicate that mobile phone-based, media-rich procedural guidance applications have significant potential for achieving consistently standardized quality of care by diverse frontline rural health providers, with patient acceptance.

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“…These include maternal and child health services, tuberculosis treatment services and anti retroviral therapy adherence programs. Many studies in India, have reported mobile phone communication as an effective and acceptable tool in management of diseases such as Type-2 diabetes, tuberculosis, epilepsy and HIV for both patients and health care providers (Ramachandran et al, 2013;Elangovan and Arulchelvan, 2013;Bigelow et al, 2013;Shetty et al, 2011;Bali and Singh, 2007;Gautham et al, 2014).…”

Rotterdam Prostate Cancer Risk Calculator: Development and Usability Testing of the Mobile Phone App

“…Some examples include the use of mobile phone–based guidance for rural health providers in Tamil Nadu, India [14], and the use of a gestational diabetes app by pregnant women in Oxford, United Kingdom [15]. Moreover, it has been documented not only in young adults [16], but also in older adults—both had a high degree of acceptance of apps that promoted physical activity [17].…”

Evaluating clinicians’ user experience and acceptability of LearnTB, a smartphone application for tuberculosis in India

“…Studies have concentrated their efforts in improving their interventions prior to evaluating the acceptability (23,24) and others investigated the acceptability of mHealth interventions demonstrating positive results (25)(26)(27)(28). Each of these studies evaluated interventions other than smartphone applications, such as short messaging service (SMS), telecommunication interfaces as well as ehealth interventions emphasizing protocol compliance and treatment adherence respectively.…”

“…Authors reported lack of knowledge to be the biggest limitation regarding the mHealth intervention. This impeded proper assessment of the application, as participants did not feel comfortable using it (25)(26)(27)(28). Based on a systematic review conducted by Gagnon et al, most mHealth studies evaluating acceptability of smartphone applications have been conducted amongst health care professionals such as nurses, pharmacists and health workers (18).…”