Malaria Public Health Cluster, KEMRI-Wellcome Trust-University of Oxford Collaborative Programme, Nairobi, Kenya.
Global Health. 2013 May 14;9:20. doi: 10.1186/1744-8603-9-20.
The rapid growth in mobile phone penetration and use of Short Message Service (SMS) has been seen as a potential solution to improve medical and public health practice in Africa. Several studies have shown effectiveness of SMS interventions to improve health workers' practices, patients' adherence to medications and availability of health facility commodities. To inform policy makers about the feasibility of facility-based SMS interventions, the coverage data on mobile phone ownership and SMS use among health workers and patients are needed.
In 2012, a national, cross-sectional, cluster sample survey was undertaken at 172 public health facilities in Kenya. Outpatient health workers and caregivers of sick children and adult patients were interviewed. The main outcomes were personal ownership of mobile phones and use of SMS among phone owners. The predictors analysis examined factors influencing phone ownership and SMS use.
The analysis included 219 health workers and 1,177 patients' respondents (767 caregivers and 410 adult patients). All health workers possessed personal mobile phones and 98.6% used SMS. Among patients' respondents, 61.2% owned phones and 71.4% of phone owners used SMS. The phone ownership and SMS use was similar between caregivers of sick children and adult patients. The respondents who were male, more educated, literate and living in urban area were significantly more likely to own the phone and use SMS. The youngest respondents were less likely to own phones, however when the phones were owned, younger age groups were more likely to use SMS. Respondents living in wealthier areas were more likely to own phones; however when phones are owned no significant association between the poverty and SMS use was observed.
Mobile phone ownership and SMS use is ubiquitous among Kenyan health workers in the public sector. Among patients they serve the coverage in phone ownership and SMS use is lower and disparities exist with respect to gender, age, education, literacy, urbanization and poverty. Some of the disparities on SMS use can be addressed through the modalities of mHealth interventions and enhanced implementation processes while further growth in mobile phone penetration is needed to reduce the ownership gap.
移动电话的普及和短消息服务(SMS)的使用呈快速增长趋势,这被视为改善非洲医疗和公共卫生实践的潜在解决方案。多项研究表明,SMS 干预措施可有效改善卫生工作者的实践、患者对药物的依从性以及卫生机构商品的供应。为了使决策者了解基于设施的 SMS 干预措施的可行性,需要了解卫生工作者和患者中移动电话拥有率和 SMS 使用情况的覆盖数据。
2012 年,在肯尼亚的 172 家公共卫生机构进行了一项全国性的、横断面的、聚类抽样调查。对门诊卫生工作者和患病儿童及成年患者的护理人员进行了访谈。主要结果是手机拥有者的个人手机拥有率和 SMS 使用情况。预测因素分析检查了影响手机拥有率和 SMS 使用情况的因素。
分析包括 219 名卫生工作者和 1177 名患者(617 名患儿护理人员和 410 名成年患者)的应答者。所有卫生工作者都拥有个人移动电话,98.6%使用 SMS。在患者应答者中,61.2%拥有手机,71.4%的手机拥有者使用 SMS。患儿护理人员和成年患者的手机拥有率和 SMS 使用情况相似。男性、受教育程度较高、识字和居住在城市地区的应答者更有可能拥有手机并使用 SMS。最年轻的应答者拥有手机的可能性较小,但当拥有手机时,年龄较小的群体更有可能使用 SMS。生活在较富裕地区的应答者更有可能拥有手机;然而,当拥有手机时,贫困状况与 SMS 使用之间没有明显的关联。
在肯尼亚公共部门的卫生工作者中,移动电话拥有率和 SMS 使用率非常高。在他们所服务的患者中,手机拥有率和 SMS 使用率较低,而且在性别、年龄、教育、识字、城市化和贫困方面存在差异。通过 mHealth 干预措施和增强实施过程可以解决部分 SMS 使用方面的差异,而需要进一步增加移动电话的普及率,以缩小拥有率差距。