scholarly journals Mobile health messaging service and helpdesk for South African mothers (MomConnect): history, successes and challenges

2018 ◽  
Vol 3 (Suppl 2) ◽  
pp. e000559 ◽  
Author(s):  
Peter Barron ◽  
Joanne Peter ◽  
Amnesty E LeFevre ◽  
Jane Sebidi ◽  
Marcha Bekker ◽  
...  
Keyword(s):  
Pregnant Women ◽  
South African ◽  
Mobile Health ◽  
Health Workers ◽  
Digital Health ◽  
Universal Coverage ◽  
Text Messages ◽  
Time Data ◽  
Department Of Health ◽  
Early Decision

MomConnect is a flagship programme of the South African National Department of Health that has reached over 1.5 million pregnant women. Using mobile technology, MomConnect provides pregnant and postpartum women with twice-weekly health information text messages as well as access to a helpdesk for patient queries and feedback. In just 3 years, MomConnect has been taken to scale to reach over 95% of public health facilities and has reached 63% of all pregnant women attending their first antenatal appointment. The helpdesk has received over 300 000 queries at an average of 250 per day from 6% of MomConnect users. The service is entirely free to its users. The rapid deployment of MomConnect has been facilitated by strong government leadership, and an ecosystem of mobile health implementers who had experience of much of the content and technology required. An early decision to design MomConnect for universal coverage has required the use of text-based technologies (short messaging service and Unstructured Supplementary Service Data) that are accessible via even the most basic mobile phones, but cumbersome to use and costly at scale. Unlike previous mobile messaging services in South Africa, MomConnect collects the user’s identification number and facility code during registration, enabling future linkages with other health and population databases and geolocated feedback. MomConnect has catalysed additional efforts to strengthen South Africa’s digital health architecture. The rapid growth in smartphone penetration presents new opportunities to reduce costs, increase real-time data collection and expand the reach and scope of MomConnect to serve health workers and other patient groups.

scholarly journals Acceptability and User Experiences of a Patient-Held Smart Card for Antenatal Services in Nigeria: A Qualitative Study

2022 ◽  
Author(s):  
Ijeoma Uchenna Itanyi ◽  
Juliet Iwelunmor ◽  
John Olawepo ◽  
Semiu Gbadamosi ◽  
Alexandra Ezeonu ◽  
...  
Keyword(s):  
Maternal Health ◽  
Health Outcomes ◽  
Pregnant Women ◽  
Smart Card ◽  
Mobile Health ◽  
Medical Information ◽  
Health Workers ◽  
Smart Cards ◽  
Major Barrier ◽  
Antenatal Services

Abstract Background Poor maternal, newborn and child health outcomes remain a major public health challenge in Nigeria. Mobile health (mHealth) interventions such as patient-held smart cards have been proposed as effective solutions to improve maternal health outcomes. Our objectives were to assess the acceptability and experiences of pregnant women with the use of a patient-held smartcard for antenatal services in Nigeria. Methods Using focus group discussions, qualitative data were obtained from 35 pregnant women attending antenatal services in four Local Government Areas (LGAs) in Benue State, Nigeria. The audio-recorded data were transcribed and analyzed using framework analysis techniques such as the PEN-3 cultural model as a guide. Results The participants were 18-44 years of age (median age: 24 years), all were married and the majority were farmers. Most of the participants had accepted and used the smartcards for antenatal services. The most common positive perceptions about the smartcards were their ability to be used across multiple health facilities, the preference for storage of the women’s medical information on the smartcards compared to the usual paper-based system, and shorter waiting times at the clinics. Notable facilitators to using the smartcards were its provision at the “Baby showers” which were already acceptable to the women, access to free medical screenings, and ease of storage and retrieval of health records from the cards. Costs associated with health services was reported as a major barrier to using the smartcards. Support from health workers, program staff and family members, particularly spouses, encouraged the participants to use the smartcards. Conclusion These findings revealed that patient-held smart card for maternal health care services is acceptable by women utilizing antenatal services in Nigeria. Understanding perceptions, barriers, facilitators, and supportive systems that enhance the use of these smart cards may facilitate the development of lifesaving mobile health platforms that have the potential to achieve antenatal, delivery, and postnatal targets in a resource-limited setting.

scholarly journals SMS feedback system as a quality assurance mechanism: experience from a household survey in rural India

2021 ◽  
Vol 6 (Suppl 5) ◽  
pp. e005287
Author(s):  
Neha Shah ◽  
Osama Ummer ◽  
Kerry Scott ◽  
Jean Juste Harrisson Bashingwa ◽  
Nehru Penugonda ◽  
...  
Keyword(s):  
Quality Assurance ◽  
Data Quality ◽  
Health Workers ◽  
Digital Health ◽  
Qualitative Interviews ◽  
Household Survey ◽  
Feedback Loops ◽  
Text Messages ◽  
Data Capture ◽  
Quality Assurance Mechanism

The increasing use of digital health solutions to support data capture both as part of routine delivery of health services and through special surveys presents unique opportunities to enhance quality assurance measures. This study aims to demonstrate the feasibility and acceptability of using back-end data analytics and machine learning to identify impediments in data quality and feedback issues requiring follow-up to field teams using automated short messaging service (SMS) text messages. Data were collected as part of a postpartum women’s survey (n=5095) in four districts of Madhya Pradesh, India, from October 2019 to February 2020. SMSs on common errors found in the data were sent to supervisors and coordinators. Before/after differences in time to correction of errors were examined, and qualitative interviews conducted with supervisors, coordinators, and enumerators. Study activities resulted in declines in the average number of errors per week after the implementation of automated feedback loops. Supervisors and coordinators found the direct format, complete information, and automated nature of feedback convenient to work with and valued the more rapid notification of errors. However, coordinators and supervisors reported preferring group WhatsApp messages as compared with individual SMSs to each supervisor/coordinator. In contrast, enumerators preferred the SMS system over in-person group meetings where data quality impediments were discussed. This study demonstrates that automated SMS feedback loops can be used to enhance survey data quality at minimal cost. Testing is needed among data capture applications in use by frontline health workers in India and elsewhere globally.

scholarly journals An analysis of specialist surgeons and their practices

2011 ◽  
Vol 14 (3) ◽  
pp. 245-262 ◽  
Author(s):  
Steve Koch ◽  
Jean D Slabbert
Keyword(s):  
South African ◽  
Empirical Analysis ◽  
Health Workers ◽  
Patient Falls ◽  
Marginal Costs ◽  
Department Of Health ◽  
Public Sector Health ◽  
Returns To Experience ◽  
Similar Range ◽  
The Empirical Analysis

A purposive sample of South African specialist doctors provided data for an empirical analysis of revenues, costs and earnings associated with specialist surgical medicine. The empirical analysis includes both parametric and nonparametric regression. Parametric estimates of revenues per new patient range between R689 to R818, while cost per new patient estimates range between R694 and R749; average surgeon income per new patient falls within a similar range.  Furthermore, costs per surgery follow a cubic specification, implying increasing marginal costs at the practice level. Returns to experience are estimated to be quadratic, although imprecisely so, given limited observations. Due to the low response rate in the survey, there is a need to conduct further research into this topic, to provide better information to both specialists and the South African Department of Health, which sets pay packages for public sector health workers.

Digital healthcare tools for the world’s poorest people and places: A new framework for syndromic surveillance forged in the fight against COVID-19 in Somalia. (Preprint)

2021 ◽  
Author(s):  
Shrey Jain ◽  
Ian Furst ◽  
Marie Charpignon ◽  
Mathew Samuel ◽  
Kimberly Gire ◽  
...  
Keyword(s):  
Data Collection ◽  
Syndromic Surveillance ◽  
Health Workers ◽  
Municipal Government ◽  
Digital Health ◽  
Rapid Development ◽  
Time Data ◽  
Survey Tool ◽  
Digital Survey ◽  
Pharmaceutical Interventions

UNSTRUCTURED Low- and middle-income (LMIC) countries often lack capacity for infectious disease surveillance. The COVID-19 pandemic has challenged many of them to implement non-pharmaceutical interventions while preparing to distribute vaccines. Because of the rapidly evolving situation in many LMICs, real-time data is crucial to understand the needs of the population, and to provide supportive evidence for healthcare interventions. In this paper, we highlight the role of international partners in a data collection effort (79,746 individuals surveyed over six weeks, beginning in April, 2020,) led by the municipal government in Mogadishu, Somalia, where health workers and officials are battling COVID-19 alongside numerous other communicable diseases, as well as violent extremism, and natural disasters. This effort united a collaboration between Canadian and Somalian digital health information engineers in developing a freely-accessible open source digital survey tool for syndromic surveillance. The project enabled extensive health data collection and sharing. It also spurred the rapid development of locally-customized digital solutions, and the training of local digital health engineers. The research insights gathered from this project have been instrumental in the implementation of non-pharmaceutical interventions and in health and sanitation resource allocation in Mogadishu, while providing an updated perspective of the socio-demographics of the population of a city that has not had a census since 1975. Nine collaborative principles are elucidated for developing digital survey tools for syndromic surveillance. The project offers a model for replication in other LMICs.

scholarly journals Evaluating AVADAR Mobile Health Intervention Using a Multi-prong Approach

2021 ◽  
Author(s):  
Godwin Ubong Akpan ◽  
Johnson Ticha ◽  
Fiona Lau ◽  
Reuben Ngofa ◽  
Diallo Mamadou ◽  
...  
Keyword(s):  
Peer Review ◽  
Mobile Health ◽  
Health Workers ◽  
Digital Health ◽  
Health Intervention ◽  
African Countries ◽  
Peer Reviews ◽  
Acute Flaccid Paralysis Surveillance ◽  
Afp Surveillance

Abstract Background The Auto-Visual AFP Detection and Reporting (AVADAR) digital health intervention programme is a programme that was introduced to Africa in 2016. The programme adopts the use of the AVADAR SMS – based smartphone application (app) in community-based AFP surveillance activities in order to enhance the detection and reporting of AFP (polio) cases and improve AFP surveillance quality. As at 2020, the AVADAR application is being used in 11 African countries. The need to conduct regular and relevant evaluations of the AVADAR programme is very essential towards improving polio eradication programme performance and effectiveness in Africa. Hence, this study aimed to review and evaluate the quality of the AFP cases reported through the AVADAR intervention and as well evaluate the documentation process of AVADAR alerts and investigations, and the assimilation of AFP cases found via AVADAR into the national databases. Methods This study reviewed and evaluated the quality of AVADAR-involved AFP case reporting and documentation process in 7 of the 11 African countries implementing the AVADAR programme (Cameroon, Chad, the DRC, Liberia, Mali, Niger, and South Sudan). Case validations of all AFP cases reported via AVADAR app, iterations of methods used for peer reviewing AVADAR reporting and documentation, informal interview of community informants (CIs) and health workers (HWs), as well as the development of interactive dashboard to showcase the results of peer reviews, were the approaches used for the review and evaluation process. Results Thirty-nine districts, cutting across the participating 7 African countries were selected for the study. A total of 581 AFP cases were reviewed in the selected districts; of which 496 AFP cases were physically seen with 384 cases confirmed as true AFP cases by the peer reviewers. Thematic findings obtained the interview with CIs and HWs identified key areas (communication, multi-disease reporting, and periodic evaluation) that needs to be improved in the AVADAR surveillance system. Also, the interactive dashboard gave a summary of the peer review outcomes at few glances. Conclusions The findings of the AVADAR AFP peer reviews revealed the app’s efficacy in reporting AFP cases and improving surveillance indicators at district level. However, its documentation at health facility level needs to be re-emphasized and improved via a systematic accountability framework implementation for the actors in the reporting cycle. In order to significantly improve AFP surveillance, we recommend on-going commitment to improve knowledge and collaboration between all AVADAR surveillance reporting teams involved in identifying children presenting with AFP. Keywords: AVADAR, Mobile Health, Peer Review, Acute Flaccid Paralysis, surveillance , Africa

scholarly journals Assessment of risk factors for Non-Communicable diseases among a cohort of community health workers in Western Cape, South Africa

2021 ◽  
Vol 33 (3) ◽  
pp. 196-203
Author(s):  
Levona Johnson ◽  
Laura Schopp ◽  
Firdouza Waggie ◽  
J.M Frantz
Keyword(s):  
South Africa ◽  
Community Health ◽  
South African ◽  
Community Health Workers ◽  
Health Workers ◽  
Communicable Diseases ◽  
Western Cape ◽  
Non Communicable Diseases ◽  
Department Of Health ◽  
Agents Of Change

Community Health Workers (CHWs) have been identified as the key health professionals to drive the agenda of the prevention of health risk behaviours, linked to non-communicable diseases (NCDs) in South Africa. They are regarded as the agents of change, who will provide impetus to the achievement of the health behaviour goals, set out by the South African National Department of Health.

EFEKTIFITAS KONSELING LAKTASI PADA IBU HAMIL TRIMESTER III TERHADAP PELAKSANAAN MENYUSUI

2019 ◽  
Vol 11 (1) ◽  
pp. 41-50
Author(s):  
Heni Purwaningsih ◽  
Umi Aniroh ◽  
Eko Mardiyaningsih
Keyword(s):  
Mortality Rate ◽  
Pregnant Women ◽  
Body Position ◽  
Development Program ◽  
Optimal Growth ◽  
Infant Mortality Rate ◽  
P Value ◽  
Time Data ◽  
Emotional Bonding ◽  
Post Test

Program pembangunan kesehatan di Indonesia masih berfokus pada upaya peningkatan derajat kesehatan ibu dan anak terutama pada masa prenatal. Hal ini disebabkan masih tingginya Angka Kematian Ibu (AKI) dan Angka Kematian Bayi (AKB). ASI yang diberikan sejak usia dini dan dilanjutkan dengan ASI eksklusif selama 6 bulan dapat menurunkan angka kesakitan dan angka kematian bayi serta meningkatkan tumbuh kembang bayi secara optimal.  Penelitian ini bertujuan untuk mengetahui efektifitas pemberian konseling laktasi terhadap pelaksanaan menyusui pada ibu hamil trimester III. Desain penelitian menggunakan quasi eksperimen dengan rancangan One Group Pre-test dan  Post-test Desain. Populasi dalam penelitian ini adalah ibu hamil trimester III dan sampel yang diambil adalah 18 ibu hamil. Alat penggumpulan data menggunakan lembar observasi BREAST (body position, respons, emotional bonding, anatomy dan sucking time). Analisis data menggunakan wilcoxon.Hasil penelitian didapatkan pelaksanaan menyusui sebelum dilakukan konseling laktasi dalam kategori kurang (72,2%) sedangkan pelaksanaan menyusui setelah dilakukan konseling laktasi (77,8%) dalam kategori baik. Konseling laktasi efektif dilakukan untuk meningkatkan pelaksanaan menyusui denganp-value 0,003 (p<0,005).Konseling laktasi seharusnya diberikan pada masa prenatal sehingga pada saat postpartum, ibu sudah mampu memberikan asi secara maksimal. Pendampingan terhadap ibu hamil juga berperan dalam pelaksanaan pemberian ASI.   Kata kunci : Konseling laktasi, ASI, pelaksanaan menyusui   THE EFFECTIVENESS OF LACTATION COUNSELING IN THE 3rd TRIMESTER PREGNANT WOMEN ON BREASTFEEDING IMPLEMENTATION   ABSTRACT Indonesia's health development program still focuses on improving mother and child health, especially at the prenatal stage. It is due to the high maternal mortality rate (MMR) and Infant Mortality Rate (IMR). Breastmilk given from an early age and continued with exclusive breastfeeding for six months can reduce infants morbidity and mortality rate and increase their optimal growth. The purpose is to investigate the effectiveness of lactation counseling to the implementation of breastfeeding in third-trimester. The study design used quasi experiments with one group pre-test and post-test. Population was the 3rd-trimester pregnant mothers, and the samples were 18 mothers. The data collection tool used BREAST observation sheets (body position, response, emotional bonding, anatomy and sucking time). Data analysis used Wilcoxon. The result of the research shows that breastfeeding before lactation counseling is in less category (72,2%) while breastfeeding after lactation counseling (77,8%) is in a goodcategory. Effective lactation counseling is performed to improve the implementation of breastfeeding with p-value 0.003 (p <0.005). Lactation counseling should be given during the prenatal period so that at the time of postpartum, the mother has been able to give breastmilk maximally. Mentoring for pregnant women also plays a role in the implementation of breastfeeding Keywords: lactation counseling, breast milk, breastfeeding implementation

STUDI KUALITATIF : KEBUTUHAN IBU HAMIL DENGAN DIABETES MELITUS GESTASIONAL DI KABUPATEN KARANGANYAR JAWA TENGAH

2020 ◽  
pp. 17-26
Author(s):  
Arista Apriani ◽  
M Mufdlilah ◽  
Menik Sri Daryanti
Keyword(s):  
Social Support ◽  
Pregnant Women ◽  
Health Center ◽  
Blood Sugar ◽  
Interpretative Phenomenological Analysis ◽  
Health Workers ◽  
Phenomenological Analysis ◽  
Lifestyle Changes ◽  
Structured Interviews ◽  
Diabetes Melitus

ABSTRAK GDM dapat berpotensi menimbulkan komplikasi serius yang dapat mengakibatkan risiko kesehatan jangka pendek dan jangka panjang bagi ibu dan bayinya. diagnosis GDM menimbulkan efek emosional yang negatif. Persepsi ibu hamil tentang GDM dapat memengaruhi perubahan gaya hidup. Garis pertama penatalaksanaan DMG yaitu dengan perubahan gaya hidup. Tujuan menggali secara mendalam kebutuhan ibu dengan diagnosis diabetes melitus gestasional. Metode penelitian kualitatif dengan pendekatan  fenomenologi. Lokasi di Kabupaten Karanganyar yaitu Puskesmas Jaten I, Puskesmas Matesih dan RSUD Kabupaten Karanganyar, pada bulan Oktober 2019 - Januari 2020. Sampel secara criterion sampling Pengumpulan data dengan semistructure interview dengan one on one interview. Uji Keabsahan Data dengan Credibility pada penelitian ini menggunakan strategi validitas triangulasi, Tranferability, Dependability, Confirmability. Analisis data dengan Interpretative Phenomenological Analysis (IPA). Hasil penelitian kebutuhan ibu hamil dengan DMG teridentifikasi empat tema, yaitu dukungan keluarga dalam hal mengontrol pola makan, mengatarkan periksa ke tenaga kesehatan, dan mengingatkan untuk aktifitas olah raga. Dukungan sosial, yaitu cara mengontrol gula darah. Dukungan tenaga kesehatan, yaitu saran dan motivasi untuk mengontrol gula darah. Informasi mendapat saran atau perawatan DMG dalam kehamilan adalah dari tenaga kesehatan yaitu bidan, dokter, serta selain tenaga kesehatan dari teman dan internet. Kesimpulannya kebutuhan ibu hamil dengan DMG teridentifikasi empat tema, yaitu dukungan keluarga, dukungan sosial, dukungan tenaga kesehatan dan informasi.   Kata kunci: diabetes melitus gestasional, kehamilan, kebutuhan.   ABSTRACT GDM can overcome serious problems that can overcome short-term and long-term health problems for mother and baby. a diagnosis of GDM has a negative emotional effect. Pregnant women 's perception of GDM can affect lifestyle changes. The first line of management of DMG is lifestyle changes. Diagnosis of gestational diabetes mellitus. Qualitative research methods by studying phenomenology. Locations in Karanganyar Regency are Jaten I Health Center, Matesih Health Center and Karanganyar District Public Hospital, in October 2019 - January 2020. Sample sampling criteria Data collection by semi-structured interviews with one-on-one interviews. Data Validity Test with Credibility in this study using the triangulation validity strategy, Transparency, Dependability, Confirmability. Data analysis with Interpretative Phenomenological Analysis (IPA). The results of the study of the needs of pregnant women with DMG identified four themes, namely supporting the family in terms of controlling diet, sending check to health workers, and reminding for sports activities. Social support, which is a way to control blood sugar. Support of Health Workers, namely advice and motivation to control blood sugar. The information obtained from DMG advice or treatment in the assessment is from health workers, namely midwives, doctors, and also health workers from friends and the internet. In conclusion, the needs of pregnant women with DMG identified four themes, namely family support, social support, support of health workers and information.  

Emergency LMS Training During COVID-19 at an African University of Technology

2020 ◽  
Vol 11 (1) ◽  
pp. 113-113
Author(s):  
Leanri van Heerden
Keyword(s):  
South African ◽  
Instructional Designers ◽  
Delivery Mode ◽  
Skills Acquisition ◽  
Online Delivery ◽  
Face To Face ◽  
Department Of Health ◽  
University Of Technology ◽  
E Learning ◽  
Participant Perspectives

After the #FeesMustFall strikes that have been haunting South African universities since 2015, Instructional Designers felt pretty confident that they can drive their institutions through any dilemma. Along came the 2020 COVID-19 epidemic and they realised they have been playing in the kiddie pool all along. On 23 March 2020, President Cyril Ramaphosa announced a national lockdown level 5 to start on 26 March 2020 (Department of Health, 2020). Three days head start for a three-week lockdown (which was eventually extended till the time of writing) was a logistical nightmare for even the most technology driven universities. All staff were sent home with only enough time to grab their office plants and laptops and no idea how they were going to move forward. The issue with staff and students all working from home is that the lecturers working at the Central University of Technology (CUT), being primarily a face-to-face delivery university, was completely unprepared for moving their traditional and blended approaches to completely online. In their study, Mogeni, Ondigi and Mufo (2020) found that most of the investigated teachers were not empowered enough to deliver instruction fully online and either needed to be retrained, receive further specialised training or be trained completely from scratch. A lack of confidence in the delivery mode of instruction will cause even the most knowledgeable subject spcialist to fail in their task. At the CUT lecturers needed a way of quickly acquiring the necessary skills to deliver their content and assessments on the institution Learning Management System (LMS). The aim of this paper is to measure participant perspectives of an emergency intervention to facilitate the process of online delivery skills acquisition quickly and online. To ensure relevant results a systematic process of designing an intervention and recording participant perspectives is necessary. This extended abstract will take a look at the methods used to drive the paper, briefly discuss the results and findings, and lastly explore the implications and significance of the research for the use of higher education institutions for emergency LMS training. Keywords: LMS training; e-Learning; Online Instruction; Instructional Design

AVADAR Application: a learning model for designing a mobile-based disease surveillance system using participatory community reporting in Africa (Preprint)

2019 ◽  
Author(s):  
Godwin Akpan ◽  
Johnson Muluh Ticha ◽  
Lara M.F. Paige ◽  
Daniel Rasheed Oyaole ◽  
Patrick Briand ◽  
...  
Keyword(s):  
Community Participation ◽  
Surveillance System ◽  
Disease Surveillance ◽  
Health Workers ◽  
Digital Health ◽  
Black Box ◽  
Project Planning ◽  
Acceptance Testing ◽  
Surveillance Strategy ◽  
Design And Implementation

BACKGROUND Acute Flaccid Paralysis (AFP) surveillance is the bedrock of polio case detection. The Auto Visual AFP Detection and Reporting (AVADAR) is a digital health intervention designed as a supplemental community surveillance system. OBJECTIVE This paper describes the design and implementation process that made AVADAR a successful disease surveillance strategy at the community level. METHODS This paper outlines the methods for the design and implementation of the AVADAR application. It explains the co-design of the application, the implementation of a helpdesk support structure, the process involved in trouble shooting the application, the benefits of utilizing a closed user group for telecommunication requirements, and the use of a consented video. We also describe how these features combined led to user acceptance testing using black box methodology. RESULTS A total of 198 community informants across two provinces, four districts and 32 settlements were interviewed about application performance, usability, security, load, stress and functionality testing black box components. The responses showed most community participants giving positive reviews. Data from the Blackbox testing yielded optimum acceptance ratings from over 90% of the users involved in the testing. A total of 22380 AFP Alerts were sent out by community informants and 21589 (95%) were investigated by health workers or WHO AVADAR coordinators. Overall there was 93% assimilation at regional level. About 83% of investigations were done in the vicinity of the alerts in 2018 compared to 77% in 2017. CONCLUSIONS AVADAR implementation model offers a simplistic step by step model that includes community participation as an integral tool for the successful deployment of a mobile based surveillance reporting tool. AVADAR can be a veritable source of project planning data and a mobile application for other interventions that target using community participation to influence health outcomes.

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