Dutt Priyanka, Godfrey Anna, Chamberlain Sara, Mitra Radharani
BBC Media Action India, New Delhi, India.
BBC Media Action, London, UK.
Integr Healthc J. 2022 Dec 29;4(1):e000139. doi: 10.1136/ihj-2022-000139. eCollection 2022.
Between 2011 and 2019, an integrated communication programme to address reproductive, maternal, neonatal and child health was implemented in the Indian state of Bihar. Along with mass media, community events and listening groups, four mobile health services were co-designed with the government of Bihar. These were -a training course for frontline health workers (FLHWs) supporting them as the last mile of the health system; -a job aid to support FLHWs' interactions with families; -a maternal messaging service delivering information directly to families' mobile phones, encouraging families to seek public health services through their FLHWs; and -mobile audio stimulus used by FLHWs in community events. While and scaled to other states (two and one, respectively), neither was adopted nationally. The Government of India adopted and and scaled to 12 additional states by 2019. In this article, we describe the programme's overarching person-centred theory of change, reflect on how the mHealth services supported integration with the health system and discuss implications for the role of health communication solutions in supporting families to navigate healthcare systems. Evaluations of and were conducted in Bihar between 2013 and 2017. Between 2018-2020, an independent evaluation was conducted involving a randomised controlled trial for in Madhya Pradesh; qualitative research on and and secondary analyses of call record data. While the findings from these evaluations are described elsewhere, this article collates key findings for all the services and offers implications for the role digital and non-digital communication solutions can play in supporting joined-up healthcare and improving health outcomes.
2011年至2019年期间,印度比哈尔邦实施了一项旨在解决生殖、孕产妇、新生儿和儿童健康问题的综合沟通计划。除了大众媒体、社区活动和倾听小组外,还与比哈尔邦政府共同设计了四项移动健康服务。它们分别是:为一线卫生工作者(FLHWs)提供的培训课程,作为卫生系统的最后一公里支持他们;支持一线卫生工作者与家庭互动的工作辅助工具;通过手机直接向家庭发送信息的孕产妇信息服务,鼓励家庭通过一线卫生工作者寻求公共卫生服务;以及一线卫生工作者在社区活动中使用的移动音频刺激工具。虽然[具体服务1]和[具体服务2]推广到了其他邦(分别为两个和一个),但都未在全国范围内采用。印度政府采用了[具体服务3]和[具体服务4],并在2019年前推广到了另外12个邦。在本文中,我们描述了该计划以人为主导的总体变革理论,反思移动健康服务如何支持与卫生系统的整合,并讨论健康沟通解决方案在支持家庭应对医疗系统方面的作用所带来的影响。2013年至2017年期间在比哈尔邦对比[具体服务1]和[具体服务2]进行了评估。2018年至2020年期间,进行了一项独立评估,包括在中央邦对[具体服务3]进行随机对照试验;对[具体服务4]和[具体服务5]进行定性研究以及对通话记录数据进行二次分析。虽然这些评估的结果在其他地方有描述,但本文整理了所有服务的关键结果,并探讨了数字和非数字沟通解决方案在支持联合医疗保健和改善健康结果方面可以发挥的作用。