Tariku Amare, Andargie Betelhem Abebe, Yilma Tesfahun Melese, Mohammed Abdulaziz, Abera Adams, Mohan Diwakar, Pandya Shivani, Kan Lena, Ruton Hinda, Kimball Meredith, Mechael Patricia, Agarwal Smisha, Tilahun Binyam
Center for Digital Health and Implementation Sciences, University of Gondar, Gondar, Ethiopia.
Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States.
Oxf Open Digit Health. 2025 Aug 14;3:oqaf018. doi: 10.1093/oodh/oqaf018. eCollection 2025.
Rwanda is harnessing digital health as a key strategy to improve optimal access to quality maternal and child health services, aiming to reduce maternal and child mortality and attain sustainable development goals. Evidence is essential to guide Rwanda's effort to integrate digital health technologies with maternal and child health service delivery. This study analyzed data from 2010, 2014/15 and 2019/20 Rwanda demographic and health surveys to explore trends and socio-economic equity in mobile phone ownership and its influence on reproductive and maternal health service utilization. Results showed a marked increase in household mobile phone ownership from 40% in 2010 to 71% in 2019/20. Significant pro-rich inequities in household mobile phone ownership were observed in 2010 (concentration index = 0.46), 2014/15 (concentration index = 0.28) and 2019/20 (concentration index = 0.22). Mobile phone was also higher among the educated in 2010 (slope index = 0.63), 2014/15 (slope index = 0.59), and 2019/20 (slope index = 0.50). Mobile phones were inequitably distributed favoring better-off (concentration index = 0.29) and educated women (slope index = 0.47), respectively. Women with mobile phone had significantly higher odds of attending four or more antenatal care visits [adjusted odds ratio (AOR) = 1.42, confidence interval (CI): 95% 1.16, 1.72] and ensuring full immunization in children aged 12-23 months [AOR = 1.61, CI: 95% 1.02, 2.55]. Differences in mobile phone ownership accounted 58% of the observed disparity in antenatal care utilization. These findings underscore that while there has been a substantial increase in mobile phone ownership, it remains unevenly distributed in Rwanda. Addressing these is critical to increasing coverage and equitable access to reproductive and maternal health services in Rwanda.
卢旺达将数字健康作为一项关键战略，以改善优质母婴健康服务的最佳可及性，旨在降低母婴死亡率并实现可持续发展目标。证据对于指导卢旺达将数字健康技术与母婴健康服务提供相结合的努力至关重要。本研究分析了2010年、2014/15年和2019/20年卢旺达人口与健康调查的数据，以探讨手机拥有情况的趋势和社会经济公平性及其对生殖和孕产妇健康服务利用的影响。结果显示，家庭手机拥有率从2010年的40%显著上升至2019/20年的71%。2010年（集中指数=0.46）、2014/15年（集中指数=0.28）和2019/20年（集中指数=0.22）观察到家庭手机拥有情况存在显著的有利于富人的不平等现象。2010年（斜率指数=0.63）、2014/15年（斜率指数=0.59）和2019/20年（斜率指数=0.50），受过教育者的手机拥有率也更高。手机分布不均，分别有利于富裕女性（集中指数=0.29）和受过教育的女性（斜率指数=0.47）。拥有手机的女性进行四次或更多次产前检查的几率显著更高[调整后的优势比（AOR）=1.42，置信区间（CI）：95% 1.16，1.72]，并确保12至23个月大儿童的全面免疫接种[AOR=1.61，CI：95% 1.02，2.55]。手机拥有情况的差异占观察到的产前检查利用差异的58%。这些发现强调，虽然手机拥有率大幅上升，但在卢旺达其分布仍然不均衡。解决这些问题对于提高卢旺达生殖和孕产妇健康服务的覆盖率及公平可及性至关重要。
