scholarly journals Explaining the impact of mHealth on maternal and child health care in low- and middle-income countries: a realist synthesis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eveline M. Kabongo ◽  
Ferdinand C. Mukumbang ◽  
Peter Delobelle ◽  
Edward Nicol
Keyword(s):  
Health Care ◽  
Child Health ◽  
Health System ◽  
Health Care Providers ◽  
Maternal And Child Health ◽  
Child Health Care ◽  
Care Providers ◽  
Middle Income ◽  
Middle Income Countries ◽  
And Child Health

Abstract Background Despite the growing global application of mobile health (mHealth) technology in maternal and child health, contextual factors, and mechanisms by which interventional outcomes are generated, have not been subjected to a systematic examination. In this study, we sought to uncover context, mechanisms, and outcome elements of various mHealth interventions based on implementation and evaluation studies to formulate theories or models explicating how mHealth interventions work (or not) both for health care providers and for pregnant women and mothers. Method We undertook a realist synthesis. An electronic search of five online databases (PubMed/Medline, Google Scholar, Scopus, Academic Search Premier and Health Systems Evidence) was performed. Using appropriate Boolean phrases terms and selection procedures, 32 articles were identified. A theory-driven approach, narrative synthesis, was applied to synthesize the data. Thematic content analysis was used to delineate elements of the intervention, including its context, actors, mechanisms, and outcomes. Abduction and retroduction were applied using a realist evaluation heuristic tool to formulate generative theories. Results We formulated two configurational models illustrating how and why mHealth impacts implementation and uptake of maternal and child health care. Implementation-related mechanisms include buy-in from health care providers, perceived support of health care providers’ motivation and perceived ease of use and usefulness. These mechanisms are influenced by adaptive health system conditions including organization, resource availability, policy implementation dynamics, experience with technology, network infrastructure and connectivity. For pregnant women and mothers, mechanisms that trigger mHealth use and consequently uptake of maternal and child health care include perceived satisfaction, motivation and positive psychological support. Information overload was identified as a potential negative mechanism impacting the uptake of maternal and child health care. These mechanisms are influenced by health system conditions, socio-cultural characteristics, socio-economic and demographics characteristics, network infrastructure and connectivity and awareness. Conclusion Models developed in this study provide a detailed understanding of implementation and uptake of mHealth interventions and how and why they impact maternal and child health care in low- and middle-income countries. These models provide a foundation for the ‘white box’ of theory-driven evaluation of mHealth interventions and can improve rollout and implementation where required.

scholarly journals Explaining the impact of mHealth on maternal and child health care in low- and middle-income countries: A realist synthesis

2020 ◽  
Author(s):  
Eveline Muika Kabongo ◽  
Ferdinand Mukumbang ◽  
Peter N/A Delobelle ◽  
Edward N/A Nicol
Keyword(s):  
Health Care ◽  
Child Health ◽  
Health System ◽  
Health Care Providers ◽  
Maternal And Child Health ◽  
Child Health Care ◽  
Care Providers ◽  
Middle Income ◽  
Middle Income Countries ◽  
And Child Health

Abstract Background: Despite the growing global application of mobile health (mHealth) technology in maternal and child health, contextual factors, and mechanisms by which interventional outcomes are generated, have not been subjected to a systematic examination. In this study, we sought to uncover context, mechanisms, and outcome elements of various mHealth interventions based on implementation and evaluation studies to formulate theories or models explicating how mHealth interventions work (or not) both for health care providers and for pregnant women and mothers.Method: We undertook a realist synthesis. An electronic search of six online databases (Medline, PubMed, Google Scholar, Scopus, Academic Search Premier, and Health Systems Evidence) was performed. Using appropriate Boolean phrases terms and selection procedures, 32 articles were identified. A theory-driven approach, narrative synthesis, was applied to synthesize the data. Thematic content analysis was used to delineate elements of the intervention, including its context, actors, mechanisms, and outcomes. Abduction and retroduction were applied using a realist evaluation heuristic tool to formulate generative theories.Results: We formulated two configurational models illustrating how and why mHealth impacts the implementation and uptake of maternal and child care services. Implementation-related mechanisms include buy-in from health care providers, perceived support of health care providers’ motivation, and perceived ease of use and usefulness. These mechanisms were influenced by adaptive health system conditions including organization, resource availability, policy implementation dynamics, experience with technology, network infrastructure, and connectivity. For pregnant women and mothers, mechanisms that trigger mHealth use and consequently uptake of maternal and child health care include perceived satisfaction, motivation, and positive psychological support. Information overload was identified as a potential negative mechanism impacting the uptake of maternal and child health care. These mechanisms were influenced by health system conditions, socio-cultural characteristics, socio-economic and demographics characteristics, network infrastructure and connectivity, and awareness.Conclusion: Models developed in this study provide a detailed understanding of the implementation and uptake of mHealth interventions and how and why they impact maternal and child health care in low- and middle-income countries. These models provide a foundation for the ‘white box’ of theory-driven evaluation of mHealth interventions and can improve rollout and implementation where required.

scholarly journals Meeting the Global Target in Reproductive, Maternal, Newborn, and Child Health Care Services in Low- and Middle-Income Countries

2020 ◽  
Vol 8 (4) ◽  
pp. 654-665
Author(s):  
Md. Mehedi Hasan ◽  
Ricardo J. Soares Magalhaes ◽  
Saifuddin Ahmed ◽  
Sayem Ahmed ◽  
Tuhin Biswas ◽  
...  
Keyword(s):  
Health Care ◽  
Child Health ◽  
Health Care Services ◽  
Child Health Care ◽  
Middle Income ◽  
Newborn And Child Health ◽  
Middle Income Countries ◽  
Care Services ◽  
Global Target ◽  
And Child Health

scholarly journals Explaining the impact of mHealth on maternal and child health care in low- and middle-income countries: A theory-driven scoping review

2019 ◽  
Author(s):  
Eveline Muika Kabongo ◽  
Ferdinand Mukumbang ◽  
Peter N/A Delobelle ◽  
Edward N/A Nicol
Keyword(s):  
Health Care ◽  
Child Health ◽  
Community Health ◽  
Community Health Workers ◽  
Health Care Providers ◽  
Maternal And Child Health ◽  
Health Workers ◽  
Child Health Services ◽  
Care Providers ◽  
And Child Health

Abstract Introduction Despite the growing global application of mobile health (mHealth) technology in maternal and child health, the contextual factors and mechanisms by which interventional outcomes are generated have not been subjected to extensive review. In this study, we sought to identify context, mechanisms and outcome elements from implementation and evaluation studies of mHealth interventions to formulate theories or models explicating how mHealth interventions work (or not) both for health care providers and for pregnant women and new mothers.Method An electronic search of six online databases (Medline, Pubmed, Google Scholar, Scopus, Academic Search Premier and Health Systems Evidence) was performed. Using appropriate MeSH terms and selection procedure, 32 articles were considered for analysis. A theory-driven approach, narrative synthesis, was applied to synthesise the data. Thematic content analysis was used to delineate the elements of the intervention, including its context, actors, mechanism and outcomes. Retroduction was applied to link these elements using a realist evaluation heuristic to form generative theories.Results Mechanisms that promote the implementation of mHealth by community health workers/health care providers include motivation, perceived skill and knowledge improvement, improved self-efficacy, improved confidence, improved relationship between community health workers and clients, perceived support of community health workers, perceived ease of use and usefulness of mHealth, For pregnant women and new mothers, mechanisms that trigger the uptake of mHealth and use of maternal and child health services included: perceived service satisfaction, perceived knowledge acquisition, support and confidence, improved self-efficacy, encouragement, empowerment and motivation. Information overload was identified as a potential negative mechanism for the uptake of maternal and child health services.Conclusion The models developed in this study provide a detailed understanding of the implementation and uptake of mHealth interventions and how they improve maternal and child health services in low and middle income countries. These models provide a foundation for the ‘white box’ or theory-driven evaluation of mHealth intervention and can improve the rollout and implementation where required.

scholarly journals Study of Local Wisdom on the Role of Culture in Maternal and Child Health in Ruteng Subdistrict, Manggarai District, NTT Province

2019 ◽  
Vol 3 (1) ◽  
pp. 46
Author(s):  
Bambang Dharwiyanto Putro ◽  
A.A. Ayu Murniasih
Keyword(s):  
Health Care ◽  
Child Health ◽  
Cultural Values ◽  
Maternal And Child Health ◽  
Child Health Care ◽  
Care Providers ◽  
Research Activities ◽  
Verification Techniques ◽  
And Child Health

Health problems are closely related to culture or tradition in society. Cultural values in the community of Manggarai is a cultural potential that can be used as a means of agreeing to various public health issues including finding solutions to problems in the field of maternal and child health. Until now, traditional cultural values (local wisdom) still play important role in the process of maternal and child health care in the practice of pregnancy and childbirth care, and some are still handled by a traditional midwife (ata pecing). This study aims at determining the role of culture in maternal and child health practices, how health care search behavior and cultural potential of maternal and child health care practices in Ruteng sub-district are. The study was conducted by using an ethnographic approach method as one of the variants of the qualitative approach. The research activities included field assessments to understand the condition of the research location, field data collection by using interview, observation, literature and document verification techniques. The data collected from various sources were then processed, analyzed, and then presented in the form of interpretative descriptive argumentation. Manggarai community still believes in local customs and some particular behaviors for pregnant and postpartum women. A cultural conception of abstinence is intended to safeguard the safety of the mother and baby. However, the reasons revealed related to the restrictions are only symbolic. Health care providers and health workers need to understand the symbolic meaning contained in the respective abstinence.

scholarly journals Impact of COVID-19 Pandemic on Utilization of Facility-Based Essential Maternal and Child Health Services in North Shewa Zone, Ethiopia

2022 ◽  
Author(s):  
Chalachew Bekele ◽  
Delayehu Bekele ◽  
Bezawit Hunegnaw ◽  
Kimiko Van Wickle ◽  
Fanos Ashenafi ◽  
...  
Keyword(s):  
Health Care ◽  
Family Planning ◽  
Child Health ◽  
Service Utilization ◽  
Health Care Providers ◽  
Maternal And Child Health ◽  
Child Health Services ◽  
Care Providers ◽  
New Family ◽  
And Child Health

Introduction: Ethiopia registered its first case of COVID-19 on March 13, 2020. We aimed to assess maternal, newborn, and child health care (MNCH) utilization during the first six months of the COVID-19 pandemic, as well as potential barriers and enablers of service utilization from health care providers and clients. Methods: Mixed study design was conducted as part of the Birhan Health and Demographic Surveillance System in Ethiopia. The trend of service utilization during the first six months of COVID-19 was compared to corresponding time and data points of the preceding year. Result: Service utilization of new family planning visits (43.2 to 28.5/month, p = 0.014) and sick under five child visits (225.0 to 139.8/month, P = 007) declined during the initial six months of the pandemic compared to the same period in the preceding year. Antenatal and postnatal care visits, facility delivery rates, and child routine immunization visits also decreased although this did not reach statistical significance. Interviews with health care providers and clients highlighted several barriers to service utilization during COVID-19, including fear of disease transmission, economic hardship, and transport service disruptions and restrictions. Enablers of service utilization included communities' decreased fear of COVID-19, and awareness-raising activities. Conclusion: Provision of essential MNCH services is crucial to ascertain favorable maternal and child health outcomes. In low- and middle-income country settings like Ethiopia, health systems might be fragile to withstand the caseloads and priority setting due to the pandemic. Our study presents early findings on the utilization of MNCH services that were maintained except sick child and new family planning visits. Government leaders, policy makers, and clinicians who wish to improve the resilience of their health system will need to continuously monitor service utilization and clients' evolving concerns during the pandemic to prevent increases in maternal and child morbidity and mortality.

scholarly journals Prevention of opportunistic non-communicable diseases

2019 ◽  
Vol 12 (1) ◽  
pp. 1-2
Author(s):  
Maria H Hegelund ◽  
Daniel Faurholt-Jepsen ◽  
Ib C Bygbjerg
Keyword(s):  
Health Care ◽  
Child Health ◽  
Maternal And Child Health ◽  
Opportunistic Infections ◽  
Communicable Diseases ◽  
Early Prevention ◽  
Middle Income ◽  
Non Communicable Diseases ◽  
Middle Income Countries ◽  
And Child Health

Abstract As strategies targeting undernutrition and infections become increasingly successful in low- and middle-income countries (LMICs), a second challenge has appeared, namely premature onset of non-communicable diseases (NCDs). In LMICs, NCDs are often related to exposure to undernutrition and infections. As NCDs strike societies and individuals with impaired resistance or a deficient health (care) state, why not label such diseases ‘opportunistic’, in analogy with opportunistic infections attacking individuals with HIV? We propose the concept of opportunistic NCDs, hoping that fighting against infections, and for better maternal and child health, is becoming acknowledged as essential for the early prevention of NCDs.

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