scholarly journals The implementation of a mobile application to support community-based health workers

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A C F Martins ◽  
P L Pereira ◽  
A C C N Mafra ◽  
J L Miraglia ◽  
C N Monteiro ◽  
...  
Keyword(s):  
Health Care ◽  
Mobile Application ◽  
Total Population ◽  
Health Workers ◽  
Data Entry ◽  
Population Data ◽  
Administrative Staff ◽  
Economic Data ◽  
Process Change ◽  
Community Based

Abstract Issue Real-time access to up-to-date population information is essential to the strategic planning of primary health care (PHC). In the Brazilian public health system community-based health workers (CHWs), working as part of PHC teams, collect health, demographic and socio-economic data from individuals mainly through paper-based forms that are later entered manually into electronic information systems. Mobile applications could help to improve the quality and speed of this process facilitating the CHWs day-to-day work while improving the access to the collected information. Description of the Problem During September of 2019, a mobile application installed in tablets for the collection of health, demographic and socio-economic data was deployed for 432 CHWs of 87 PHC teams in the southern region of São Paulo, Brazil, serving a total population of 283,324 individuals. During implementation, the acceptability and challenges faced by CHWs were evaluated and the time taken to complete data entry. Results Seventy-two hours of training were offered to CHWs and other 139 professionals including managers, nurses and administrative staff (AS). Some CHWs reported concerns about the process change and fear of not being able to operate the application, especially those unfamiliar to the technology. With training and team support, fear was transformed into satisfaction with the realization of the benefits of the system. The main infrastructure challenge was the need for installation of Wi-Fi routers in some health care units, in addition to the replacement 4.4% of damaged tablets. In four months 97.6% of the total population was registered in the application. Lessons A WhatsApp group was created to clarify AS doubts, receive suggestions and disseminate guidelines. AS remained as the reference point at healthcare units and data completeness still needs to be reinforced. Key messages A mobile application was well-accepted by CHWs and could facilitate the collection of population data. A tablet app proved to be a useful tool to generate information for the PHC teams.

scholarly journals Can public sector community health workers deliver a nurturing care intervention in South Africa? The Amagugu Asakhula feasibility study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Sonja Klingberg ◽  
Esther M. F. van Sluijs ◽  
Stephanie T. Jong ◽  
Catherine E. Draper
Keyword(s):  
South Africa ◽  
Health Care ◽  
Public Sector ◽  
Health Workers ◽  
Care Facility ◽  
Health Care Facility ◽  
Preschool Age ◽  
Primary Health Care Facility ◽  
Community Based ◽  
Primary Health

Abstract Background Nurturing care interventions have the potential to promote health and development in early childhood. Amagugu Asakhula was designed to promote developmentally important dietary and movement behaviours among children of preschool age (3–5 years) in South Africa. An initial formative study in Cape Town found the intervention to be feasible and acceptable when delivered by community health workers (CHWs) linked to a community-based organisation. This study evaluated the delivery of the Amagugu Asakhula intervention by CHWs linked to a public sector primary health care facility in Soweto, as this mode of delivery could have more potential for sustainability and scalability. Methods A qualitative design was utilised to assess feasibility, acceptability, adoption, appropriateness, implementation, fidelity and context. CHWs (n = 14) delivered the intervention to caregivers (n = 23) of preschool-age children in Soweto over 6 weeks. Following the completion of the intervention, focus group discussions were held with CHWs and caregivers. Further data were obtained through observations, study records and key informant interviews (n = 5). Data were analysed using deductive thematic analysis guided by a process evaluation framework. Results The delivery of the Amagugu Asakhula intervention through CHWs linked to a primary health care facility in Soweto was not found to be feasible due to contextual challenges such as late payment of salaries influencing CHW performance and willingness to deliver the intervention. CHWs expressed dissatisfaction with their general working conditions and were thus reluctant to take on new tasks. Despite barriers to successful delivery, the intervention was well received by both CHWs and caregivers and was considered a good fit with the CHWs’ scope of work. Conclusions Based on these findings, delivery of the Amagugu Asakhula intervention is not recommended through public sector CHWs in South Africa. This feasibility study informs the optimisation of implementation and supports further testing of the intervention’s effectiveness when delivered by CHWs linked to community-based organisations. The present study further demonstrates how implementation challenges can be identified through qualitative feasibility studies and subsequently addressed prior to large-scale trials, avoiding the wasting of research and resources.

scholarly journals m-Palliative Care Link: Developing a Mobile Application to Improve Symptom Control and Information Exchange Among Specialists and Local Health Workers Treating Tanzanian Cancer Patients (Preprint)

2020 ◽  
Author(s):  
Robert S Morse ◽  
Kaley Lambden ◽  
Erin Quinn ◽  
Twalib Ngoma ◽  
Beatrice Mushi ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Care Coordination ◽  
Mobile Application ◽  
Health Workers ◽  
Symptom Control ◽  
Symptom Assessment ◽  
Local Health ◽  
Community Based ◽  
Functional Prototype

BACKGROUND Improving access to end-of-life symptom control interventions among cancer patients is a public health priority in Tanzania in need of innovative community-based solutions. Mobile health technology holds promise; however, existing resources are limited and access to palliative care specialists (hereafter, specialists) is poor. A mobile platform that extends specialist access via shared care with community-based local health workers (LHWs) and provides remote support for pain and symptom management can address this gap in care, particularly in low-resource settings. OBJECTIVE The aim of this study was to design and develop mobile-Palliative Care Link (mPCL), a mobile/web application to support symptom assessment and care coordination and control, with a focus on pain. METHODS A human-centered iterative design framework was used to develop the mPCL prototype for use by specialists (palliative care physicians and nurses), poor-prognosis cancer patients and their lay caregivers (patients/caregivers), and LHWs. Central to mPCL is the validated patient-focused African Palliative care Outcome Scale (POS), adapted for automated, twice-weekly collection of patient/caregiver responses, and timely review, reaction and tracking by specialists and LHWs. Prototype usability testing sessions were conducted in person in a controlled setting with 21 key informants representing target end users. Sessions consisted of direct observations and qualitative feedback on ease-of-use and recommendations for improvement. Results were used to build a usable, functional prototype for subsequent real-world testing. Early pilot testing was conducted by deploying the application among ten patients/caregivers, randomized to mPCL use versus phone-contact POS collection, and then gathering feedback from the specialists, LHWs and nurses who used mPCL to manage care. This feedback was employed to further optimize the application for a broader randomized field study to examine the application’s effectiveness in symptom control among cancer patients. RESULTS mPCL functionalities include the ability to create and update a synoptic clinical record; regular real-time symptom assessment; patient/caregiver and care team communication and care coordination; symptom-focused educational resources; and easy access to emergency contact information. Results from usability and pilot testing demonstrated that all users were able to successfully navigate the application and feedback suggests that mPCL has clinical utility. User-informed recommendations included: further improvement in navigation of the application, simplification of patient/caregiver components and language, and delineation of user roles. CONCLUSIONS We designed, built, and tested a usable, functional prototype of a mobile application supporting palliative care for cancer patients in Tanzania. mPCL is expressly designed to support coordinated care via customized interfaces supporting core users—patients/caregivers, LHWs and members of the palliative care team—and their respective roles. Future work is needed to demonstrate the effectiveness and sustainability of mPCL to remotely support symptom control needs of Tanzanian cancer patients, particularly in harder-to-reach areas.

Can Digitization of Health Care Help Low-Resourced Countries Provide Better Community-Based Rehabilitation Services?

2019 ◽  
Author(s):  
Joseph Kimuli Balikuddembe ◽  
Jan D Reinhardt
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Workers ◽  
Information Access ◽  
Vulnerable Groups ◽  
Community Based ◽  
Full Spectrum ◽  
Community Based Rehabilitation ◽  
Rural And Remote Areas ◽  
Traditional Health Care

Abstract In the wake of globalization, proliferation of digital technologies (DTs) is rapidly changing many activities across sectors, including health to “go digital”. Harnessing opportunities of DTs can be a pathway for delivery of health services such as community-based rehabilitation to the vulnerable groups of populations, particularly those in the low resourced countries where the health systems are still weak and experiencing a deficit of trained health workers to effectively deliver a full spectrum of health services. This perspective explored how some DTs can be leveraged in delivery of CBR services in the rural and remote areas of low resourced countries. This is described based on information access and exchange, social satisfaction, shortages of rehabilitation workforce, professional development and capacity building. However, a caution is made since seizing such advantages of DTs can inevitably be associated with spillovers and limitations among others including needs prioritization, skills and language limitations, internet addiction and censorship, professionalism and ethical dilemma and sustainability if proper remedies are not taken. Moreover, as DTs are revolutionizing various activities across sectors, including health; this is not meant to substitute the traditional health care activities including those delivered through CBR but rather to augment their delivery in low resourced settings and elsewhere.

Local Primary Health Care Committees and Community-Based Health Workers in Mkuranga District, Tanzania:

2007 ◽  
Vol 1 (1) ◽  
pp. 27-35 ◽  
Author(s):  
Godfrey M. Mubyazi ◽  
Adiel K. Mushi ◽  
Elizabeth Shayo ◽  
Kassembe Mdira ◽  
Joyce Ikingura ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Workers ◽  
Community Based ◽  
Primary Health

scholarly journals The Quality of Tuberculosis Services in Health Care Centres in a Rural District in Uganda: The Providers’ and Clients’ Perspective

2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
Author(s):  
Lilian Bulage ◽  
Juliet Sekandi ◽  
Omar Kigenyi ◽  
Ezekiel Mupere
Keyword(s):  
Health Care ◽  
Health Workers ◽  
Data Entry ◽  
Cross Sectional Study ◽  
Health Care Facilities ◽  
Control Measures ◽  
District Health ◽  
Cross Sectional ◽  
Infection Control Measures

Quality of care plays an important role in the status of tuberculosis (TB) control, by influencing timely diagnosis, treatment adherence, and treatment completion. In this study, we aimed at establishing the quality of TB service care in Kamuli district health care centres using Donabedian structure, process, and outcomes model of health care. A cross-sectional study was conducted in 8 health care facilities, among 20 health care workers and 392 patients. Data was obtained using face-to-face interviews, an observation guide, a check list, and record review of the TB unit and laboratory registers. Data entry and analysis were done using EPI INFO 2008 and STATA 10 versions, respectively. A high number 150 (87.21%) of TB patients were not aware of all the signs to stop TB medication, and 100 (25.51%) patients received laboratory results after a period of 3–5 working days. The major challenges faced by health workers were poor attitude of fellow health workers, patients defaulting treatment, and fear of being infected with TB. One of the worst performance indicators was low percentage of cure. Comprehensive strengthening of the health system focusing on quality of support supervisions, patient follow up, promoting infection control measures, and increasing health staffing levels at health facilities is crucial.

scholarly journals Utilization of Maternal Health Care Services in India: A Community Based Cross-sectional Study in Rural Belgaum

2019 ◽  
pp. 1-11
Author(s):  
Maginsh Dahal ◽  
Kushalata Baral ◽  
Mubashir Angolkar
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Care Delivery ◽  
Health Workers ◽  
Care Delivery ◽  
Health Care Delivery System ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional

Introduction: Sub Centre (SC) is the peripheral unit of the existing health care delivery system under the allopathic system of medicine in India. These basically provide preventive, promotive and the curative services and are facilitated by Female Health Workers (ANM) and Male Health Workers (MHW). They are the integral part of health care delivery system. Also, key to achieve a goal of health for all and to promote the community people for their overall development. Methods: A community based descriptive cross-sectional study was conducted from August 2011 to February 2013 in all 9 sub centers of Kinaye PHC of Belgaum district, all 14 maternal health care workers were selected  and 272 beneficiaries were selected from catchments area of these sub-centers were interviewed by administering structured, pretested interview schedule. Data were analyzed by SPSS (20 Version). Results: Study revealed that (85%) of the workers had correct knowledge but could not transform it into practice completely. This is due to multiple problems that encounter such as include lack of equipments(85.71%), transport facilities (77.78%), delay in decision-making by community to seek care (77.78%), lack of supportive supervision (>20%). Besides these, they were lacking in career development opportunities. There are no promotional avenues and low remuneration and benefits. The acceptance of service provided through sub centers was satisfactory (>90%) among beneficiaries and ANMs (98%) were most accepted than MHW. Beneficiaries faced many problems to access services such as lack of need based services (60%), poor attention by health service provider towards the need of consumers (5.2%) and difficulty in reaching to sub health post (21%). Conclusion: The regular supply of necessary equipments and medicines needs to be ensured          at the sub centre and frequent in-service trainings and career development opportunities to be given to health workers to maintain the enthusiasm and devotion towards the profession.                Also there is a need to provide skill development opportunities and ensure the convenience of service at all sub centers and communication between health workers and beneficiaries to be emphasized.

scholarly journals Development and Evaluation of a Perinatal Service Delivery Web Platform for Prenatal Care Coordinators (Preprint)

2018 ◽  
Author(s):  
Beenish Chaudhry
Keyword(s):  
Health Care ◽  
Prenatal Care ◽  
Pregnant Women ◽  
Care Coordination ◽  
Low Income ◽  
Health Workers ◽  
Real Life ◽  
Evaluation Process ◽  
Community Based ◽  
Care Coordinators

BACKGROUND Digital technology is increasingly being used to enhance various aspects of health care. In the area of community-based, it is important to understand the circumstances and challenges of deploying this technology to solve health care issues. OBJECTIVE To develop a tool to support communication and care coordination efforts of community-based prenatal care coordinators who serve low-income pregnant women, and to uncover barriers and facilitators to the tool's use before a wide-scale pilot study. METHODS We devised a four-step development and evaluation process: (1) state-wide stakeholder collaboration to conceptualize the system; (2) expert panel to identify key functionalities to support care coordination and communication between community-based health workers and pregnant women; (3) iterative and incremental development using agile design and software development; and (4) two evaluations to test usability and user acceptance of the system using real-life scenarios. RESULTS Participants found the web app easy to use and envisioned many benefits of using it in their practices. From the qualitative data, we uncovered many barriers around implementation of the technology, including care coordinator’s lack of motivation to participate in the study and provide feedback on the system design. CONCLUSIONS This research provides a methodology for development and deployment of a web-delivered technology in community-based setting. In addition, the research provides insights on real-life challenges of deploying a technology-based solution in community-based settings.

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