The State of Digital Interventions for Demand Generation in Low- and Middle-Income Countries: Considerations, Emerging Approaches, and Research Gaps

Gibson, Dustin G.; Tamrat, Tigest; Mehl, Garrett

doi:10.9745/ghsp-d-18-00165

Cited by 24 publications

(28 citation statements)

References 53 publications

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“…This timeframe coincides with the emergence of WHO guidance on digital interventions for health systems 11 and recognises the rapidly changing nature of digital technology. Building on our previous reviews of two-way digital clinical communication [12][13][14][15][16][17][18] , with added parameters for LMIC contexts, we identified seven systematic reviews [19][20][21][22][23][24][25] and five empirical studies [26][27][28][29][30] involving mConsulting in LMICs, as per our definition 7 (see, Appendix 1, for our search strategy).…”

Section: Conceptual Framework: Access In a Complex Adaptive Systemmentioning

confidence: 99%

“…The seven reviews included studies from a range of LMIC countries [19][20][21][22][23][24][25] , while the empirical studies were from Ghana 30 , Kenya 28 , Bangladesh 26,29 and India 27 . mConsulting was used in maternal, newborn and child health care in two reviews 24,25 and four studies [27][28][29][30] .…”

Section: Conceptual Framework: Access In a Complex Adaptive Systemmentioning

confidence: 99%

“…mConsulting was used in maternal, newborn and child health care in two reviews 24,25 and four studies [27][28][29][30] . Other conditions included chronic care (n=3) 22,23,26 for non-communicable disease, diabetes, tuberculosis, HIV and cancer; general health (n=2) 20,21 ; mental health for mothers living with HIV (n=1) 27 ; and adolescent health (n=1) 19 .…”

Section: Conceptual Framework: Access In a Complex Adaptive Systemmentioning

confidence: 99%

See 2 more Smart Citations

Mobile consulting (mConsulting) as an option for accessing healthcare services for communities in remote rural areas and urban slums in low- and middle- income countries: A mixed methods study

Harris

Ajisola

Alam

et al. 2020

Preprint

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ObjectiveRemote or mobile consulting (mConsulting) is being promoted to strengthen health systems, deliver universal health coverage and facilitate safe clinical communication during COVID-19 and beyond. We explored whether mConsulting is a viable option for communities with minimal resources in low- and middle-income countries (LMICs).MethodsWe reviewed evidence published since 2018 about mConsulting in LMICs and undertook a scoping study (pre-COVID) in two rural settings (Pakistan, Tanzania) and five urban slums (Kenya, Nigeria, Bangladesh), using policy/document review, secondary analysis of survey data (from the urban sites), and thematic analysis of interviews/workshops with community members, healthcare workers, digital/telecommunications experts, mConsulting providers, local and national decision-makers. Project advisory groups guided the study in each country.ResultsWe reviewed five empirical studies and seven reviews, analysed data from 5,219 urban slum households and engaged with 419 stakeholders in rural and urban sites. Regulatory frameworks are available in each country. mConsulting services are operating through provider platforms (n=5-17) and, at community-level, some direct experience of mConsulting with healthcare workers using their own phones was reported - for emergencies, advice and care follow-up. Stakeholder willingness was high, provided challenges are addressed in technology, infrastructure, data security, confidentiality, acceptability and health system integration. mConsulting can reduce affordability barriers and facilitate care-seeking practices.ConclusionsThere are indications of readiness for mConsulting in communities with minimal resources. However, wider system strengthening is needed to bolster referrals, specialist services, laboratories and supply-chains to fully realise the continuity of care and responsiveness that mConsulting services offer, particularly during/beyond COVID-19.

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Section: Conceptual Framework: Access In a Complex Adaptive Systemmentioning

confidence: 99%

Section: Conceptual Framework: Access In a Complex Adaptive Systemmentioning

confidence: 99%

Section: Conceptual Framework: Access In a Complex Adaptive Systemmentioning

confidence: 99%

See 1 more Smart Citation

Mobile consulting (mConsulting) as an option for accessing healthcare services for communities in remote rural areas and urban slums in low- and middle- income countries: A mixed methods study

Harris

Ajisola

Alam

et al. 2020

Preprint

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“…The existing literature on psychosocial interventions leveraging digital technologies shows a growing number of studies from high-income countries. [29][30][31] As low-and middle-income countries (LMICs) have a higher proportion of palliative care needs and associated psychosocial challenges, [32] their under-representation in the scientific evidence shows a critical gap of implementation research in those countries. This lack of evidence may be a result of inadequate digital interventions or integration of digital health in palliative care in those contexts.…”

Section: Sultana Et Al (2020)mentioning

confidence: 99%

Psychosocial challenges in palliative care: Bridging the gaps using digital health

Sultana¹,

Tasnim²,

Sharma³

et al. 2020

Preprint

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Psychosocial health is a major palliative care concern globally. Patients and caregivers engaged in palliative care may experience deteriorated mental and social health conditions. Global evidence informs a high burden of depression, anxiety, psychological distress, and other mental health problems among the palliative care populations. Those challenges aggravate the preexisting palliative care issues, such as lack of access and suboptimal quality of care. Palliative caregiving, both in the institutional and community settings, should be strengthened, incorporating psychosocial support for the patients and their caregivers. The recent advancements in digital health technologies have shown promising impacts in facilitating health communication, decision-making, and delivering psychosocial interventions using digital devices and platforms. Adopting evidence-based interventions can help the users to access mental health resources and communicate with each other to promote shared decision-making and management of health problems. Healthcare organizations and systems may explore opportunities to advance psychosocial care using digital technologies. Leveraging advanced technologies in palliative caregiving may require multifaceted research exploring potential barriers and opportunities at the user, institutional, and systems levels. Nonetheless, palliative care policies and health systems measures should be strengthened to develop and implement digital support systems that may improve psychosocial health and overall palliative care outcomes.

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“…Finally, 2 articles take on the dual aspects of health service delivery—separately tackling digital innovations that target the providers of care (supply-side focus) and the receipt of care (demand-side, client focus). Together with digital health colleagues at WHO, Gibson et al 17 review the state of digital demand-generation interventions, highlighting emerging trends in this space. They identify subtleties in the literature that suggest that the contextual tailoring of behavioral interventions by addressing message ‘dose,’ prevalence, and timing may be crucial to program success.…”

Section: Examining the Literaturementioning

confidence: 99%

Digital Health and Health Systems of the Future

Labrique

Vasudevan

Mehl

et al. 2018

Glob Health Sci Pract

Self Cite

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Digital strategies have been formally recognized as a critical health systems strengthening strategy to help meet the Sustainable Development Goals and universal health coverage targets. This landscaping collection reviews multiple possible approaches across health system pillars, from digital referrals to decision support systems, identifying key knowledge gaps across these domains and recognizing the growth needed in the field to realize its full potential.

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The State of Digital Interventions for Demand Generation in Low- and Middle-Income Countries: Considerations, Emerging Approaches, and Research Gaps

Cited by 24 publications

References 53 publications

Mobile consulting (mConsulting) as an option for accessing healthcare services for communities in remote rural areas and urban slums in low- and middle- income countries: A mixed methods study

Mobile consulting (mConsulting) as an option for accessing healthcare services for communities in remote rural areas and urban slums in low- and middle- income countries: A mixed methods study

Psychosocial challenges in palliative care: Bridging the gaps using digital health

Digital Health and Health Systems of the Future

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