Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA.
Quantitative Sciences Unit, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA.
J Glob Health. 2020 Dec;10(2):021005. doi: 10.7189/jogh.10.021005. Epub 2020 Dec 19.
Mobile health (mHealth) tools have potential for improving the reach and quality of health information and services through community health workers in low- and middle-income countries. This study evaluates the impact of an mHealth tool implemented at scale as part of the statewide reproductive,maternal, newborn and child health and nutrition (RMNCHN) program in Bihar, India.
Three survey-based data sets were analysed to compare the health-related knowledge, attitudes and behaviours amongst childbearing women exposed to the Mobile and Dr. Anita mHealth tools during their visits with frontline workers compared with those who were unexposed.
An evaluation by Mathematica (2014) revealed that exposure to Mobile and Dr. Anita recordings were associated with significantly higher odds of consuming iron-folic acid tablets (odds ratio (OR) = 2.3, 95% confidence interval (CI) = 1.8-3.1) as well as taking a set of three measures for delivery preparedness (OR = 2.8, 95% CI = 1.9-4.2) and appropriate infant complementary feeding (OR = 1.9, 95% CI = 1.0-3.5). CARE India's Community-based Household Surveys (2012-2017) demonstrated significant improvements in early breastfeeding (OR = 1.64, 95% CI = 1.5-1.78) and exclusive breastfeeding (OR = 1.46, 95% CI = 1.33-1.62) in addition to birth preparedness practices. BBC Media Action's Usage & Engagement Survey (2014) demonstrated a positive association between exposure to Mobile and Dr. Anita and exclusive breastfeeding (58% exposed vs 43% unexposed, < 0.01) as well as maternal respondents' trust in their frontline worker.
Significant improvements in RMNCHN-related knowledge and behaviours were observed for Bihari women who were exposed to Mobile and Dr. Anita. This analysis is unique in its rigorous evaluation across multiple data sets of mHealth interventions implemented at scale. These results can help inform global understanding of how best to use mHealth tools, for whom, and in what contexts.
ClinicalTrials.gov number NCT02726230.
移动医疗（mHealth）工具具有通过中低收入国家的社区卫生工作者扩大卫生信息和服务覆盖范围并提高其质量的潜力。本研究评估了在印度比哈尔邦作为全州生殖、产妇、新生儿和儿童健康与营养（RMNCHN）计划的一部分大规模实施的 mHealth 工具所产生的影响。
对三个基于调查的数据集进行了分析，以比较在与一线工作人员的访问中接触 Mobile 和 Dr. Anita mHealth 工具的生育妇女与未接触的妇女在健康相关知识、态度和行为方面的差异。
Mathematica（2014 年）的评估结果显示，接触 Mobile 和 Dr. Anita 的录音与更高的铁叶酸片摄入几率（比值比（OR）=2.3，95%置信区间（CI）=1.8-3.1）以及采取一系列三项分娩准备措施（OR=2.8，95%CI=1.9-4.2）和适当的婴儿补充喂养（OR=1.9，95%CI=1.0-3.5）显著相关。CARE India 的社区家庭调查（2012-2017 年）表明，在早期母乳喂养（OR=1.64，95%CI=1.5-1.78）和纯母乳喂养（OR=1.46，95%CI=1.33-1.62）方面取得了显著改善，此外还有分娩准备实践。BBC Media Action 的使用和参与调查（2014 年）表明，接触 Mobile 和 Dr. Anita 与纯母乳喂养（58%接触 vs 43%未接触，<0.01）以及产妇受访者对其一线工作人员的信任之间存在正相关关系。
与接触 Mobile 和 Dr. Anita 的比哈里妇女相比，RMNCHN 相关知识和行为有了显著提高。这项分析在多个数据集之间进行了严格评估，是对大规模实施的 mHealth 干预措施的独特分析。这些结果有助于更好地了解如何最好地在全球范围内使用 mHealth 工具、针对谁以及在什么情况下使用。
ClinicalTrials.gov 编号 NCT02726230。
