University of Washington, US.
Mzuzu University, MW.
Ann Glob Health. 2019 Apr 25;85(1):61. doi: 10.5334/aogh.919.
Community Case Management (CCM) aims to improve health outcomes among children under five with malaria, diarrhea, and pneumonia, but its effectiveness in Malawi is limited by inconsistent standards of delivery characteristic of paper-based interventions. This may lead to negative impacts on child health outcomes and inefficient use of health system resources. This study evaluated the acceptability and impact of the Supporting LIFE Community Case Management App (SL eCCM App) by Health Surveillance Assistants (HSAs) and caregivers in two districts of Northern Malawi.
Data were collected through semi-structured interviews with HSAs and caregivers as part of a nested study within a larger trial. We used deductive and inductive approaches during data analysis. Relevant constructs were identified from the Consolidated Framework for Implementation Research and combined with emerging concepts from the data. The Framework Method was used to chart and explore data, leading to the development of themes.
Seventeen HSAs and 28 caregivers were interviewed. Participants were generally enthusiastic about the SL eCCM App. Nearly all HSAs expressed a preference for the App over routine paper-based CCM. Most HSAs claimed the App was more reliable and less error prone, facilitated more accurate diagnoses and treatment recommendations, and enhanced professional confidence and respect in the community. Some HSAs believed additional features would improve usability of the App, others identified mobile network or electricity shortages as barriers. Not all caregivers understood the purpose of the App, but most welcomed it as a health and technological advancement.
The SL eCCM App is acceptable to both HSAs and caregivers, and in most cases, preferred, as it was believed to foster improvements in CCM delivery. Our findings suggest that mobile health interventions for CCM, such as the SL eCCM App, may have potential to improve the effectiveness and efficiency of care to children under five.
社区病例管理（CCM）旨在改善五岁以下儿童的疟疾、腹泻和肺炎的健康结果，但在马拉维，由于基于纸张的干预措施交付标准不一致，其效果受到限制。这可能对儿童健康结果产生负面影响，并导致卫生系统资源利用效率低下。本研究评估了在马拉维北部两个地区，由卫生监督助理（HSA）和照顾者使用支持生命社区病例管理应用程序（SL eCCM App）的可接受性和影响。
数据是通过对 HSA 和照顾者进行半结构化访谈收集的，作为一项更大试验中的嵌套研究的一部分。我们在数据分析中采用了演绎和归纳方法。从实施研究综合框架中确定了相关结构，并结合数据中出现的新概念。采用框架方法对数据进行图表和探索，从而形成主题。
共访谈了 17 名 HSA 和 28 名照顾者。参与者普遍对 SL eCCM App 表示热情。几乎所有的 HSA 都表示更喜欢 App 而不是常规的基于纸张的 CCM。大多数 HSA 表示 App 更可靠、错误更少，有助于更准确的诊断和治疗建议，并增强了在社区中的专业信心和尊重。一些 HSA 认为增加其他功能会提高 App 的可用性，其他人则认为移动网络或电力短缺是障碍。并非所有照顾者都了解 App 的目的，但大多数人都欢迎它作为健康和技术进步。
SL eCCM App 受到 HSA 和照顾者的欢迎，在大多数情况下受到青睐，因为它被认为可以促进 CCM 提供的改善。我们的研究结果表明，针对 CCM 的移动健康干预措施，如 SL eCCM App，可能有潜力提高五岁以下儿童护理的效果和效率。
