scholarly journals Challenges and prospects for implementation of community health volunteers’ digital health solutions in Kenya: a qualitative study

2020 ◽  
Author(s):  
Pauline Bakibinga ◽  
Eva Kamande ◽  
Lyagamula Kisia ◽  
Milka Omuya ◽  
Dennis J Matanda ◽  
...  
Keyword(s):  
Community Health ◽  
Information And Communication Technologies ◽  
Health Workers ◽  
Digital Health ◽  
Healthcare Delivery ◽  
Mobile App ◽  
Health Technologies ◽  
Community Health Volunteers ◽  
Barriers To Use ◽  
Health Managers

Abstract Background: The value of digital health technologies in delivering vital health care interventions, especially in low resource settings is increasingly appreciated. We co-developed and tested a decision support mobile health (m-Health) application (app); an integrated data capture tool running as a mobile app with selected reporting forms for Community Health Volunteers (CHVs) in Kenya and connected to health facilities. This paper explores the experiences of CHVs, health workers and members of Sub-County Health Management Teams following implementation of the project.Methods: Data were collected in December 2017 through in-depth interviews (health workers and CHVs) and key informant interviews (health managers) and focus group discussions (CHVs) working in Kamukunji sub-County of Nairobi, Kenya. Data coding and analysis was performed in NVivo 12.Results: Regarding users and health managers’ perceptions towards the system; three main themes were identified: 1) variations in use, 2) barriers to use and 3) recommendations to improve use. Health workers at the private facility and some CHVs used the system more than health workers at the public facilities. Four sub-themes under barriers to use were socio-political environment, attitudes and behaviour, issues related to the system and poor infrastructure. A prolonged health workers’ strike, the contentious presidential election in the year of implementation, interrupted electricity supply and lack of basic electric fixtures were major barriers to use. Suggestions to improve usage were: 1) integration of the system with others in use and making it available on users’ regular phones, and 2) provision of extra financial motivation for users as well as performance based remuneration. Conclusions: The findings reveal the importance of considering the readiness of information and communication technologies (ICT) users before rollout of ICT solutions. The political and sociocultural environment in which the innovation is to be implemented and integration of new solutions into existing ones is critical for success. As more healthcare delivery models are developed, harnessing the potential of digital technologies, strengthening health systems is critical as this provides the backbone on which such innovations draw support.

scholarly journals Challenges and prospects for implementation of community health volunteers’ digital health solutions in Kenya: a qualitative study

2020 ◽  
Author(s):  
Pauline Bakibinga ◽  
Eva Kamande ◽  
Lyagamula Kisia ◽  
Milka Omuya ◽  
Dennis J Matanda ◽  
...  
Keyword(s):  
Health Care ◽  
Community Health ◽  
Information And Communication Technologies ◽  
Health Workers ◽  
Digital Health ◽  
Healthcare Delivery ◽  
Health Technologies ◽  
Community Health Volunteers ◽  
Barriers To Use ◽  
Health Managers

Abstract Background: The value of digital health technologies in delivering vital health care interventions, especially in low resource settings is increasingly appreciated. We co-developed and tested a decision support mobile health (m-Health) application (app);with some of the forms used by Community Health Volunteers (CHVs) in Kenya to collect data and connected to health facilities. This paper explores the experiences of CHVs, health workers and members of Sub-County Health Management Teams following implementation of the project.Methods: Data were collected in December 2017 through in-depth interviews and focus group discussions with CHVs and key informant interviews with health care workers and health managers in Kamukunji sub-County of Nairobi, Kenya. Data coding and analysis was performed in NVivo 12.Results: Regarding users and health managers’ perceptions towards the system; three main themes were identified: 1) variations in use, 2) barriers to use and 3) recommendations to improve use. Health workers at the private facility and some CHVs used the system more than health workers at the public facilities. Four sub-themes under barriers to use were socio-political environment, attitudes and behaviour, issues related to the system and poor infrastructure. A prolonged health workers’ strike, the contentious presidential election in the year of implementation, interrupted electricity supply and lack of basic electric fixtures were major barriers to use. Suggestions to improve usage were: 1) integration of the system with others in use and making it available on users’ regular phones, and 2) explore sustainable motivation models to users as well as performance based remuneration. Conclusions: The findings reveal the importance of considering the readiness of information and communication technologies (ICT) users before rollout of ICT solutions. The political and sociocultural environment in which the innovation is to be implemented and integration of new solutions into existing ones is critical for success. As more healthcare delivery models are developed, harnessing the potential of digital technologies, strengthening health systems is critical as this provides the backbone on which such innovations draw support.

scholarly journals Challenges and prospects for implementation of community health volunteers’ digital health solutions in Kenya: a qualitative study

2020 ◽  
Author(s):  
Pauline Bakibinga ◽  
Eva Kamande ◽  
Lyagamula Kisia ◽  
Milka Omuya ◽  
Dennis J Matanda ◽  
...  
Keyword(s):  
Health Care ◽  
Community Health ◽  
Information And Communication Technologies ◽  
Health Workers ◽  
Digital Health ◽  
Healthcare Delivery ◽  
Health Technologies ◽  
Community Health Volunteers ◽  
Barriers To Use ◽  
Health Managers

Abstract Background The value of digital health technologies in delivering vital health care interventions, especially in low resource settings is increasingly appreciated. We co-developed and tested a decision support mobile health (m-Health) application (app);with some of the forms used by Community Health Volunteers (CHVs) in Kenya to collect data and connected to health facilities. This paper explores the experiences of CHVs, health workers and members of Sub-County Health Management Teams following implementation of the project. Methods Data were collected in December 2017 through in-depth interviews and focus group discussions with CHVs and key informant interviews with health care workers and health managers in Kamukunji sub-County of Nairobi, Kenya. Data coding and analysis was performed in NVivo 12. Results Regarding users and health managers’ perceptions towards the system; three main themes were identified: 1) variations in use, 2) barriers to use and 3) recommendations to improve use. Health workers at the private facility and some CHVs used the system more than health workers at the public facilities. Four sub-themes under barriers to use were socio-political environment, attitudes and behaviour, issues related to the system and poor infrastructure. A prolonged health workers’ strike, the contentious presidential election in the year of implementation, interrupted electricity supply and lack of basic electric fixtures were major barriers to use. Suggestions to improve usage were: 1) integration of the system with others in use and making it available on users’ regular phones, and 2) explore sustainable motivation models to users as well as performance based remuneration. Conclusions The findings reveal the importance of considering the readiness of information and communication technologies (ICT) users before rollout of ICT solutions. The political and sociocultural environment in which the innovation is to be implemented and integration of new solutions into existing ones is critical for success. As more healthcare delivery models are developed, harnessing the potential of digital technologies, strengthening health systems is critical as this provides the backbone on which such innovations draw support.

scholarly journals Challenges and prospects for implementation of community health volunteers’ digital health solutions in Kenya: a qualitative study

2020 ◽  
Author(s):  
Pauline Bakibinga ◽  
Eva Kamande ◽  
Lyagamula Kisia ◽  
Milka Omuya ◽  
Dennis J Matanda ◽  
...  
Keyword(s):  
Health Care ◽  
Community Health ◽  
Information And Communication Technologies ◽  
Health Workers ◽  
Digital Health ◽  
Mobile App ◽  
Health Technologies ◽  
Community Health Volunteers ◽  
Barriers To Use ◽  
Health Managers

Abstract Background: The value of digital health technologies in delivering vital health care interventions, especially in low resource settings is increasingly appreciated. We co-developed and tested a decision support mobile health (m-Health) application (app); an integrated data capture tool running as a mobile app with selected reporting forms for Community Health Volunteers (CHVs) in Kenya and connected to health facilities. This paper explores the experiences of CHVs, health workers and members of Sub-County Health Management Teams following implementation of the project.Methods: Data were collected in December 2017 through in-depth interviews and focus group discussions with CHVs, and key informant interviews with health care workers and health managers in Kamukunji sub-County of Nairobi, Kenya. Data coding and analysis was performed in NVivo 12.Results: Regarding users and health managers’ perceptions towards the system; three main themes were identified: 1) variations in use, 2) barriers to use and 3) recommendations to improve use. Health workers at the private facility and some CHVs used the system more than health workers at the public facilities. Four sub-themes under barriers to use were socio-political environment, attitudes and behaviour, issues related to the system and poor infrastructure. A prolonged health workers’ strike, the contentious presidential election in the year of implementation, interrupted electricity supply and lack of basic electric fixtures were major barriers to use. Suggestions to improve usage were: 1) integration of the system with others in use and making it available on users’ regular phones, and 2) explore sustainable motivation models to users as well as performance based remuneration. Conclusions: The findings reveal the importance of considering the readiness of information and communication technologies (ICT) users before rollout of ICT solutions. The political and sociocultural environment in which the innovation is to be implemented and integration of new solutions into existing ones is critical for success. As more healthcare delivery models are developed, harnessing the potential of digital technologies, strengthening health systems is critical as this provides the backbone on which such innovations draw support.

scholarly journals Challenges and prospects for implementation of community health volunteers’ digital health solutions in Kenya: a qualitative study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Pauline Bakibinga ◽  
Eva Kamande ◽  
Lyagamula Kisia ◽  
Milka Omuya ◽  
Dennis J. Matanda ◽  
...  
Keyword(s):  
Health Care ◽  
Community Health ◽  
Information And Communication Technologies ◽  
Health Workers ◽  
Digital Health ◽  
Healthcare Delivery ◽  
Health Technologies ◽  
Community Health Volunteers ◽  
Barriers To Use ◽  
Health Managers

Abstract Background The value of digital health technologies in delivering vital health care interventions, especially in low resource settings is increasingly appreciated. We co-developed and tested a decision support mobile health (m-Health) application (app);with some of the forms used by Community Health Volunteers (CHVs) in Kenya to collect data and connected to health facilities. This paper explores the experiences of CHVs, health workers and members of Sub-County Health Management Teams following implementation of the project. Methods Data were collected in December 2017 through in-depth interviews and focus group discussions with CHVs and key informant interviews with health care workers and health managers in Kamukunji sub-County of Nairobi, Kenya. Data coding and analysis was performed in NVivo 12. Results Regarding users and health managers’ perceptions towards the system; three main themes were identified: 1) variations in use, 2) barriers to use and 3) recommendations to improve use. Health workers at the private facility and some CHVs used the system more than health workers at the public facilities. Four sub-themes under barriers to use were socio-political environment, attitudes and behaviour, issues related to the system and poor infrastructure. A prolonged health workers’ strike, the contentious presidential election in the year of implementation, interrupted electricity supply and lack of basic electric fixtures were major barriers to use. Suggestions to improve usage were: 1) integration of the system with others in use and making it available on users’ regular phones, and 2) explore sustainable motivation models to users as well as performance based remuneration. Conclusions The findings reveal the importance of considering the readiness of information and communication technologies (ICT) users before rollout of ICT solutions. The political and sociocultural environment in which the innovation is to be implemented and integration of new solutions into existing ones is critical for success. As more healthcare delivery models are developed, harnessing the potential of digital technologies, strengthening health systems is critical as this provides the backbone on which such innovations draw support.

scholarly journals Digital Health-Enabled Community-Centered Care (D-CCC): A Scalable Model to Empower Future Community Health Workers utilizing Human-in-the-Loop AI

2021 ◽  
Author(s):  
Sarah M. Rodrigues ◽  
Anil Kanduri ◽  
Adeline M. Nyamathi ◽  
Nikil Dutt ◽  
Pramod P. Khargonekar ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Closed Loop ◽  
Health Workers ◽  
Digital Health ◽  
Human In The Loop ◽  
Collaborative Community ◽  
Health And Social Care ◽  
The Future ◽  
Centered Care

AbstractDigital Health-Enabled Community-Centered Care (D-CCC) represents a pioneering vision for the future of community-centered care. Utilizing an artificial intelligence-enabled closed-loop digital health platform designed for, and with, community health workers, D-CCC enables timely and individualized delivery of interventions by community health workers to the communities they serve. D-CCC has the potential to transform the current landscape of manual, episodic and restricted community health worker-delivered care and services into an expanded, digitally interconnected and collaborative community-centered health and social care ecosystem which centers around a digitally empowered community health workforce of the future.

Abstract 16462: Using Geospatial Mapping to Target Risk and Facilitate Placement of Community Health Workers, Educational Tools, and AHA Field Teams

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Zoe L Zwecker ◽  
Susan Spratt ◽  
Benjamin A Goldstien ◽  
Bradi B Granger
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Care Delivery ◽  
Healthcare Delivery ◽  
Undiagnosed Diabetes ◽  
Median Income ◽  
Educational Tools ◽  
Public Data ◽  
Neighborhood Boundaries

Introduction: Diabetes is a chronic condition that affects 34.2 million Americans. Long-lasting or undiagnosed diabetes increases the risk of developing cardiovascular disease (CVD). Geographic Information Systems (GIS) inform healthcare delivery interventions to target patients, clinicians, health systems and communities at highest risk. A gap remains in how data and GIS are applied and leveraged in the context of value-based care delivery systems. This spatial analysis demonstrates the application of a generalizable methodology for allocating resources such as AHA Field Teams, community health workers (CHWs), and educational tools to areas most burdened by diabetes and CVD. Methods: The automated geocoding infrastructure from the Duke Medicine electronic data warehouse was developed to standardize and scale geocoding addresses for a population of people with type 2 diabetes from the Southeastern Diabetes Initiative (SEDI) in 2017. While maintaining accuracy and assuring that patients’ protected health information was secure, we used geocoded data and public data (public health data, census tract data, and information on the built environment) to assess risk and identify accessible resources. Results and Discussion: Using this method to understand racial distribution, level of education, and income,we identified high risk communities in Durham County. We correlated geospatial patterns of health risk, illness burden, and determined accessible resources for diabetes and CVD.We calculated a resource ratio of one CHW to 100 patient-population and identified a central hub for fixed resource access. Using neighborhood boundaries, we identified a community where the burden of diabetes reached 17%, 60% of inhabitants were African American, median income was $55,945, and just 17.7% had a bachelor’s degree. Understanding risk using these social determinants (Figure 1) supports the intentional allocation of resources and hiring of CHWs.

scholarly journals The Digital Health Revolution and People with Disabilities: Perspective from the United States

2020 ◽  
Vol 17 (2) ◽  
pp. 381 ◽  
Author(s):  
Mike Jones ◽  
Frank DeRuyter ◽  
John Morris
Keyword(s):  
United States ◽  
Mobile Health ◽  
Chronic Conditions ◽  
Digital Health ◽  
Wearable Sensors ◽  
Healthcare Delivery ◽  
People With Disabilities ◽  
The United States ◽  
Models Of Care ◽  
Health Technologies

This article serves as the introduction to this special issue on Mobile Health and Mobile Rehabilitation for People with Disabilities. Social, technological and policy trends are reviewed. Needs, opportunities and challenges for the emerging fields of mobile health (mHealth, aka eHealth) and mobile rehabilitation (mRehab) are discussed. Healthcare in the United States (U.S.) is at a critical juncture characterized by: (1) a growing need for healthcare and rehabilitation services; (2) maturing technological capabilities to support more effective and efficient health services; (3) evolving public policies designed, by turns, to contain cost and support new models of care; and (4) a growing need to ensure acceptance and usability of new health technologies by people with disabilities and chronic conditions, clinicians and health delivery systems. Discussion of demographic and population health data, healthcare service delivery and a public policy primarily focuses on the U.S. However, trends identified (aging populations, growing prevalence of chronic conditions and disability, labor shortages in healthcare) apply to most countries with advanced economies and others. Furthermore, technologies that enable mRehab (wearable sensors, in-home environmental monitors, cloud computing, artificial intelligence) transcend national boundaries. Remote and mobile healthcare delivery is needed and inevitable. Proactive engagement is critical to ensure acceptance and effectiveness for all stakeholders.

scholarly journals Telemonitoring and remote counseling in hypertensive patients. Looking for new ways to do old jobs

2019 ◽  
Vol 25 (4) ◽  
pp. 337-356 ◽  
Author(s):  
М. V. Ionov ◽  
N. Е. Zvartau ◽  
I. V. Emelyanov ◽  
A. О. Konradi
Keyword(s):  
Information And Communication Technologies ◽  
Digital Health ◽  
Healthcare Delivery ◽  
Communication Technologies ◽  
Noncommunicable Diseases ◽  
Digital Era ◽  
Number Of Patients ◽  
Information And Communication ◽  
Based Medicine ◽  
Modifiable Cardiovascular Risk Factor

XXI century emphasized humanity to embrace the digital era after a reality of Third and Fourth Industrial Revolutions, nowadays dictating new terms of social networking. It is expected that information and communication technologies integrated with value-based medicine will significantly impact healthcare delivery to tremendous number of patients with socially important noncommunicable diseases. Cardiovascular illnesses comprise the greatest part of such pathologies. Hypertension (HTN) being the most prevalent cardiovascular disease is also the key modifiable cardiovascular risk factor yet seems to be an attractive target for both value-based concept and telehealth interventions. Present review addresses up-to-date science on telehealth, sets out the main well-known, but yet unsolved challenges in management of HTN along with the new approaches involving telemedicine programs, digital health outlooks. The main barriers of telehealth implementation are also considered along with the possible solutions.

scholarly journals Proactive case detection of common childhood illnesses by community health workers: a systematic review

2019 ◽  
Vol 4 (6) ◽  
pp. e001799 ◽  
Author(s):  
Caroline Whidden ◽  
Julie Thwing ◽  
Julie Gutman ◽  
Ethan Wohl ◽  
Clémence Leyrat ◽  
...  
Keyword(s):  
Community Health ◽  
Low Income ◽  
Health Workers ◽  
Meta Analysis ◽  
Healthcare Delivery ◽  
Intervention Design ◽  
Case Detection ◽  
Access To Treatment ◽  
Childhood Illnesses ◽  
Design And Implementation

IntroductionIdentifying design features and implementation strategies to optimise community health worker (CHW) programmes is important in the context of mixed results at scale. We systematically reviewed evidence of the effects of proactive case detection by CHWs in low-income and middle-income countries (LMICs) on mortality, morbidity and access to care for common childhood illnesses.MethodsPublished studies were identified via electronic databases from 1978 to 2017. We included randomised and non-randomised controlled trials, controlled before–after studies and interrupted time series studies, and assessed their quality for risk of bias. We reported measures of effect as study investigators reported them, and synthesised by outcomes of mortality, disease prevalence, hospitalisation and access to treatment. We calculated risk ratios (RRs) as a principal summary measure, with CIs adjusted for cluster design effect.ResultsWe identified 14 studies of 11 interventions from nine LMICs that met inclusion criteria. They showed considerable diversity in intervention design and implementation, comparison, outcomes and study quality, which precluded meta-analysis. Proactive case detection may reduce infant mortality (RR: 0.52–0.94) and increase access to effective treatment (RR: 1.59–4.64) compared with conventional community-based healthcare delivery (low certainty evidence). It is uncertain whether proactive case detection reduces mortality among children under 5 years (RR: 0.04–0.80), prevalence of infectious diseases (RR: 0.06–1.02), hospitalisation (RR: 0.38–1.26) or increases access to prompt treatment (RR: 1.00–2.39) because the certainty of this evidence is very low.ConclusionProactive case detection may provide promising benefits for child health, but evidence is insufficient to draw conclusions. More research is needed on proactive case detection with rigorous study designs that use standardised outcomes and measurement methods, and report more detail on complex intervention design and implementation.PROSPERO registration numberCRD42017074621.

Digital Health Interventions for Community Health Worker Training, Ongoing Education, and Supportive Supervision

2021 ◽  
pp. 67-86
Author(s):  
Beatrice Wasunna ◽  
Isaac Holeman
Keyword(s):  
Community Health ◽  
Health Workers ◽  
Digital Health ◽  
Health Interventions ◽  
World Health ◽  
Supportive Supervision ◽  
Governmental Organization ◽  
Implementation Challenges ◽  
Worker Training ◽  
The Right

According to the World Health Organization’s No Health Without a Workforce report, the global shortage of community health workers (CHWs) is expected to reach 12.9 million by 2035. This shortfall raises pressing questions about how CHWs are recruited, trained, and supported as front-line care providers. Lay people become CHWs in a variety of ways; they might be chosen by a non-governmental organization or a government programme, elected by community members, or simply volunteer themselves at the right time and place. After recruitment, CHWs typically undergo training, and the scope and quality of this training can vary enormously. Often, limited funds are stretched to conduct trainings in person at facilities that may or may not be readily accessible for health workers, and refresher trainings are often cut in times of budget shortfall. While there may be no simple solution to these challenges, many now look to the use of digital technologies as a promising opportunity. Digital health interventions have come to play a growing role in healthcare in the last decade, yet the uses of technology for training, ongoing education, and supportive supervision remain understudied in lower-income settings. In this chapter, we examine a case study of digital health interventions in Nepal. We examine matters of baseline literacy and access to technology, the interweaving of technology and health system design issues, and prospects for integrating digital and face-to-face education and support. While the role of technology is easily overstated, we nonetheless argue that new digital workflows can address real implementation challenges if designed in a human-centred manner.

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