scholarly journals Sustainability of a mobile phone application-based data reporting system in Myanmar’s malaria elimination program: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Win Han Oo ◽  
Kaung Myat Thu ◽  
Julia C. Cutts ◽  
Win Htike ◽  
Kyawt Mon Win ◽  
...  
Keyword(s):  
Mobile Phone ◽  
Mobile Phones ◽  
Malaria Elimination ◽  
User Satisfaction ◽  
Parallel Systems ◽  
Cost Effective ◽  
Surveillance Systems ◽  
Malaria Surveillance ◽  
System Integrity ◽  
Case Based

Abstract Background Strengthening surveillance systems to collect near-real-time case-based data plays a fundamental role in achieving malaria elimination in the Greater Mekong Subregion (GMS). With the advanced and widespread use of digital technology, mHealth is increasingly taking a prominent role in malaria surveillance systems in GMS countries, including Myanmar. In Myanmar’s malaria elimination program, an mHealth system called Malaria Case-based Reporting (MCBR) has been applied for case-based reporting of malaria data by integrated community malaria volunteers (ICMVs). However, the sustainability of such mHealth systems in the context of existing malaria elimination programs in Myanmar is unknown. Methods Focus group discussions were conducted with ICMVs and semi-structured in-depth interviews were conducted with malaria program stakeholders from Myanmar’s Ministry of Health and Sports and its malaria program implementing partners. Thematic (deductive followed by inductive) analysis was undertaken using a qualitative descriptive approach. Results Technological and financial constraints such as inadequate internet access, software errors, and insufficient financial resources to support mobile phone-related costs have hampered users’ access to MCBR. Poor system integrity, unpredictable reporting outcomes, inadequate human resources for system management, and inefficient user support undermined the perceived quality of the system and user satisfaction, and hence its sustainability. Furthermore, multiple parallel systems with functions overlapping those of MCBR were in use. Conclusions Despite its effectiveness and efficiency in malaria surveillance, the sustainability of nationwide implementation of MCBR is uncertain. To make it sustainable, stakeholders should deploy a dedicated human workforce with the necessary technical and technological capacities; secure sustainable, long-term funding for implementation of MCBR; find an alternative cost-effective plan for ensuring sustainable system access by ICMVs, such as using volunteer-owned mobile phones for reporting rather than supporting new mobile phones to them; and find a solution to the burden of multiple parallel systems. Trial registration Not applicable.

scholarly journals Sustainability of a Mobile Phone Application-Based Data Reporting System in Myanmar’s Malaria Elimination Program: A Qualitative Study

2021 ◽  
Author(s):  
Win Han Oo ◽  
Kaung Myat Thu ◽  
Julia Cutts ◽  
Win Htike ◽  
Kyawt Mon Win ◽  
...  
Keyword(s):  
Mobile Phone ◽  
Mobile Phones ◽  
Malaria Elimination ◽  
User Satisfaction ◽  
Parallel Systems ◽  
Cost Effective ◽  
Surveillance Systems ◽  
Malaria Surveillance ◽  
System Integrity ◽  
Case Based

Abstract Background Strengthening surveillance systems to collect near-real-time case-based data plays a fundamental role in achieving malaria elimination in the Greater Mekong Subregion (GMS). With the advanced and widespread use of digital technology, mHealth is increasingly taking a prominent role in malaria surveillance systems in GMS countries, including Myanmar. In Myanmar’s malaria elimination program, an mHealth system called Malaria Case-based Reporting (MCBR) has been applied for case-based reporting of malaria data by integrated community malaria volunteers (ICMVs). However, the sustainability of such mHealth systems in the context of existing malaria elimination programs in Myanmar is unknown. Methods Focus group discussions were conducted with ICMVs and semi-structured in-depth interviews were conducted with malaria program stakeholders from Myanmar’s Ministry of Health and Sports and its malaria program implementing partners. Thematic (deductive followed by inductive) analysis was undertaken using a qualitative descriptive approach. Results Technological and financial constraints such as inadequate internet access, software errors, and insufficient financial resources to support mobile phone-related costs have hampered users’ access to MCBR. Poor system integrity, unpredictable reporting outcomes, inadequate human resources for system management, and inefficient user support undermined the perceived quality of the system and user satisfaction, and hence its sustainability. Furthermore, multiple parallel systems with functions overlapping those of MCBR were in use. Conclusions Despite its effectiveness and efficiency in malaria surveillance, the sustainability of nationwide implementation of MCBR is uncertain. To make it sustainable, stakeholders should deploy a dedicated human workforce with the necessary technical and technological capacities; secure sustainable, long-term funding for implementation of MCBR; find an alternative cost-effective plan for ensuring sustainable system access by ICMVs, such as using volunteer-owned mobile phones for reporting rather than supporting new mobile phones to them; and find a solution to the burden of multiple parallel systems. Trial registration: Not applicable

scholarly journals A mobile phone application for malaria case-based reporting to advance malaria surveillance in Myanmar: a mixed methods evaluation

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Win Han Oo ◽  
Win Htike ◽  
Julia C. Cutts ◽  
Kyawt Mon Win ◽  
Kaung Myat Thu ◽  
...  
Keyword(s):  
Mobile Phone ◽  
Malaria Case ◽  
Malaria Elimination ◽  
Reporting System ◽  
Evaluation Study ◽  
Malaria Surveillance ◽  
Mobile Phone Application ◽  
Mixed Methods Evaluation ◽  
Greater Mekong Subregion ◽  
Case Based

Abstract Background To achieve malaria elimination in the Greater Mekong Subregion, including Myanmar, it is necessary to ensure all malaria cases are detected, treated, and reported in a timely manner. Mobile phone-based applications for malaria reporting, case management, and surveillance implemented at a community-level may overcome reporting limitations associated with current paper-based reporting (PBR), but their effectiveness in this context is unknown. Methods A mixed methods evaluation study was undertaken to determine the effectiveness of a national Malaria Case-Based Reporting (MCBR) mobile phone application in improving malaria case reporting compared to the existing PBR reporting system in Myanmar. Methods included secondary analysis of malaria case report data, questionnaires, focus group discussions and field observations of community volunteers, interviews and direct observations of malaria programme stakeholders, and cost analysis. Using a combination of these approaches the following areas were investigated: data quality and completeness, data access and usage, capacity for timely reporting, the acceptability, functionality, and ease of use of the application and facilitators and barriers to its use, and the relative cost of MCBR compared to the PBR system. Results Compared to PBR, MCBR enabled more accurate and complete data to be reported in a much timelier manner, with 63% of MCBR users reporting they transmit rapid diagnostic test outcomes within 24 h, compared to 0% of PBR users. MCBR was favoured by integrated community malaria volunteers and their supervisors because of its efficiency. However, several technical and operational challenges associated with internet coverage, data transmission, and e-literacy were identified and stakeholders reported not being confident to rely solely on MCBR data for programmatic decision-making. Conclusions Implementation of MCBR provided timely and accurate data for malaria surveillance. Findings from this evaluation study will enable the optimization of an application-based reporting system for malaria monitoring and surveillance in the Greater Mekong Subregion and advance systems to track progress towards, and certify, the achievement of malaria elimination targets.

Malaria elimination in India requires additional surveillance mechanisms

2021 ◽  
Author(s):  
Manju Rahi ◽  
Payal Das ◽  
Amit Sharma
Keyword(s):  
Real Time ◽  
Malaria Elimination ◽  
Surveillance Data ◽  
Surveillance Systems ◽  
Malaria Surveillance ◽  
Aggregated Data ◽  
Malaria Burden ◽  
The Core ◽  
Reporting Systems ◽  
Geographic Regions

Abstract Malaria surveillance is weak in high malaria burden countries. Surveillance is considered as one of the core interventions for malaria elimination. Impressive reductions in malaria-associated morbidity and mortality have been achieved across the globe, but sustained efforts need to be bolstered up to achieve malaria elimination in endemic countries like India. Poor surveillance data become a hindrance in assessing the progress achieved towards malaria elimination and in channelizing focused interventions to the hotspots. A major obstacle in strengthening India’s reporting systems is that the surveillance data are captured in a fragmented manner by multiple players, in silos, and is distributed across geographic regions. In addition, the data are not reported in near real-time. Furthermore, multiplicity of malaria data resources limits interoperability between them. Here, we deliberate on the acute need of updating India’s surveillance systems from the use of aggregated data to near real-time case-based surveillance. This will help in identifying the drivers of malaria transmission in any locale and therefore will facilitate formulation of appropriate interventional responses rapidly.

scholarly journals Home Videos as a Cost-Effective Tool for the Diagnosis of Paroxysmal Events in Infants: Prospective Study (Preprint)

2018 ◽  
Author(s):  
Lu-Lu Huang ◽  
Yang-Yang Wang ◽  
Li-Ying Liu ◽  
Hong-Ping Tang ◽  
Meng-Na Zhang ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Mobile Phone ◽  
Mobile Phones ◽  
Cost Savings ◽  
Cost Effective ◽  
Educational Background ◽  
Hospital Level ◽  
Home Videos ◽  
Online Consultation ◽  
The Mean

BACKGROUND The diagnosis of paroxysmal events in infants is often challenging. Reasons include the child’s inability to express discomfort and the inability to record video electroencephalography at home. The prevalence of mobile phones, which can record videos, may be beneficial to these patients. In China, this advantage may be even more significant given the vast population and the uneven distribution of medical resources. OBJECTIVE The aim of this study is to investigate the value of mobile phone videos in increasing the diagnostic accuracy and cost savings of paroxysmal events in infants. METHODS Clinical data, including descriptions and home videos of episodes, from 12 patients with paroxysmal events were collected. The investigation was conducted in six centers during pediatric academic conferences. All 452 practitioners present were asked to make their diagnoses by just the descriptions of the events, and then remake their diagnoses after watching the corresponding home videos of the episodes. The doctor’s information, including educational background, profession, working years, and working hospital level, was also recorded. The cost savings from accurate diagnoses were measured on the basis of using online consultation, which can also be done easily by mobile phone. All data were recorded in the form of questionnaires designed for this study. RESULTS We collected 452 questionnaires, 301 of which met the criteria (66.6%) and were analyzed. The mean correct diagnoses with and without videos was 8.4 (SD 1.7) of 12 and 7.5 (SD 1.7) of 12, respectively. For epileptic seizures, mobile phone videos increased the mean accurate diagnoses by 3.9%; for nonepileptic events, it was 11.5% and both were statistically different (P=.006 for epileptic events; P<.001 for nonepileptic events). Pediatric neurologists with longer working years had higher diagnostic accuracy; whereas, their working hospital level and educational background made no difference. For patients with paroxysmal events, at least US $673.90 per capita and US $128 million nationwide could be saved annually, which is 12.02% of the total cost for correct diagnosis. CONCLUSIONS Home videos made on mobile phones are a cost-effective tool for the diagnosis of paroxysmal events in infants. They can facilitate the diagnosis of paroxysmal events in infants and thereby save costs. The best choice for infants with paroxysmal events on their initial visit is to record their events first and then show the video to a neurologist with longer working years through online consultation.

scholarly journals Perspectives of Adolescents, Parents, Service Providers and Teachers on Mobile Phone Ownership, Access and use For SRH Information Among Adolescents

2021 ◽  
Author(s):  
Beverlyn Marion Ochieng ◽  
Monica A Magadi ◽  
Lesley Smith ◽  
Bev Orton ◽  
Mark Hayter ◽  
...  
Keyword(s):  
Mobile Phone ◽  
Mobile Phones ◽  
Health Knowledge ◽  
Service Providers ◽  
Qualitative Content Analysis ◽  
Public Health Practice ◽  
Cost Effective ◽  
Mobile Phone Use ◽  
Ease Of Access ◽  
School Heads

Abstract Introduction: Mobile health (mHealth) programmes offer opportunities to improve sexual and reproductive health (SRH) for adolescents by providing information. Researchers define mHealth as a “medical and public health practice supported by mobile devices”. mHealth is increasingly used to deliver health interventions including adolescent SRH. However, knowledge gaps remain regarding the utilization and effectiveness of these programmes. This study reports findings of a qualitative study carried out in Homabay County, Kenya. Purpose: We aimed to establish if mHealth would facilitate access of SRH information by adolescents, and whether adolescents would participate in SRH-related content delivered on mobile phones, based on their experiences and existing constraints.Methods: This was a qualitative exploratory study seeking to gain an understanding of the experiences of adolescents concerning their mobile phone ownership, access and use. The study population included adolescents, parents, teachers and health care workers and community health volunteers (CHVs). Data were collected through 25 Focus Group Discussions (FGDs) and 19 key informant interviews (KIIs). The FGDs consisted of five groups each for girls, boys, fathers, mothers and CHVs. We purposively selected five primary school heads, five secondary school heads and nine health facilities in-charges for KIIs. Data were analyzed through thematic and qualitative content analysis.Results: Mobile phone use was frequent among adolescents accessing phones from parents and friends. The most popular use of mobile phones was short messaging service (SMS) with girls and boys citing chatting, SMS and watching movies. Service providers emphasized accessing health knowledge. Teachers emphasized accessing SRH information. All respondent categories highlighting ease of access and potential reach to large numbers of adolescents and hence an effective and efficient approach. Respondents lauded the potential of mobile phones to promote learning of useful SRH information among adolescents to influence their behavior formation, modification and or change by learning about diseases and receiving advice. Mobile phones overcame barriers experienced by adolescents when seeking sensitive SRH information and services such as stigma, discrimination, and lack of privacy and confidentiality. Conclusion: Mobile phones can provide safe, accurate, cost-effective, and timely SRH information and services tailored to the needs of adolescents to influence their behavior

scholarly journals Strengthening surveillance systems for malaria elimination: a global landscaping of system performance, 2015–2017

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Christopher Lourenço ◽  
Andrew J. Tatem ◽  
Peter M. Atkinson ◽  
Justin M. Cohen ◽  
Deepa Pindolia ◽  
...  
Keyword(s):  
Malaria Elimination ◽  
Surveillance System ◽  
Health Sector ◽  
Surveillance Data ◽  
World Health ◽  
Surveillance Systems ◽  
Malaria Surveillance ◽  
Remote Communities ◽  
Median Percentage ◽  
Health Organization

Abstract Background Surveillance is a core component of an effective system to support malaria elimination. Poor surveillance data will prevent countries from monitoring progress towards elimination and targeting interventions to the last remaining at-risk places. An evaluation of the performance of surveillance systems in 16 countries was conducted to identify key gaps which could be addressed to build effective systems for malaria elimination. Methods A standardized surveillance system landscaping was conducted between 2015 and 2017 in collaboration with governmental malaria programmes. Malaria surveillance guidelines from the World Health Organization and other technical bodies were used to identify the characteristics of an optimal surveillance system, against which systems of study countries were compared. Data collection was conducted through review of existing material and datasets, and interviews with key stakeholders, and the outcomes were summarized descriptively. Additionally, the cumulative fraction of incident infections reported through surveillance systems was estimated using surveillance data, government records, survey data, and other scientific sources. Results The landscaping identified common gaps across countries related to the lack of surveillance coverage in remote communities or in the private sector, the lack of adequate health information architecture to capture high quality case-based data, poor integration of data from other sources such as intervention information, poor visualization of generated information, and its lack of availability for making programmatic decisions. The median percentage of symptomatic cases captured by the surveillance systems in the 16 countries was estimated to be 37%, mostly driven by the lack of treatment-seeking in the public health sector (64%) or, in countries with large private sectors, the lack of integration of this sector within the surveillance system. Conclusions The landscaping analysis undertaken provides a clear framework through which to identify multiple gaps in current malaria surveillance systems. While perfect systems are not required to eliminate malaria, closing the gaps identified will allow countries to deploy resources more efficiently, track progress, and accelerate towards malaria elimination. Since the landscaping undertaken here, several countries have addressed some of the identified gaps by improving coverage of surveillance, integrating case data with other information, and strengthening visualization and use of data.

Perceived Usefulness and Satisfaction of Mobile Phone for Users with Disabilities

2016 ◽  
Vol 13 (02) ◽  
pp. 1650010
Author(s):  
Brenda Mak ◽  
Paul Beckman ◽  
Nicole Bohn
Keyword(s):  
Mobile Phone ◽  
Technology Acceptance ◽  
Mobile Phones ◽  
User Satisfaction ◽  
Latent Variable ◽  
Perceived Usefulness ◽  
Inclusive Development ◽  
Development Effort ◽  
Persons With Disabilities ◽  
Development Framework

The United Nations Convention on the Rights of Persons with Disabilities came into force in 2008. The ICT Opportunity for a Disability-Inclusive Development Framework produced by UNESCO in 2013 formulated a development agenda for these rights, highlighting the importance of mobile devices in this development effort. For most persons with disabilities, the mobile phone is an innovation. What factors affect their satisfaction of mobile phones? The technology acceptance model (TAM) suggests that the perceived usefulness of the device will affect a person’s attitude towards the technology and the associated satisfaction. This study examines the perceived usefulness of mobile phones for persons with disabilities. A survey was conducted. The structural equation model developed showed the latent variable Perceived Usefulness, manifested as Social Function, Emergency Help, Sense of Security, positively affected user satisfaction. Implications for enhancing mobile phone perceived usefulness for users with disabilities are discussed.

scholarly journals Strengthening Surveillance Systems for Malaria Elimination by Integrating Molecular and Genomic Data

2019 ◽  
Vol 4 (4) ◽  
pp. 139 ◽  
Author(s):  
Christian Nsanzabana
Keyword(s):  
Malaria Elimination ◽  
Cost Effective ◽  
Morbidity And Mortality ◽  
Surveillance Systems ◽  
Computing Power ◽  
Routine Surveillance ◽  
Substantial Investment ◽  
Trained Staff ◽  
Polymerase Chain ◽  
Next Generation Sequencing Ngs

Unprecedented efforts in malaria control over the last 15 years have led to a substantial decrease in both morbidity and mortality in most endemic settings. However, these progresses have stalled over recent years, and resurgence may cause dramatic impact on both morbidity and mortality. Nevertheless, elimination efforts are currently going on with the objective of reducing malaria morbidity and mortality by 90% and malaria elimination in at least 35 countries by 2030. Strengthening surveillance systems is of paramount importance to reach those targets, and the integration of molecular and genomic techniques into routine surveillance could substantially improve the quality and robustness of data. Techniques such as polymerase chain reaction (PCR) and quantitative PCR (qPCR) are increasingly available in malaria endemic countries, whereas others such as sequencing are already available in a few laboratories. However, sequencing, especially next-generation sequencing (NGS), requires sophisticated infrastructure with adequate computing power and highly trained personnel for data analysis that require substantial investment. Different techniques will be required for different applications, and cost-effective planning must ensure the appropriate use of available resources. The development of national and sub-regional reference laboratories could help in minimizing the resources required in terms of equipment and trained staff. Concerted efforts from different stakeholders at national, sub-regional, and global level are needed to develop the required framework to establish and maintain these reference laboratories.

scholarly journals The Role of Adaptive Surveillance as a Core Intervention to Achieve Malaria Elimination

2021 ◽  
Author(s):  
Arantxa Roca-Feltrer ◽  
Ann-Sophie Stratil ◽  
James K. Tibenderana
Keyword(s):  
Malaria Elimination ◽  
Surveillance Systems ◽  
National Programmes ◽  
Level Increase ◽  
Substantial Investment ◽  
Multi Level ◽  
Link Data ◽  
Operational Guidance ◽  
Case Based

Adaptive surveillance systems are essential for national programmes to achieve their malaria elimination goals. Core principles of surveillance systems including accurate diagnosis and reporting of malaria cases, integration of health data across administrative levels and the need to link data to a response are well defined by international guidelines. Nevertheless, while the requirements of surveillance systems along the transmission continuum are clearly documented, the operationalization remains challenging for national programmes. Firstly, because the multi-level increase of surveillance efforts demanding real-time and case-based data as well as the capacity of the health force to trigger locally customized responses, is resource intensive and requires substantial investment. Secondly, because there is a gap in international alignment on best tools and practices on how to operationally implement these requirements. Recently, several initiatives have started to address this gap in international coordination, aiming to establish the operational guidance for elimination programmes to successfully implement adaptive surveillance systems.

scholarly journals Home Videos as a Cost-Effective Tool for the Diagnosis of Paroxysmal Events in Infants: Prospective Study

10.2196/11229 ◽  
2019 ◽  
Vol 7 (9) ◽  
pp. e11229 ◽  
Author(s):  
Lu-Lu Huang ◽  
Yang-Yang Wang ◽  
Li-Ying Liu ◽  
Hong-Ping Tang ◽  
Meng-Na Zhang ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Mobile Phone ◽  
Mobile Phones ◽  
Cost Savings ◽  
Cost Effective ◽  
Educational Background ◽  
Hospital Level ◽  
Home Videos ◽  
Online Consultation ◽  
The Mean

Background The diagnosis of paroxysmal events in infants is often challenging. Reasons include the child’s inability to express discomfort and the inability to record video electroencephalography at home. The prevalence of mobile phones, which can record videos, may be beneficial to these patients. In China, this advantage may be even more significant given the vast population and the uneven distribution of medical resources. Objective The aim of this study is to investigate the value of mobile phone videos in increasing the diagnostic accuracy and cost savings of paroxysmal events in infants. Methods Clinical data, including descriptions and home videos of episodes, from 12 patients with paroxysmal events were collected. The investigation was conducted in six centers during pediatric academic conferences. All 452 practitioners present were asked to make their diagnoses by just the descriptions of the events, and then remake their diagnoses after watching the corresponding home videos of the episodes. The doctor’s information, including educational background, profession, working years, and working hospital level, was also recorded. The cost savings from accurate diagnoses were measured on the basis of using online consultation, which can also be done easily by mobile phone. All data were recorded in the form of questionnaires designed for this study. Results We collected 452 questionnaires, 301 of which met the criteria (66.6%) and were analyzed. The mean correct diagnoses with and without videos was 8.4 (SD 1.7) of 12 and 7.5 (SD 1.7) of 12, respectively. For epileptic seizures, mobile phone videos increased the mean accurate diagnoses by 3.9%; for nonepileptic events, it was 11.5% and both were statistically different (P=.006 for epileptic events; P<.001 for nonepileptic events). Pediatric neurologists with longer working years had higher diagnostic accuracy; whereas, their working hospital level and educational background made no difference. For patients with paroxysmal events, at least US $673.90 per capita and US $128 million nationwide could be saved annually, which is 12.02% of the total cost for correct diagnosis. Conclusions Home videos made on mobile phones are a cost-effective tool for the diagnosis of paroxysmal events in infants. They can facilitate the diagnosis of paroxysmal events in infants and thereby save costs. The best choice for infants with paroxysmal events on their initial visit is to record their events first and then show the video to a neurologist with longer working years through online consultation.

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