Dept. of Intl. Development, London School of Economics & Political Science, Houghton Street, London WC2A 2AE, UK; Dept. of Management, London School of Economics & Political Science, Houghton Street, London WC2A 2AE, UK.
Department of Social Policy, London School of Economics & Political Science, Houghton Street, London WC2A 2AE, UK; CBM - Haiti, 10 Rue Latortue, Delmas, 48, Port au Prince, Haiti.
Soc Sci Med. 2014 Feb;102:103-10. doi: 10.1016/j.socscimed.2013.11.036. Epub 2013 Nov 28.
The increasing proliferation of mobiles offers possibilities for improving health systems in developing countries. A case in point is Tanzania which has piloted a mobile phone-based Management Information System (MIS) for the control of neglected tropical diseases (NTDs) where village health workers (VHWs) were given mobile phones with web-based software to test the feasibility of using frontline health workers to capture data at point of source. Based on qualitative case study research carried out in 2011, we found that providing mobile phones to VHWs has helped to increase the efficiency of routine work boosting the motivation and self-esteem of VHWs. However, despite these advantages, the information generated from the mobile phone-based NTD MIS has yet to be used to support decentralised decision-making. Even with improved technology and political will, the biggest hindrance to local usage of information for health planning is the lack of synthesised and analysed health information from the district and national levels to the villages. Without inculcating a culture of providing health information feedback to frontline workers and community organisations, the benefits of the intervention will be limited. If not addressed, this will mean that mobiles have maintained the one-way upward flow of information for NTD control and simply made reporting more hi-tech.
移动设备的日益普及为改善发展中国家的卫生系统提供了可能性。坦桑尼亚就是一个很好的例子，该国已经试点了一个基于手机的管理信息系统（MIS）来控制被忽视的热带病（NTDs），为乡村卫生工作者（VHWs）配备了具有基于网络的软件的手机，以测试利用一线卫生工作者在源头捕获数据的可行性。基于 2011 年进行的定性案例研究，我们发现，为 VHWs 提供手机有助于提高日常工作的效率，提高 VHWs 的积极性和自尊心。然而，尽管有这些优势，基于手机的 NTD MIS 生成的信息尚未用于支持权力下放的决策。即使有了改进的技术和政治意愿，阻碍当地使用信息进行卫生规划的最大障碍是缺乏来自地区和国家各级到村庄的综合和分析卫生信息。如果不培养向一线工作人员和社区组织提供卫生信息反馈的文化，干预措施的好处将是有限的。如果不加以解决，这将意味着手机只是维持了 NTD 控制的单向向上信息流，使报告变得更加高科技。
