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SMS-based digital health intervention in Rwanda's home-based care program for remote management of COVID-19 cases and contacts: A qualitative study of sustainability and scalability.

作者信息

Babili Abdulaa, Nsanzimana Sabin, Rwagasore Edson, Lester Richard T

机构信息

Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom.

Central Administration, Rwanda Biomedical Center, Kigali, Rwanda.

出版信息

Front Digit Health. 2023 Jan 9;4:1071790. doi: 10.3389/fdgth.2022.1071790. eCollection 2022.


DOI:10.3389/fdgth.2022.1071790
PMID:36714610
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9879010/
Abstract

BACKGROUND: COVID-19 pandemic resulted in unprecedented global health challenges. Rwanda identified its first COVID-19 case on March 14, 2020 and subsequently introduced Home-Base Care (HBC) Program in August 2020 following community transmission of the virus and to alleviate logistical and financial strain on the healthcare system. Cases and contacts eligible for HBC were remotely supported by WelTel, an SMS-based mHealth intervention that was successfully implemented before for HIV epidemic in Rwanda. Enrolled cases and contacts were supported and monitored daily their cell and/or mobile phones until they complete isolation/quarantine period. This study explored the rationale, perspectives, and experiences of key informants (KIs) during the implementation WelTel's mHealth tool for HBC in Rwanda. METHODS: Semi-structured one-on-one virtual interviews were conducted with KIs in this qualitative study. The KIs were classified into 2 major categories: (A) Senior staff including policymakers, directors, and senior managers; (B) Technical teams including case managers, and other staff supporting the implementation of WelTel (e.g., IT staff). Interviews were audio-recorded, transcribed, and analyzed in NVivo. Thematic analysis was conducted using a hybrid approach. A topic guide was developed using the Modified Consolidated Framework for Implementation Research and feedback from local stakeholders. RESULTS: 7 KIs were interviewed. Five themes emerged following thematic analysis including: SMS-Based mHealth for Home-Isolation; Facilitators for Intervention Adoption; Barriers for Intervention Adoption; Infection prevention and control for Home-Isolation; and SMS-Based mHealth for Future Pandemics and Epidemics. Based on interviews, strong political commitment and advanced digital infrastructure were major facilitators for adopting WelTel for HBC. A major barrier to adopting WelTel was identified as technical-based issues. This was followed by local communication culture. All participates agreed on the significance of using WelTel to improve access and adherence to infection prevention and control measures, understand transmission dynamics, and inform public health decision-making regarding HBC. CONCLUSIONS: Rwanda successfully adopted WelTel for supporting and monitoring COVID-19 cases and contacts in home-isolation and the implementation was instrumental to the country's effort to manage the pandemic. Experiences and perspectives of cases and contacts enrolled into WelTel must be explored to understand the appropriateness and effectiveness of the intervention.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e568/9879010/d79a8f3c6dbf/fdgth-04-1071790-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e568/9879010/08e3ad1b87ea/fdgth-04-1071790-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e568/9879010/abcc8ab3a02a/fdgth-04-1071790-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e568/9879010/d79a8f3c6dbf/fdgth-04-1071790-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e568/9879010/08e3ad1b87ea/fdgth-04-1071790-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e568/9879010/abcc8ab3a02a/fdgth-04-1071790-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e568/9879010/d79a8f3c6dbf/fdgth-04-1071790-g003.jpg

相似文献

[1]
SMS-based digital health intervention in Rwanda's home-based care program for remote management of COVID-19 cases and contacts: A qualitative study of sustainability and scalability.

Front Digit Health. 2023-1-9

[2]
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[3]
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[6]
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引用本文的文献

[1]
One Health investigation and response to a nationwide outbreak of Rift Valley fever in Rwanda - March to December 2022.

One Health. 2024-7-4

[2]
Natural language processing to evaluate texting conversations between patients and healthcare providers during COVID-19 Home-Based Care in Rwanda at scale.

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[3]
Association between e-health literacy and perceived importance of future pandemic preparedness in sub-saharan Africa.

Sci Rep. 2024-12-28

[4]
Qualitative Evaluation of mHealth Implementation for Infectious Disease Care in Low- and Middle-Income Countries: Narrative Review.

JMIR Mhealth Uhealth. 2024-12-13

[5]
Implementation and impact of the global access principles at the University of British Columbia: current successes and future challenges.

Front Pharmacol. 2023-12-15

本文引用的文献

[1]
Evaluation of the implementation process of the mobile health platform 'WelTel' in six sites in East Africa and Canada using the modified consolidated framework for implementation research (mCFIR).

BMC Med Inform Decis Mak. 2021-10-26

[2]
Authorized, clear and timely communication of risk to guide public perception and action: lessons of COVID-19 from China.

BMC Public Health. 2021-8-12

[3]
Early centralized isolation strategy for all confirmed cases of COVID-19 remains a core intervention to disrupt the pandemic spreading significantly.

PLoS One. 2021

[4]
The secondary transmission pattern of COVID-19 based on contact tracing in Rwanda.

BMJ Glob Health. 2021-6

[5]
A scope of mobile health solutions in COVID-19 pandemics.

Inform Med Unlocked. 2021

[6]
Barriers to Use of Remote Monitoring Technologies Used to Support Patients With COVID-19: Rapid Review.

JMIR Mhealth Uhealth. 2021-4-20

[7]
A global panel database of pandemic policies (Oxford COVID-19 Government Response Tracker).

Nat Hum Behav. 2021-4

[8]
Lessons Learned from Rwanda: Innovative Strategies for Prevention and Containment of COVID-19.

Ann Glob Health. 2021-2-25

[9]
Use of short message service in at-home COVID-19 patient management.

BMC Med. 2020-12-16

[10]
COVID-19 Mobile Apps: A Systematic Review of the Literature.

J Med Internet Res. 2020-12-9

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