Use of a mHealth System to Improve Antenatal Care in Low and Lower-Middle Income Countries: Report on Patients and Healthcare Workers’ Acceptability in Tanzania

Abstract

Antenatal care (ANC) is considered a cornerstone of reproductive health programmes, but many women face difficulties in accessing these services, particularly in some sub-Saharan African countries, such as Tanzania. This study aimed to test ANC visit acceptability using mHealth system PANDA (Pregnancy And Newborn Diagnostic Assessment) in the Mufindi district (Tanzania). We investigated the ANC visit acceptability of pregnant women and healthcare workers (HCWs) in an intervention area using the PANDA system compared with a control area. An ad hoc questionnaire was administered to pregnant women in an implementation area (n = 52) and in a control area (n = 46). In the implementation area, group interviews with 50 pregnant women were conducted and five HCWs evaluated ANC visits through a questionnaire. The implementation group was significantly more satisfied with the ANC visit compared with the control group. All the 52 women and the HCWs declared that PANDA icons were useful in understanding and remembering the provided information and the PANDA app was able to improve the ANC quality and to positively influence the relationship of HCWs and pregnant women. HCWs reported that the PANDA app was “easy-to-use” and “able to improve the adherence to ANC WHO recommendations”. In underserved areas, many pregnant women could benefit from the PANDA system increasing their access to high-quality ANC and overcoming language and/or literacy barriers.

A Scoping Review of Digital Technologies in Antenatal Care: Recent Progress and Applications of Digital Technologies

“…The DHIs were categorised into two primary groups according to their intended purpose: as a supplementary or substitute to routine care. Among the 61 included studies, 32 ( [77,71,72,23,69,54,55,33,34,36,37,40,92,41,42,43,44,88,45,46,47,70,49,50,51,58,79,57,56].…”

“…Additionally, mobile phone apps are used as an interface to simplify data gathering, decision-making, and patient-HCP communication. A few of the included studies reported that the integration of mobile apps with telehealth services was used to augment healthcare quality [34,37,39,47,69,71,72].…”

“…Sixteen studies [72,34,35,57,37,40,44,45,81,50,51,58,59,46,49,65] assessed user satisfaction with DHI, of which 81.25% (n=13) reported a high rate of satisfaction, where one article reported that 86.9% of patients and 87.8% of providers were satis ed with the use of telehealth for the care of high-risk obstetrical patients [50]. Three studies (18.75%) reported dissatisfaction with the use of DHI-integrated care, mainly telehealth [46, 49, 65], especially among patients with a previous poor obstetric history in vulnerable populations and the feeling of reassurance and grati cation with conventional visits [46].…”

“…Most of the studies included in the present review used mobile apps[89, 86, 69,55, 78,33,90,52,91, 66, 56, 67,33,35,37, 76, 38, 80, 87,39,92,47, 81,70, 58, 68,75, 85], six studies used one-or two-way text messaging systems[73, 64, 65, 83, 48, 84], two studies used web-based cloud apps (59, 60), and only one study mentioned the use of a clinical decision support system to support antenatal health care(1). Twenty-two studies used synchronised telehealth communication either through audio/telephone consultation[63,42,45, 46] or virtual care…”

Healthcare workers’ perceptions about the use of mobile health technologies in public health facilities in Lagos, Nigeria

“…The results showed that the system was widely accepted by the majority of HCWs due to its ease of use. 31 Exploring user acceptability is thus crucial in implementing innovative mHealth technologies since it can give potential implementers valuable insight into factors influencing users’ motivation to utilize the technology. 30 According to Nilsen et al, one of the major challenges to the deployment and uptake of mHealth technology is user resistance, which can be related to both the technology and resistance to change.…”