Section of Global Health, Department of Emergency Medicine, College of Medicine, University of Florida, Gainesville, Florida, USA.
Department of Environmental & Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA.
Trop Med Int Health. 2023 Sep;28(9):763-770. doi: 10.1111/tmi.13921. Epub 2023 Aug 3.
We sought to evaluate the prerequisites (demand, interest, feasibility) for adapting a paediatric nighttime telemedicine and medication delivery service (TMDS) to Ghana.
A cross-sectional survey of households and associated healthcare providers was conducted in urban and rural Ghana. Households were identified through randomised geospatial sampling; households with at least one child <10 years were enrolled. Household surveys collected information relating to demographics, household resources, standardised case scenarios, recent paediatric health events, satisfaction with healthcare access, and interest in TMDS intervention models. Providers were identified by households and enrolled. Provider surveys collected provider type, hours of operation, services, and opinions of a TMDS model.
A total of 511 (263 urban, 248 rural) households and 18 providers (10 urban, 8 rural) were surveyed. A total of 262 health events involving children <10 years were reported, of which 47% occurred at night. Care was sought for >70% of health events presenting at night; however, care-seeking was delayed until morning or later for >75% of these events; 54% of households expressed dissatisfaction with their current access to paediatric care at night; 99% of households expressed that a nighttime TMDS service for children would be directly useful to their families. Correspondingly, 17 of 18 providers stated that a TMDS was needed in their community; >99% of households had access to a cellular phone. All households expressed willingness to use their phones to call a TMDS and allow a TMDS provider into their homes at night. Willingness to pay and provider-recommended price points varied by setting.
Prerequisites for adapting a TMDS to Ghana were met. A nighttime paediatric TMDS service was found to be needed, appealing, and feasible in Ghana. These data motivate the adaptation of a TMDS to urban and rural Ghana.
我们旨在评估将儿科夜间远程医疗和药物输送服务（TMDS）改编为加纳的先决条件（需求、兴趣、可行性）。
在加纳城乡地区进行了一项横断面调查，调查对象为家庭和相关医疗服务提供者。通过随机地理空间抽样确定家庭；招募至少有一名 10 岁以下儿童的家庭。家庭调查收集了与人口统计学、家庭资源、标准化病例情景、最近儿科健康事件、对医疗保健获取的满意度以及对 TMDS 干预模式的兴趣相关的信息。通过家庭确定并招募提供者。提供者调查收集了提供者类型、营业时间、服务以及对 TMDS 模型的意见。
共调查了 511 个（263 个城市，248 个农村）家庭和 18 个提供者（10 个城市，8 个农村）。共报告了 262 起涉及 10 岁以下儿童的健康事件，其中 47%发生在夜间。超过 70%的夜间发生的健康事件寻求了治疗；然而，超过 75%的这些事件直到早上或更晚才寻求治疗；54%的家庭对他们夜间获得儿科护理的现状表示不满；99%的家庭表示夜间儿童 TMDS 服务对他们的家庭直接有用。相应地，18 名提供者中有 17 名表示他们所在社区需要 TMDS；超过 99%的家庭都有手机。所有家庭都表示愿意使用手机拨打 TMDS 电话，并允许 TMDS 提供者在夜间进入他们的家中。支付意愿和提供者建议的价格点因环境而异。
改编 TMDS 到加纳的先决条件得到满足。在加纳，夜间儿科 TMDS 服务被认为是必要的、有吸引力的和可行的。这些数据促使我们将 TMDS 改编为加纳的城市和农村地区。
