scholarly journals Evaluating the Feasibility and Acceptability of a Mobile Health–Based Female Community Health Volunteer Program for Hypertension Control in Rural Nepal: Cross-Sectional Study

10.2196/15419 ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. e15419 ◽  
Author(s):  
Zhao Ni ◽  
Namratha Atluri ◽  
Ryan J Shaw ◽  
Jingru Tan ◽  
Kinza Khan ◽  
...  
Keyword(s):  
Health Care ◽  
Mobile Phone ◽  
Community Health ◽  
Volunteer Program ◽  
Health Volunteer ◽  
Community Health Volunteers ◽  
Female Community ◽  
Community Health Volunteer ◽  
Female Community Health Volunteers ◽  
Rural Nepal

Background Hypertension is a major modifiable risk factor for cardiovascular disease, the world’s leading cause of death. The prevalence of hypertension is disproportionately higher in South Asian countries than in other regions of the world. Screening for hypertension in primary care settings remains a challenge in many South Asian countries, including Nepal. Nepal is located in the Himalayan Mountains region, posing significant geographical challenges for its rural citizens to access primary health care and service delivery. This barrier increases the costs and inconvenience for rural Nepalis to access hypertension screening and treatment. As a result, the prevalence of hypertension in Nepal tripled in the last 25 years to 22.4%-38.6%. Nepal’s Ministry of Health and Population relies on female community health volunteers to link health centers and communities to provide basic health services. Over 50,000 of these volunteers in Nepal have received basic health care training and are assigned to take care of maternal and child health. Due to limited health care resources, adopting new methods to control hypertension is an urgent need in Nepal. Several recent studies in Nepal have recommended extending the role of female community health volunteers to include hypertension management through blood pressure monitoring and home-based education. Objective The goal of this study was to assess if a mobile health–based female community health volunteer approach of combining the traditional community health volunteer program with digital technologies would be feasible and acceptable in rural Nepal. Methods In this study, we recruited 17 female community health volunteers and extended their role from maternal and child health to hypertension management through screening blood pressures. Results All 17 female community health volunteers successfully measured 1113 rural Nepalis’ blood pressures, identified 169 hypertensive patients, and collected health behaviors data of the 169 hypertensive patients. Among the 169 patients, 70% of them had a mobile phone, and 92% were interested in receiving health-related information via a mobile phone. Among those who were interested in receiving information via a mobile phone, 84% preferred voice calls, and 7% and 1% preferred texting and apps, respectively. Conclusions Results from this study indicate that a digital health intervention that leverages feature-phones combined with female community health volunteers may be an acceptable and pragmatic way to implement an evidence-based program to reduce hypertension in rural Nepal.

scholarly journals Evaluating the Feasibility and Acceptability of a Mobile Health–Based Female Community Health Volunteer Program for Hypertension Control in Rural Nepal: Cross-Sectional Study (Preprint)

2019 ◽  
Author(s):  
Zhao Ni ◽  
Namratha Atluri ◽  
Ryan J Shaw ◽  
Jingru Tan ◽  
Kinza Khan ◽  
...  
Keyword(s):  
Health Care ◽  
Mobile Phone ◽  
Community Health ◽  
Volunteer Program ◽  
Health Volunteer ◽  
Community Health Volunteers ◽  
Female Community ◽  
Community Health Volunteer ◽  
Female Community Health Volunteers ◽  
Rural Nepal

BACKGROUND Hypertension is a major modifiable risk factor for cardiovascular disease, the world’s leading cause of death. The prevalence of hypertension is disproportionately higher in South Asian countries than in other regions of the world. Screening for hypertension in primary care settings remains a challenge in many South Asian countries, including Nepal. Nepal is located in the Himalayan Mountains region, posing significant geographical challenges for its rural citizens to access primary health care and service delivery. This barrier increases the costs and inconvenience for rural Nepalis to access hypertension screening and treatment. As a result, the prevalence of hypertension in Nepal tripled in the last 25 years to 22.4%-38.6%. Nepal’s Ministry of Health and Population relies on female community health volunteers to link health centers and communities to provide basic health services. Over 50,000 of these volunteers in Nepal have received basic health care training and are assigned to take care of maternal and child health. Due to limited health care resources, adopting new methods to control hypertension is an urgent need in Nepal. Several recent studies in Nepal have recommended extending the role of female community health volunteers to include hypertension management through blood pressure monitoring and home-based education. OBJECTIVE The goal of this study was to assess if a mobile health–based female community health volunteer approach of combining the traditional community health volunteer program with digital technologies would be feasible and acceptable in rural Nepa METHODS In this study, we recruited 17 female community health volunteers and extended their role from maternal and child health to hypertension management through screening blood pressures. RESULTS All 17 female community health volunteers successfully measured 1113 rural Nepalis’ blood pressures, identified 169 hypertensive patients, and collected health behaviors data of the 169 hypertensive patients. Among the 169 patients, 70% of them had a mobile phone, and 92% were interested in receiving health-related information via a mobile phone. Among those who were interested in receiving information via a mobile phone, 84% preferred voice calls, and 7% and 1% preferred texting and apps, respectively. CONCLUSIONS Results from this study indicate that a digital health intervention that leverages feature-phones combined with female community health volunteers may be an acceptable and pragmatic way to implement an evidence-based program to reduce hypertension in rural Nepal.

scholarly journals Lessons learned through piloting a community-based SMS referral system for common mental health disorders used by female community health volunteers in rural Nepal

2020 ◽  
Author(s):  
Anvita Bhardwaj ◽  
Prasansa Subba ◽  
Sauharda Rai ◽  
Chaya Bhat ◽  
Renasha Ghimire ◽  
...  
Keyword(s):  
Mental Health ◽  
Community Health ◽  
Mental Healthcare ◽  
Text Messages ◽  
Case Record ◽  
Community Health Volunteers ◽  
Female Community ◽  
Female Community Health Volunteers ◽  
Rural Nepal

Abstract Objective: The Community Informant Detection Tool (CIDT) is a paper-based proactive case detection strategy with evidence for improving help-seeking behavior for mental healthcare. Key implementation barriers for the paper-based CIDT include delayed reporting of cases and lack of active follow up. We used mobile phones and the structured text messages to improve timeliness of case reporting, encouraging follow up, and case record keeping. 36 female community health volunteers piloted this mobile phone CIDT (mCIDT) for three months in 2017 in rural Nepal. Results: Only 8 cases were identified by health volunteers using mCIDT, and only two of these cases engaged with health services post-referral. Accuracy with the mCIDT was considerably lower than paper-based CIDT, especially among older health volunteers, those with lower education, and those unfamiliar with sending text messages. Qualitative findings revealed implementation challenges including cases not following through on referrals due to perceived lack of staff at health facilities, assumptions among health volunteers that all earthquake-related mental health needs had been met, and lack of financial incentives for use of mCIDT. Based on study findings, we provide 5 recommendations—in particular attitudinal and system preparedness changes—to effectively introduce new mental healthcare technology in low resource health systems.

scholarly journals Lessons learned through piloting a community-based SMS referral system for common mental health disorders used by female community health volunteers in rural Nepal

2020 ◽  
Author(s):  
Anvita Bhardwaj ◽  
Prasansa Subba ◽  
Sauharda Rai ◽  
Chaya Bhat ◽  
Renasha Ghimire ◽  
...  
Keyword(s):  
Mental Health ◽  
Community Health ◽  
Mental Healthcare ◽  
Text Messages ◽  
Case Record ◽  
Community Health Volunteers ◽  
Female Community ◽  
Female Community Health Volunteers ◽  
Rural Nepal

Abstract Objective: The Community Informant Detection Tool (CIDT) is a paper-based proactive case detection strategy with evidence for improving help-seeking behavior for mental healthcare. Key implementation barriers for the paper-based CIDT include delayed reporting of cases and lack of active follow up. We used mobile phones and the structured text messages to improve timeliness of case reporting, encouraging follow up, and case record keeping. 36 female community health volunteers piloted this mobile phone CIDT (mCIDT) for three months in 2017 in rural Nepal. Results: Only 8 cases were identified by health volunteers using mCIDT, and only two of these cases engaged with health services post-referral. Accuracy with the mCIDT was considerably lower than paper-based CIDT, especially among older health volunteers, those with lower education, and those having difficulties sending text messages. Qualitative findings revealed implementation challenges including cases not following through on referrals due to perceived lack of staff at health facilities, assumptions among health volunteers that all earthquake-related mental health needs had been met, and lack of financial incentives for use of mCIDT. Based on study findings, we provide 5 recommendations—in particular attitudinal and system preparedness changes—to effectively introduce new mental healthcare technology in low resource health systems.

scholarly journals Effect of an Educational Intervention on Knowledge and Perception Regarding Rational Medicine Use and Self-medication

2018 ◽  
Vol 16 (3) ◽  
pp. 313-320
Author(s):  
Nisha Jha ◽  
Pathiyil Ravi Shankar ◽  
Anurag Marasini
Keyword(s):  
Drug Use ◽  
Community Health ◽  
Healthcare Professionals ◽  
Medicine Use ◽  
Self Medication ◽  
Community Health Volunteers ◽  
Female Community ◽  
Pharmaceutical Promotion ◽  
Female Community Health Volunteers ◽  
The Mean

Background: Rational use of medicines is important for safe and cost-effective pharmacotherapy. However, nearly half of the medicines available in the market may be used irrationally. The present study assessed the perceptions and knowledge about rational medicine use and responsible self-medication among participants before and after an educational intervention at KIST Medical College, Lalitpur. Methods: An educational module was conducted among healthcare professionals, media personnel and female community health volunteers. The questionnaire was administered before and immediately after the module. The areas addressed were rational medicine use, ethical prescribing, rational drug use situation in Nepal, pharmaceutical promotion, rational self-medication, safe use of antibiotics, and drug use problems in Nepal. Results: Among healthcare professionals, the rational drug use situation in Nepal and the total score significantly increased post-intervention (p<0.05). Among media personnel the mean scores increased significantly in pharmaceutical promotion and drug use problems in Nepal areas but there was a significant decrease in safe use of antibiotics. The pre-intervention pharmaceutical promotion score was significantly higher among healthcare professionals compared to media personnel while the rational self-medication scores were highest among female community health volunteers, safe use of antibiotics scores were highest among the media personnel. Post-intervention the mean pharmaceutical promotion scores was highest among healthcare professionals, rational self-medication scores among female community health volunteers, safe use of antibiotics, drug use problems in Nepal and total scores were highest among the media personnel. Conclusions: There were differences in the mean pre-intervention scores among different subgroups. A single session may not be enough to bring about significant changes in knowledge and perception. The retention of knowledge could be measured in future studies. Keywords: Female community health volunteers; health care professionals; media; rational medicine use; self medication.

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