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

Nigeria leads the world in the number of cases of sickle cell disease (SCD). An estimated 150,000 babies are born annually in Nigeria with SCD, a heredity disorder, and 70-90% die before age 5. Only a small portion of affected infants and children in sub Saharan Africa (SSA) reach adolescence. Over 650 children die per day in sub-Saharan Africa from SCD. These dismal statistics are in sharp contrast to outcomes in high-income countries (HICs) where more than 90% of SCD patients reach adulthood. The World Health Organization (WHO) estimates that 70% of deaths could be prevented with a low cost diagnostic and treatment plan. Meaningful preventive care and treatment cannot be implemented without a structured plan for early diagnosis and patient tracking.Early diagnosis requires improved access to parents and guardians of children with SCD, and gaining this access remains a challenge in most of SSA. In 2015, Nigeria's Kano state government, with support from foreign partners, established a community-based program for newborn registration. This platform provides unique access to newborn babies in one of Nigeria's most populous cities, but still lacks a functioning patient testing, tracking, and monitoring system, which we plan to address in our ongoing study. This study will introduce mobile health in a low-income country with low literacy rate and hopefully accustom that segment of the population to more varied mobile health applications that will ultimately improve their health in the long run. Our current operational platform in Kano, Nigeria provides access to a large population with a high prevalence of SCD. We have previously completed pilot testing of 315 subjects for SCD using our microchip electrophoresis test. We are planning to test up to 4,500 additional subjects less than 5 years of age at Murtala Muhammed Specialist Hospital. The hospital staff includes 97 physicians and 415 nurses and outpatient clinics serve about 30,000 patients monthly. The maternity department has a 200-bed capacity and the antenatal clinic performs about 1,000 deliveries and serves an average of 3,000 mothers monthly. Enrollment is planned to start on September 15, 2019 and medical staff are currently being trained to run the tests. Our study is registered in the United States National Library of Medicine's ClinicalTrials.gov (Identifier: NCT03948516). Our technology is uniquely paired with an automatic reader and an Electronic Medical Record (EMR) and patient management solution to record POC test results, register new cases, and track patients for follow-up (Fig. 1). The reader enables automated interpretation of test results, local and remote test data storage, and includes geolocation (Global Positioning System) (Fig. 2). The system will generate reports for all cases of SCD, track hospital visits, appointments, lab tests, and will have mobile and dashboard applications for tracking patients and samples. The application will be installed on mobile devices provided to users. The proposed system will be compliant with the existing privacy standards to handle medical data (e.g., HIPAA in the US and GDPR in the EU). All communications between the parties will be secured via end-to-end encryption as a safeguard. We anticipate that our project will increase the rates of screening, diagnosis and timely treatment of SCD in Kano State of Nigeria. The project's broader impact will likely be the ability to track and monitor screening, disease detection, diagnosis and treatment, which can be scaled up to the whole nation of Nigeria, then to sub-Saharan Africa. The data obtained and analyzed will be the first of their kind and will be used to inform the design of programs to improve access to, and availability of, effective care for this underserved populations. The importance of increased access to diagnosis and treatment should not be underestimated - it is crucial for realizing effective management of people with SCD. The impact can be enhanced by complementing diagnosis and patient tracking with education for the families so they can provide or seek the necessary preventative treatment. Identification of the location of the patients in need would help identify the areas where family, parent, caregiver education should be provided. Disclosures Fraiwan: Hemex Health, Inc.: Equity Ownership, Patents & Royalties. Hasan:Hemex Health, Inc.: Equity Ownership, Patents & Royalties. An:Hemex Health, Inc.: Patents & Royalties. Thota:Hemex Health, Inc.: Employment. Gurkan:Hemex Health, Inc.: Consultancy, Employment, Equity Ownership, Patents & Royalties, Research Funding.

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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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Mapping Evidence of Mobile Health Technologies for Disease Diagnosis and Treatment Support by Health Workers in Sub-Saharan Africa: A Scoping Review

10.21203/rs.2.16644/v1 ◽

2019 ◽

Author(s):

Ernest Osei ◽

Desmond Kuupiel ◽

Portia Nelisiwe Vezi ◽

Tivani P. Mashamba-Thompson

Keyword(s):

Mobile Health ◽

Scoping Review ◽

Full Text ◽

Methodological Quality ◽

Health Workers ◽

Disease Diagnosis ◽

Sub Saharan Africa ◽

Diagnosis And Treatment ◽

Treatment Support ◽

Sub Saharan

Abstract Background: The rapid growth of mobile technology has given rise to the development of mobile health programmes aimed at treating and preventing a wide range of health conditions. However, evidence on the use of mHealth in high disease burdened settings such as SSA is not clear. We systematically mapped evidence on mHealth for disease diagnosis and treatment support by health workers in SSA. Methods: We conducted a scoping review study guided by the Arksey and O’Malley’s framework, Levac et al recommendations, and Joanna Briggs Institute guidelines. We thoroughly searched the following databases: MEDLINE and CINAHL with full-text via EBSCOhost; PubMed; Science Direct and Google Scholar for relevant articles from inception to July 2019. Two independent reviewers screened abstracts and full-text articles using the eligibility criteria as reference. This study employed the mixed methods appraisal tool version 2018 to assess the methodological quality of the included studies. Results: Out of the 572 articles identified , only 10 published articles presented evidence on mHealth for treatment support by health workers in SSA since 2010. No studies reported evidence on mHealth for disease diagnosis by health workers in SSA. Of the 10 studies, four studies were conducted in Kenya; one in South Africa; one in Malawi; one in Zimbabwe; one in Mozambique; one in Nigeria and one in Lesotho. Of the 10 studies: three reported the use of mHealth to manage HIV; two on the management of HIV/TB; two on treatment of malaria; one each on the management of hypertension; cervical cancer; and one was not specific on any disease condition. All the 10 included studies underwent methodological quality appraisal with a scored between 70 and 100%. Conclusions: The study shows that there is limited research on the availability and use of mHealth by health workers for treatment support in SSA. This study also shows there is no literature on the availability and use of mHealth by health workers for disease diagnosis in SSA. We, therefore, recommend primary studies focusing on the use of mHealth by health workers for disease diagnosis in SSA. Keywords: Mobile Health; Disease diagnosis; Treatment support; sub-Saharan Africa

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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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Mobile Health Interventions Addressing Childhood and Adolescent Obesity in Sub-Saharan Africa and Europe: Current Landscape and Potential for Future Research

Frontiers in Public Health ◽

10.3389/fpubh.2021.604439 ◽

2021 ◽

Vol 9 ◽

Author(s):

Priscilla Reddy ◽

Natisha Dukhi ◽

Ronel Sewpaul ◽

Mohammad Ali Afzal Ellahebokus ◽

Nilen Sunder Kambaran ◽

...

Keyword(s):

Mobile Phone ◽

Mobile Health ◽

Public Health Problem ◽

Adolescent Obesity ◽

Overweight And Obesity ◽

Sub Saharan Africa ◽

Future Research ◽

Free Text ◽

Childhood And Adolescent Obesity ◽

Sub Saharan

Child and adolescent overweight is a growing public health problem globally. Europe and low and middle-income (LMIC) countries in Sub-Saharan Africa provide sufficiently suitable populations to learn from with respect to the potential for mobile health (mHealth) interventions in this area of research. The aim of this paper is to identify mHealth interventions on prevention and treatment of childhood and adolescent obesity in Sub-Saharan Africa and Sweden and report on their effects, in order to inform future research in this area. A search of peer-reviewed publications was performed using PubMed, ScienceDirect, EBSCOhost, and Scopus. The search included all articles published up to August 2019. The search strings consisted of MeSH terms related to mHealth, overweight or obesity, children, adolescents or youth and individual countries in Europe and Sub-Saharan Africa. Second, a combination of free-text words; mobile phone, physical activity, exercise, diet, weight, BMI, and healthy eating was also used. Seven studies were reported from Europe and no eligible studies from Sub-Saharan Africa. The results of this narrative review indicate a lack of research in the development and testing of mHealth interventions for childhood and adolescent obesity. There is a need for an evidence base of mHealth interventions that are both relevant and appropriate in order to stem the epidemic of overweight and obesity among children and adolescents in these countries. Uptake of such interventions is likely to be high as there is high penetrance of mobile phone technology amongst adolescents, even within poor communities in Africa.

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Innovative Healthcare Technologies in Otorhinolarnygological Practice in Sub-Saharan Africa: Strategies for Accelerated Uptake

Western Journal of Medical and Biomedical Sciences ◽

10.46912/wjmbs.8 ◽

2020 ◽

Vol 1 (1) ◽

pp. 58-63

Author(s):

OE Braimah ◽

AL Okhakhu

Keyword(s):

Literature Review ◽

New Technologies ◽

Daily Practice ◽

Sub Saharan Africa ◽

Patient Comfort ◽

Technological Innovations ◽

Health Technologies ◽

The World ◽

Healthcare Technologies ◽

Sub Saharan

Healthcare innovations are geared towards greater patient comfort, improved diagnosis and better treatment outcomes. Otorhinolaryngology (ORL) has witnessed many technological innovations become a core aspect of daily practice. Sub-Saharan Africa is currently lagging behind the rest of the world in both development and uptake of innovative health technologies. This paper aims to examine these innovations in otorhinolaryngology as well as the challenges and routes to their timely deployment in Sub-Saharan Africa (SSA). A literature review was conducted on papers retrieved from Google scholar and Pubmed. Several factors have hampered practitioners in SSA from fully leveraging new technologies. By applying political, legal, economic, educational and scientific strategies these practitioners may adopt safe, effective, home-grown adaptations of emerging technologies for accelerated uptake.

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Feasible E-Health Strategies to Reduce Maternal Mortality in Kenya

International Journal of Extreme Automation and Connectivity in Healthcare ◽

10.4018/ijeach.2020070103 ◽

2020 ◽

Vol 2 (2) ◽

pp. 26-36

Author(s):

Richard Charles Millham ◽

Israel Edem Agbehadji ◽

T. Puckree ◽

V. Mukami ◽

Tengyue Li

Keyword(s):

Maternal Mortality ◽

Information Dissemination ◽

Sub Saharan Africa ◽

Cross Sectional ◽

Mobile Phone Technology ◽

Health Technologies ◽

Health Strategy ◽

Nomadic People ◽

Sub Saharan ◽

In Pregnancy

Maternal mortality remains a persistent cause of death in Sub-Saharan Africa. Although e-health technologies are rapidly advancing, many technologies are infeasible given the infrastructure constraints and context of Sub-Saharan Africa. This paper proposes and implement a feasible e-health strategy, which involves the use of simple mobile phone technology and was designed to reduce maternal mortality and neonatal rates through information dissemination, among the nomadic people within a select part of Kenya. This strategy was developed, through an interactive pilot study, to determine the most feasible technique, which was found to be SMS messages, and most appropriate customized information depending on the patient's condition and period in pregnancy. A cross-sectional randomized e-health intervention was implemented in order to determine the effectiveness of the intervention. Due to exceptional circumstances, such as a prolonged health strike, this intervention had mixed results but shows promise of both feasibility and effectiveness.

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Mapping evidence of mobile health technologies for disease diagnosis and treatment support by health workers in sub-Saharan Africa: a scoping review

BMC Medical Informatics and Decision Making ◽

10.1186/s12911-020-01381-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ernest Osei ◽

Desmond Kuupiel ◽

Portia Nelisiwe Vezi ◽

Tivani P. Mashamba-Thompson

Keyword(s):

Mobile Health ◽

Scoping Review ◽

Full Text ◽

Methodological Quality ◽

Health Workers ◽

Disease Diagnosis ◽

Sub Saharan Africa ◽

Diagnosis And Treatment ◽

Treatment Support ◽

Sub Saharan

Abstract Background The rapid growth of mobile technology has given rise to the development of mobile health (mHealth) applications aimed at treating and preventing a wide range of health conditions. However, evidence on the use of mHealth in high disease burdened settings such as sub-Sharan Africa is not clear. Given this, we systematically mapped evidence on mHealth for disease diagnosis and treatment support by health workers in sub-Saharan Africa. Methods We conducted a scoping review study guided by the Arksey and O’Malley’s framework, Levac et al. recommendations, and Joanna Briggs Institute guidelines. We thoroughly searched the following databases: MEDLINE and CINAHL with full text via EBSCOhost; PubMed; Science Direct and Google Scholar for relevant articles from the inception of mHealth technology to April 2020. Two reviewers independently screened abstracts and full-text articles using the eligibility criteria as reference. This study employed the mixed methods appraisal tool version 2018 to assess the methodological quality of the included studies. Results Out of the 798 articles identified, only 12 published articles presented evidence on the availability and use of mHealth for disease diagnosis and treatment support by health workers in SSA since 2010. Of the 12 studies, four studies were conducted in Kenya; two in Malawi; two in Nigeria; one in South Africa; one in Zimbabwe; one in Mozambique, and one in Lesotho. Out of the 12 studies, one reported the use of mHealth for diseases diagnosis; three reported the use of mHealth to manage HIV; two on the management of HIV/TB; two on the treatment of malaria; one each on the management of hypertension; cervical cancer; and three were not specific on any disease condition. All the 12 included studies underwent methodological quality appraisal with a scored between 70 and 100%. Conclusions The study shows that there is limited research on the availability and use of mHealth by health workers for disease diagnosis and treatment support in sub-Saharan Africa. We, therefore, recommend primary studies focusing on the use of mHealth by health workers for disease diagnosis and treatment support in sub-Saharan Africa.

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