A systematic review of the factors that hinder the scale up of mobile health technologies in antenatal care programmes in sub-Saharan Africa

Background. Effective health systems are needed to care for the coming surge of diabetics in sub-Saharan Africa (SSA). Objective. We conducted a systematic review of literature to determine the capacity of SSA health systems to manage diabetes. Methodology. We used three different databases (Embase, Scopus, and PubMed) to search for studies, published from 2004 to 2017, on diabetes care in SSA. Results. Fifty-five articles met the inclusion criteria, covering the different aspects related to diabetes care such as availability of drugs and diagnostic tools, the capacity of healthcare workers, and the integration of diabetes care into HIV and TB platforms. Conclusion. Although chronic care health systems in SSA have developed significantly in the last decade, the capacity for managing diabetes remains in its infancy. We identified pilot projects to enhance these capacities. The scale-up of these pilot interventions and the integration of diabetes care into existing robust chronic disease platforms may be a feasible approach to begin to tackle the upcoming pandemic in diabetes. Nonetheless, much more work needs to be done to address the health system-wide deficiencies in diabetes care. More research is also needed to determine how to integrate diabetes care into the healthcare system in SSA.

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The impact of antenatal care on neonatal mortality in sub-Saharan Africa: A systematic review and meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0222566 ◽

2019 ◽

Vol 14 (9) ◽

pp. e0222566 ◽

Cited By ~ 12

Author(s):

Tesfalidet Tekelab ◽

Catherine Chojenta ◽

Roger Smith ◽

Deborah Loxton

Keyword(s):

Systematic Review ◽

Antenatal Care ◽

Neonatal Mortality ◽

Meta Analysis ◽

Sub Saharan Africa ◽

Sub Saharan ◽

The Impact

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Mobile health for non-communicable diseases in Sub-Saharan Africa: a systematic review of the literature and strategic framework for research

Globalization and Health ◽

10.1186/1744-8603-10-49 ◽

2014 ◽

Vol 10 (1) ◽

pp. 49 ◽

Cited By ~ 74

Author(s):

Gerald S Bloomfield ◽

Rajesh Vedanthan ◽

Lavanya Vasudevan ◽

Anne Kithei ◽

Martin Were ◽

...

Keyword(s):

Systematic Review ◽

Mobile Health ◽

Communicable Diseases ◽

Sub Saharan Africa ◽

Review Of The Literature ◽

Non Communicable Diseases ◽

Strategic Framework ◽

Sub Saharan

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Optimizing Network Connectivity for Mobile Health Technologies in sub-Saharan Africa

PLoS ONE ◽

10.1371/journal.pone.0045643 ◽

2012 ◽

Vol 7 (9) ◽

pp. e45643 ◽

Cited By ~ 17

Author(s):

Mark J. Siedner ◽

Alexander Lankowski ◽

Derrick Musinga ◽

Jonathon Jackson ◽

Conrad Muzoora ◽

...

Keyword(s):

Mobile Health ◽

Network Connectivity ◽

Sub Saharan Africa ◽

Health Technologies ◽

Sub Saharan

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Achieving Sustainability and Scale-Up of Mobile Health Noncommunicable Disease Interventions in Sub-Saharan Africa: Views of Policy Makers in Ghana (Preprint)

10.2196/preprints.11497 ◽

2018 ◽

Author(s):

Daniel Opoku ◽

Reinhard Busse ◽

Wilm Quentin

Keyword(s):

Mobile Health ◽

Scale Up ◽

Noncommunicable Disease ◽

Sub Saharan Africa ◽

Successful Implementation ◽

Policy Makers ◽

Context Factors ◽

Number Of Patients ◽

Sub Saharan

BACKGROUND A growing body of evidence shows that mobile health (mHealth) interventions may improve treatment and care for the rapidly rising number of patients with noncommunicable diseases (NCDs) in sub-Saharan Africa (SSA). A recent realist review developed a framework highlighting the influence of context factors, including predisposing characteristics, needs, and enabling resources (PNE), for the long-term success of mHealth interventions. The views of policy makers will ultimately determine implementation and scale-up of mHealth interventions in SSA. However, their views about necessary conditions for sustainability and scale-up remain unexplored. OBJECTIVE This study aimed to understand the views of policy makers in Ghana with regard to the most important factors for successful implementation, sustainability, and scale-up of mHealth NCD interventions. METHODS Members of the technical working group responsible for Ghana’s national NCD policy were interviewed about their knowledge of and attitude toward mHealth and about the most important factors contributing to long-term intervention success. Using qualitative methods and applying a qualitative content analysis approach, answers were categorized according to the PNE framework. RESULTS A total of 19 policy makers were contacted and 13 were interviewed. Interviewees had long-standing work experience of an average of 26 years and were actively involved in health policy making in Ghana. They were well-informed about the potential of mHealth, and they strongly supported mHealth expansion in the country. Guided by the PNE framework’s categories, the policy makers ascertained which critical factors would support the successful implementation of mHealth interventions in Ghana. The policy makers mentioned many factors described in the literature as important for mHealth implementation, sustainability, and scale-up, but they focused more on enabling resources than on predisposing characteristics and need. Furthermore, they mentioned several factors that have been rather unexplored in the literature. CONCLUSIONS The study shows that the PNE framework is useful to guide policy makers toward a more systematic assessment of context factors that support intervention implementation, sustainability, and scale-up. Furthermore, the framework was refined by adding additional factors. Policy makers may benefit from using the PNE framework at the various stages of mHealth implementation. Researchers may (and should) use the framework when investigating reasons for success (or failure) of interventions.

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Determinants of antenatal care utilisation in sub-Saharan Africa: a systematic review

BMJ Open ◽

10.1136/bmjopen-2019-031890 ◽

2019 ◽

Vol 9 (10) ◽

pp. e031890 ◽

Cited By ~ 16

Author(s):

Ijeoma Nkem Okedo-Alex ◽

Ifeyinwa Chizoba Akamike ◽

Obumneme Benaiah Ezeanosike ◽

Chigozie Jesse Uneke

Keyword(s):

Systematic Review ◽

Antenatal Care ◽

Assessment Tool ◽

Unplanned Pregnancy ◽

Data Extraction ◽

Sub Saharan Africa ◽

Intersectoral Collaboration ◽

Geographical Access ◽

Sub Saharan ◽

Antenatal Visits

ObjectivesTo identify the determinants of antenatal care (ANC) utilisation in sub-Saharan Africa.DesignSystematic review.Data sourcesDatabases searched were PubMed, OVID, EMBASE, CINAHL and Web of Science.Eligibility criteriaPrimary studies reporting on determinants of ANC utilisation following multivariate analysis, conducted in sub-Saharan Africa and published in English language between 2008 and 2018.Data extraction and synthesisA data extraction form was used to extract the following information: name of first author, year of publication, study location, study design, study subjects, sample size and determinants. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist for reporting a systematic review or meta-analysis protocol was used to guide the screening and eligibility of the studies. The Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was used to assess the quality of the studies while the Andersen framework was used to report findings.Results74 studies that met the inclusion criteria were fully assessed. Most studies identified socioeconomic status, urban residence, older/increasing age, low parity, being educated and having an educated partner, being employed, being married and Christian religion as predictors of ANC attendance and timeliness. Awareness of danger signs, timing and adequate number of antenatal visits, exposure to mass media and good attitude towards ANC utilisation made attendance and initiation of ANC in first trimester more likely. Having an unplanned pregnancy, previous pregnancy complications, poor autonomy, lack of husband’s support, increased distance to health facility, not having health insurance and high cost of services negatively impacted the overall uptake, timing and frequency of antenatal visits.ConclusionA variety of predisposing, enabling and need factors affect ANC utilisation in sub-Saharan Africa. Intersectoral collaboration to promote female education and empowerment, improve geographical access and strengthened implementation of ANC policies with active community participation are recommended.

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