Duclos Vincent, Yé Maurice, Moubassira Kagoné, Sanou Hamidou, Sawadogo N Hélène, Bibeau Gilles, Sié Ali
Department of Global Studies and Modern Languages, Center for Science, Technology & Society, Drexel University, 3101 Market Street, 2nd Floor Suite, Philadelphia, PA, 19104, USA.
Nouna Health Research Center, Nouna, P.O. BOX 02, Burkina Faso.
Health Res Policy Syst. 2017 Jul 12;15(Suppl 1):47. doi: 10.1186/s12961-017-0211-y.
The implementation of mobile health (mHealth) projects in low- and middle-income countries raises high and well-documented expectations among development agencies, policymakers and researchers. By contrast, the expectations of direct and indirect mHealth users are not often examined. In preparation for a proposed intervention in the Nouna Health District, in rural Burkina Faso, this study investigates the expected benefits, challenges and limitations associated with mHealth, approaching these expectations as a form of situated knowledge, inseparable from local conditions, practices and experiences.
The study was conducted within the Nouna Health District. We used a qualitative approach, and conducted individual semi-structured interviews and group interviews (n = 10). Participants included healthcare workers (n = 19), godmothers (n = 24), pregnant women (n = 19), women with children aged 12-24 months (n = 33), and women of childbearing age (n = 92). Thematic and content qualitative analyses were conducted.
Participants expect mHealth to help retrieve patients lost to follow-up, improve maternal care monitoring, and build stronger relationships between pregnant women and primary health centres. Expected benefits are not reducible to a technological realisation (sending messages), but rather point towards a wider network of support. mHealth implementation is expected to present considerable challenges, including technological barriers, organisational challenges, gender issues, confidentiality concerns and unplanned aftereffects. mHealth is also expected to come with intrinsic limitations, to be found as obstacles to maternal care access with which pregnant women are confronted and on which mHealth is not expected to have any significant impact.
mHealth expectations appear as situated knowledges, inseparable from local health-related experiences, practices and constraints. This problematises universalistic approaches to mHealth knowledge, while nevertheless hinting at concrete, expected benefits. Findings from this study will help guide the design and implementation of mHealth initiatives, thus optimising their chances for success.
在低收入和中等收入国家实施移动健康（mHealth）项目，在发展机构、政策制定者和研究人员中引发了高度且有充分记录的期望。相比之下，mHealth直接和间接用户的期望却常常未得到审视。为筹备拟在布基纳法索农村的努纳健康区开展的一项干预措施，本研究调查了与mHealth相关的预期益处、挑战和局限，将这些期望视为一种情境化知识的形式，与当地条件、实践和经验不可分割。
该研究在努纳健康区内进行。我们采用定性方法，开展了个人半结构化访谈和小组访谈（共10次）。参与者包括医护人员（19人）、教母（24人）、孕妇（19人）、有12至24个月大孩子的妇女（33人）以及育龄妇女（92人）。进行了主题和内容定性分析。
参与者期望mHealth有助于找回失访患者，改善孕产妇护理监测，并加强孕妇与初级卫生中心之间的关系。预期益处并非仅限于技术实现（发送信息），而是指向更广泛的支持网络。预计mHealth的实施将面临诸多重大挑战，包括技术障碍、组织挑战、性别问题、保密问题以及意外的后遗症。mHealth也预计存在内在局限，这些局限会成为孕妇在获得孕产妇护理时面临的障碍，而mHealth预计对此不会产生任何重大影响。
mHealth期望表现为情境化知识，与当地与健康相关的经验、实践和限制不可分割。这使mHealth知识的普遍主义方法成问题，不过同时也暗示了具体的预期益处。本研究结果将有助于指导mHealth倡议的设计和实施，从而优化其成功机会。
