Mobile Health (mHealth) Approaches and Lessons for Increased Performance and Retention of Community Health Workers in Low- and Middle-Income Countries

A Review

Bibliographic Data

ID23316941
AuthorsKarin Källander (0000-0002-5778-5780, Malaria Consortium), James Tibenderana (0000-0002-0755-4597, Malaria Consortium), James K Tibenderana, Onome Akpogheneta (0000-0002-5213-4903, Malaria Consortium), Onome J Akpogheneta, Daniel Llywelyn Strachan (0000-0001-6143-1742, University College London), Zelee Hill (0000-0002-5949-6448, University College London), Augustinus H A ten Asbroek, Lesong Conteh (0000-0002-0719-3672, London School of Hygiene & Tropical Medicine), Burton Kirkwood (0000-0001-5274-6072, London School of Hygiene & Tropical Medicine), Betty R Kirkwood, Sylvia Meek (Malaria Consortium), Sylvia R Meek
Year2013
Volume15
Issue1
Pagese17
Publication date2013-01-25
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueJournal of Medical Internet Research (JOURNAL)
Journal identifiersISSN: 1438-8871 • E-ISSN: 1438-8871
PublisherJMIR Publications Inc. (PUBLISHER • CA)
DOI10.2196/jmir.2130
PMID23353680
OpenAlexW2108760064
LanguageEN
Citations received65
References cited13

BACKGROUND: Mobile health (mHealth) describes the use of portable electronic devices with software applications to provide health services and manage patient information. With approximately 5 billion mobile phone users globally, opportunities for mobile technologies to play a formal role in health services, particularly in low- and middle-income countries, are increasingly being recognized. mHealth can also support the performance of health care workers by the dissemination of clinical updates, learning materials, and reminders, particularly in underserved rural locations in low- and middle-income countries where community health workers deliver integrated community case management to children sick with diarrhea, pneumonia, and malaria. OBJECTIVE: Our aim was to conduct a thematic review of how mHealth projects have approached the intersection of cellular technology and public health in low- and middle-income countries and identify the promising practices and experiences learned, as well as novel and innovative approaches of how mHealth can support community health workers. METHODS: In this review, 6 themes of mHealth initiatives were examined using information from peer-reviewed journals, websites, and key reports. Primary mHealth technologies reviewed included mobile phones, personal digital assistants (PDAs) and smartphones, patient monitoring devices, and mobile telemedicine devices. We examined how these tools could be used for education and awareness, data access, and for strengthening health information systems. We also considered how mHealth may support patient monitoring, clinical decision making, and tracking of drugs and supplies. Lessons from mHealth trials and studies were summarized, focusing on low- and middle-income countries and community health workers. RESULTS: The review revealed that there are very few formal outcome evaluations of mHealth in low-income countries. Although there is vast documentation of project process evaluations, there are few studies demonstrating an impact on clinical outcomes. There is also a lack of mHealth applications and services operating at scale in low- and middle-income countries. The most commonly documented use of mHealth was 1-way text-message and phone reminders to encourage follow-up appointments, healthy behaviors, and data gathering. Innovative mHealth applications for community health workers include the use of mobile phones as job aides, clinical decision support tools, and for data submission and instant feedback on performance. CONCLUSIONS: With partnerships forming between governments, technologists, non-governmental organizations, academia, and industry, there is great potential to improve health services delivery by using mHealth in low- and middle-income countries. As with many other health improvement projects, a key challenge is moving mHealth approaches from pilot projects to national scalable programs while properly engaging health workers and communities in the process. By harnessing the increasing presence of mobile phones among diverse populations, there is promising evidence to suggest that mHealth can be used to deliver increased and enhanced health care services to individuals and communities, while helping to strengthen health systems.

Business · Community health workers · Developing country · Economic growth · Economics · eHealth · Environmental health · Health care · Health services · Low and middle income countries · mHealth · Population · Psychological intervention · COVID-19 Digital Contact Tracing · ICT in Developing Communities · Medicine · Mobile Health and mHealth Applications · Nursing · Psychology · Gerontology

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