Perspectives of health care professionals’ on delivering mHealth sexual and reproductive health services in rural settings in low-and-middle-income countries: a qualitative systematic review

Abstract

Background In low to middle income countries (LMICs) with limited health care providers (HCPs) and health infrastructure, digital technologies are rapidly being adopted to help augment service delivery. In this sphere, sexual and reproductive health (SRH) services are increasingly leveraging mobile health (mHealth) technologies to improve service and information provision in rural areas. This systematic review aimed to identify HCPs perspectives on barriers to, and facilitators of, mobile phone based SRH services and information in rural areas of LMICs from current literature. Methods Searches were conducted using the following databases: Medline, Scopus, PsychINFO, CINAHL and Cochrane Library. Based on the inclusion and exclusion criteria, twelve full text qualitative studies published in English between January 2000 and December 2020 were included. The methodological quality of papers was assessed by two authors using the critical skills appraisal programme and synthesized using the narrative thematic analysis approach. Results Positive HCPs experiences surrounding the provision of mHealth based SRH services in LMICs included saving consultation time, ability to shift tasks, reduction in travel costs, easy referrals and follow up on clients, convenience in communicating health information confidentially, and the ability to consult groups of clients remotely rather than face-to-face. Barriers to the provision of mHealth reported by HCPs included lack of technological infrastructure, unreliable networks, limited power, the cost of mobile airtime/data and mobile phones and limited technological literacy or skills. Conclusions Implementing innovative mHealth based SRH services could bridge a service provision and access gap of SRH information and services in rural areas of LMICs. Despite the advantages of this technology, several challenges associated with delivering mHealth SRH services need to be urgently addressed to enable scale-up and integration of sexual and reproductive mHealth into rural health systems.

Digital rights and mobile health in Southeast Asia: A scoping review

“…The right to privacy and the role of mHealth in ensuring privacy were mentioned in a systematic review of healthcare professional perspectives on mHealth-driven sexual and reproductive health (SRH) services in rural settings in LMICs, one of which was Cambodia. 55 The authors reported that compared to in-person health consultations mHealth services advance privacy, confidentiality, and trust. Although a Cambodia study was included in the review, the authors did not relate the privacy considerations to that study.…”

“…The authors stated that SRH generally implies that people “have the capability to reproduce and the freedom to decide if, when, and how often to do so” and that mHealth specifically helps clients in making those health decisions, supporting freedom of choice. 55 …”

“Ripping off the band-aid”: uncovering future health care professionals' “fractured knowledge” about sexual and reproductive health

“…Their understandings and perspectives towards those with gender variant identities are also diverse ( 8 , 9 , 20 , 31 ). This group also reports varied levels of sexual health literacy ( 19 , 67 , 68 ), even when some of those perspectives reflect those of young adults growing up in countries with comprehensive sex education schemas ( 69 ).…”