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加纳上西部农村地区母婴健康服务移动医疗技术评估。

Assessment of mobile health technology for maternal and child health services in rural Upper West Region of Ghana.

机构信息

REJ Institute, Research and ICT Consultancy Services, P.O. Box TL1139, Tamale, Ghana.

REJ Institute, Research and ICT Consultancy Services, P.O. Box TL1139, Tamale, Ghana.

出版信息

Public Health. 2019 Mar;168:1-8. doi: 10.1016/j.puhe.2018.11.014. Epub 2019 Jan 17.

Abstract

OBJECTIVES

This study assessed the perspectives of women and health workers on the feasibility of using mobile health technology (mHealth) for the provision of maternal and child health services in rural settings of the Upper West Region of Ghana.

STUDY DESIGN

The study used a mixed-design approach of quantitative and qualitative methods.

METHODS

Interviewer-administered questionnaires, focus group discussions (FGDs), and key informant interviews (KIIs) were employed. Participants included pregnant women, lactating mothers, and health workers from three rural districts.

RESULTS

A total of 489 interviews were conducted, consisting of 290 pregnant women and 199 lactating mothers, with an average age of 26.9 years. Some level of formal education had been received by 67.1% of participants. The mHealth intervention was implemented in the study districts via mobile phones in the form of SMS voice messages, text messages, and phone call reminders. Our results show that participants who received follow-up call reminders and messages (10.2%) from health providers about their health expressed general satisfaction and high optimism toward receiving future follow-ups via their mobile phones. The high acceptability level was also demonstrated in the FGDs and KIIs. Overall, our findings showed that this mHealth intervention was an acceptable and feasible solution to the challenges of access to healthcare services seen in rural areas. Despite the high acceptability level, participants also highlighted barriers, such as limited or erratic power supply and poor mobile network connectivity, which need to be addressed.

CONCLUSIONS

mHealth interventions targeting health providers and rural women have the potential to reduce barriers to equitable access to maternal and child healthcare services in these settings. These findings are of clear public health importance and are relevant to policy-makers in this area of service delivery and use; however, policy-makers and program implementers should be cautious of the challenges involved in the scale-up of such an intervention.

摘要

目的

本研究评估了妇女和卫生工作者对在加纳上西部农村地区使用移动医疗技术(mHealth)提供母婴保健服务的可行性的看法。

研究设计

本研究采用了定量和定性方法相结合的混合设计方法。

方法

采用访谈式问卷、焦点小组讨论(FGD)和关键知情人访谈(KII)。参与者包括来自三个农村地区的孕妇、哺乳期母亲和卫生工作者。

结果

共进行了 489 次访谈,其中包括 290 名孕妇和 199 名哺乳期母亲,平均年龄为 26.9 岁。参与者中有 67.1%接受过一定程度的正规教育。该 mHealth 干预措施通过手机以短信语音、短信和电话提醒的形式在研究地区实施。我们的结果表明,接受过卫生提供者关于其健康状况的后续电话提醒和信息(10.2%)的参与者对通过手机接收未来随访表示普遍满意和高度乐观。FGD 和 KII 也显示出了高接受程度。总体而言,我们的研究结果表明,这种 mHealth 干预措施是解决农村地区医疗服务获取方面挑战的一种可接受且可行的解决方案。尽管接受程度很高,但参与者也强调了一些障碍,例如电力供应有限或不稳定以及移动网络连接不良,这些都需要解决。

结论

针对卫生提供者和农村妇女的 mHealth 干预措施有可能减少这些环境中公平获得母婴保健服务的障碍。这些发现具有明确的公共卫生重要性,与该服务提供和使用领域的政策制定者相关;然而,政策制定者和项目实施者在扩大这种干预措施时应谨慎对待所涉及的挑战。

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