scholarly journals Patients’ and Doctors’ Perceptions of a Mobile Phone–Based Consultation Service for Maternal, Neonatal, and Infant Health Care in Bangladesh: A Mixed-Methods Study (Preprint)

2018 ◽  
Author(s):  
Mafruha Alam ◽  
Cathy Banwell ◽  
Anna Olsen ◽  
Kamalini Lokuge
Keyword(s):  
Health Care ◽  
Mobile Phone ◽  
Pregnant Women ◽  
Infant Health ◽  
Text Messages ◽  
New Mothers ◽  
Consultation Service ◽  
The Right ◽  
The Impact ◽  
Remote Consultations

BACKGROUND A mobile-based consultation service, or telehealth, can be used for remote consultations with health care professionals for screening, self-care management, and referral. In rural Bangladesh, where there is high demand for scarce male and even scarcer female doctors, remote consultations may help women seeking maternal and child health care. Aponjon is a mHealth service in Bangladesh that provides weekly voice or text messages to pregnant women, new mothers, and family members on various aspects of maternal, neonatal, and infant health. Subscribers can also access a dedicated 24*7 call center to discuss maternal, neonatal, and infant health or emergencies with medically trained doctors. The service provides advice, primary diagnoses, prescriptions, and referrals to subscriber callers. OBJECTIVE We investigated the Aponjon service to understand access, acceptability, usability, benefits, and challenges of a mobile phone-based consultation service. METHODS We conducted call log data analysis for September to November 2015 to understand how many unique subscribers accessed the service, who accessed the service, the geographical distribution of callers, and the purpose of the calls. We also conducted a qualitative exploratory substudy of eight married women and eight married men who were subscribers to and accessed the service during this time to understand their experiences. We interviewed 11 doctors from the same service who provided phone consultations to subscribers. RESULTS Approximately 3894 unique subscribers accessed the service for single or multiple consultations during the study period; 68.36% (2662/3894) of subscribers were from rural households, and 53.00% (2064/3894) of calls were made by pregnant women or new mothers. Approximately 96.08% (5081/5288) calls were nonurgent, 2.69% (142/5288) semiurgent, and 1.23% (65/5288) urgent. Almost 64.7% (134/207) semiurgent or urgent calls came between 8 PM and 8 AM. Callers found the consultation service trustworthy, cost-effective, and convenient. The doctors dispelled misconceptions and promoted good health care practices, regular health check-ups, and responsible use of medicine. They helped families understand the severity of sicknesses and advised them to seek care at health facilities for semiurgent or urgent conditions. The service lacked a pro-poor policy to support talk times of subscribers from poor households and a proper referral system to help patients find the right care at the right facilities. CONCLUSIONS Although a regular messaging service is constrained by a one-way communication system, this service using the same platform, gave subscribers access to an abbreviated “consultation” with medical doctors. The consultations provided subscribers with valued medical advice and support, although they were limited in their population reach and their integration into the wider medical system. Further research is required to understand the impact of advice and referral, cost-effectiveness, and willingness to pay for mHealth consultation services, but this research suggests that these services should be supported or even expanded.

scholarly journals Text Messaging and Type 1 Diabetes Management: Qualitative Study Exploring Interactions Among Patients and Health Care Professionals (Preprint)

2018 ◽  
Author(s):  
Francesco Miele ◽  
Silvia Clementi ◽  
Renzo Gennaro ◽  
Ilaria Nicolao ◽  
Tiziana Romanelli ◽  
...  
Keyword(s):  
Health Care ◽  
Type 1 Diabetes ◽  
Pregnant Women ◽  
Health Care Professionals ◽  
Text Messaging ◽  
Text Messages ◽  
Adult Patients ◽  
Specific Patient ◽  
The Impact

BACKGROUND The diffusion of information and communication technologies (ICTs) in type 1 diabetes (T1D) management has generated a debate on the ways in which ICTs can support the patient-provider relationship. Several studies have focused on text messages. Most of the literature proposes quantitative analysis of the impact of text messaging on the clinical conditions of patients and/or their satisfaction with the technology, while the qualitative studies have focused mainly on patients’ perceptions about strengths and weaknesses of this technology. OBJECTIVE In contrast to past studies, we adopted a qualitative approach for the in-depth examination of patient-health care professionals’ interactions in text messaging. METHODS The study focused on the use of the Trento Cartella Clinica del Cittadino Diabetes System (TreC-DS), a digital platform with a built-in messaging system, in two diabetes centers, integrating message analysis with interviews with patients and health care professionals. Each center focused on a specific patient profile: the first one focused on pregnant women with T1D and the second one focused on adult patients with poorly controlled diabetes. RESULTS The main results of the study were as follows: (1) Health care professionals and patients perceived the messaging system as useful for sharing information (ie, pregnant women for prescriptions and adults with poorly controlled diabetes for advice); (2) The content and communication styles of the two centers differed: in the case of pregnant women, interactions via text messaging were markedly prescriptive, while in the case of adult patients with poorly controlled diabetes, they were conceived as open dialogues; and (3) Conversations were initiated mainly by professionals; in the cases considered, it was mainly the diabetes center that decided whether a messaging conversation was needed. CONCLUSIONS The results show how the features of interactions of text messaging changed based on the patient profiles in two different centers. In addition, in both diabetes centers that were involved, the system seems to have laid a foundation for a closer relationship between patients and health care professionals.

Prophylaxis of obstetric and perinatal pathology at women with pathological increase of body weight during pregnancy

2018 ◽  
pp. 7-79
Author(s):  
S.Yu. Vdovichenko ◽  
◽  
T.D. Fakhrutdinova ◽  
Keyword(s):  
Health Care ◽  
Body Weight ◽  
Pregnant Women ◽  
Key Words ◽  
Perinatal Outcomes ◽  
Perinatal Complications ◽  
Perinatal Pathology ◽  
Fetoplacental Complex ◽  
The Right ◽  
Selection Of

The objective: depression of obstetric and perinatal complications at pregnant women with pathological increase of body weight during pregnancy on the basis of studying of clinical-functional, endocrinologic, metabolic, morphological features of condition of fetoplacental complex and development of advanced algorithm of treatment-and-prophylactic actions. Materials and methods. We conducted examination of 264 patients who consisted on the account concerning pregnancy in female consultations of Kiev. By a method of selection of 178 women were included in retrospective research and 86 – in prospective. The main group was made by 39 pregnant women with whom led individual discussions, control – 142 women, that received traditional references in female consultation. Results. Use of the algorithm improved by us allows to improve obstetric (decrease of frequency of a preeclampsia by 12.3%; anomalies of a patrimonial deyalnost for 8.4%) and perinatal outcomes (depression of level of an asphyxia at a delivery for 9.4% and post-natal adaptation for 7.8%) deliveries of women with an excessive increase of body weight during pregnancy. Conclusion. The received results grant the right to recommend the algorithm improved by us for wide use in practical health care. Key words: obstetric and perinatal pathology, pathological increase of body weight, prophylaxis.

PP155 The Impact Of Lawsuits In The Brazilian Public Health System

2017 ◽  
Vol 33 (S1) ◽  
pp. 141-141
Author(s):  
Carla Biella ◽  
Viviane Pereira ◽  
Fabiana Raynal ◽  
Jorge Barreto ◽  
Vania Canuto ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health System ◽  
Public Health System ◽  
Scientific Evidence ◽  
Health Technology ◽  
Health Technologies ◽  
Access To Health ◽  
The Right ◽  
The Impact

INTRODUCTION:The increase of litigation in Brazil on the right to health, and the Brazilian Public Health System (SUS) targets of litigation, are phenomena that generate discussions both in the judiciary, and among researchers and managers of health. The lawsuits are based on the integrality that includes the right to any health technology. Our aim was to gather information on the use of scientific evidence by judges and other law professionals to support their decisions in lawsuits involving health care in Brazil.METHODS:A narrative review by literature search using key terms of legalization in specific databases was conducted.RESULTS:Twenty-five studies showed litigation matters relating to health care which were focused on legal claims about drugs. In general, law operators used the scientific evidences in a limited way when making decisions, by considering the medical report and medication label indications and disregarding therapeutic alternatives contemplated in the SUS list. The access to health technologies, by litigation, reveals that the gap between scientific knowledge and legal practice are similar to those found between science and decision-making in the formulation and implementation of health policies. The Health Technology Assessment studies have high potential for use by the judiciary as a reference source to support technical and scientific decisions in lawsuits on health care.CONCLUSIONS:For the judiciary to ensure not only access to health technologies, but also the efficacy and safety of technologies to system users, their decisions must be substantiated by scientific evidence. The National Committee for Health Technology Incorporation (CONITEC) in SUS has established actions in conjunction with law operators and society, such as a communication using e-mail, aiding the decision for the injunction and elaboration of technical reports and a policy brief, with the intention that the decisions are taken with the greatest possible knowledge about technologies provided by SUS, and based on scientific evidence.

scholarly journals Forced migration and reproductive rights: Pregnant women fleeing Venezuela

2021 ◽  
Author(s):  
Cindy Paola Hawkins Rada
Keyword(s):  
Health Care ◽  
Reproductive Health ◽  
Health System ◽  
Pregnant Women ◽  
Health Care Access ◽  
Forced Migration ◽  
System Structure ◽  
Immigration Status ◽  
Increased Risk ◽  
The Right

Numerous pregnant Venezuelan women have fled Venezuela, given the health system crisis that has increased risk to their lives and their children. Thousands of them have arrived in Colombia in search of reproductive health care. Notwithstanding Colombia’s government efforts to provide some relief measures to the massive influx of Venezuelan migrants, pregnant women are not receiving the prenatal and postnatal care they need. One of the primary barriers to health care access is their immigration status and the health system structure regarding migrants. Therefore, this paper studies Colombia’s international human rights obligations concerning their immigration status and the right to reproductive health to conclude that government measures have been insufficient to meet these obligations.

scholarly journals The Impact of Supply-side and Demand-side Interventions on Use of Antenatal and Maternal Services in Western Kenya: A Qualitative Study

2020 ◽  
Author(s):  
Mitsuaki Hirai ◽  
Jamae Morris ◽  
Jill Luoto New ◽  
Rosebel Ouda ◽  
Nancy Atieno ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Neonatal Resuscitation ◽  
Text Messages ◽  
Child Health Services ◽  
Supply Side ◽  
Nurse Training ◽  
Demand Side ◽  
Western Kenya ◽  
The Impact ◽  
Pregnant Mothers

Abstract Background : Antenatal care (ANC) and delivery by skilled providers have been well recognized as effective strategies to prevent maternal and neonatal mortality. ANC and delivery services at health facilities, however, have been underutilized in Kenya. One potential strategy to increase the demand for ANC services is to provide health interventions as incentives for pregnant women. In 2013, an integrated ANC program was implemented in western Kenya to promote ANC visits by addressing both supply- and demand-side factors. Supply-side interventions included nurse training and supplies for obstetric emergencies and neonatal resuscitation. Demand-side interventions included SMS text messages with appointment reminders and educational contents, group education sessions, and vouchers to purchase health products. Methods : To explore pregnant mothers’ experiences with the intervention, ANC visits, and delivery, we conducted focus group discussions (FGDs) at pre- and post-intervention. A total of 19 FGDs were held with pregnant mothers, nurses, and community health workers (CHWs) during the two assessment periods. We performed thematic analyses to highlight study participants’ perceptions and experiences. Results : FGD data revealed that pregnant women perceived the risks of home-based delivery, recognized the benefits of facility-based delivery, and were motivated by the incentives to seek care despite barriers to care that included poverty, lack of transport, and poor treatment by nurses. Nurses also perceived the value of incentives to attract women to care but described obstacles to providing health care such as overwork, low pay, inadequate supplies and equipment, and insufficient staff. CHWs identified the utility and limitations of text messages for health education. Conclusions : Future interventions should ensure that adequate workforce, training, and supplies are in place to respond to increased demand for maternal and child health services stimulated by incentive programs.

scholarly journals Right to Health and the Social Determinants of Health in the Face of COVID-19. Tthe Spanish Experience after Austerity Policies

2021 ◽  
pp. 220-241
Author(s):  
Carlos Lema Añón
Keyword(s):  
Health Care ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Health Care Systems ◽  
Right To Health ◽  
Determinants Of Health ◽  
The Face ◽  
Care Systems ◽  
The Right ◽  
The Impact

The COVID-19 pandemic has particularly affected Spain in 2020. Although the specific causes and Spain’s response—as well as the aspects to be improved—are yet to be evaluated, many experts agree that this crisis has magnified some of the problems of the Spanish health system, highlighting the problems derived from the cuts in the capacities of the health and public health systems. We assess the current situation from the perspective of the right to health in its twofold dimension: health care and social determinants. For this purpose, we look into the configuration of the right to health in Spain and how the economic crisis and austerity policies affected it. In particular, we consider the impact both on institutional health care systems and in terms of social determinants of health. Finally, we make several proposals for strengthening the right to health.

scholarly journals Romanized Sindhi Rules for Text Communication

2021 ◽  
Vol 40 (2) ◽  
pp. 298-304
Author(s):  
Irum Naz Sodhar ◽  
Akhtar Hussain Jalbani ◽  
Muhammad Ibrahim Channa ◽  
Dil Nawaz Hakro
Keyword(s):  
Natural Language Processing ◽  
Mobile Phone ◽  
Language Processing ◽  
Text Messages ◽  
Proper Solution ◽  
The People ◽  
Sindh Province ◽  
The World ◽  
The Right ◽  
Text Writing

Sindhi is one of the historical languages which is widely used in all over the world, but especially in the province of Sindh Pakistan. Sindhi language has its own script and written by the right-handed. Nowadays the use of different Sindhi platforms is increasing especially for communication. The majority of the people of Sindh province read, write and speak very well, but they face the problem in text communication while using different communication platforms. However, the users of computer and mobile phone feel trouble/difficulty during the use of the Sindhi script in typing of text messages, tweets and comments while using different platforms in computer and mobile phone. Natural Language Processing (NLP) is one of the better options for the solution of these problems of text communication on different platforms. For the proper solution of text communication issues, Romanized Sindhi text is used instead of Sindhi text. Romanized text writing is easier than the Sindhi text writing because Sindhi text writing needs the special type of keyboard while writing of Romanized text does not need any special type of keyboard. For the writing of Romanized Sindhi text, rules are defined in this paper which provide easiness during writing and understanding of the text. Romanized Sindhi Rules (RSR) are simple and easy to understand the meaning of the text and provide fast communication (text). This study is also helpful for further research in the Romanized Sindhi text by using different approaches and provides easiness in communication.

scholarly journals Mobile-Based Oral Chemotherapy Adherence–Enhancing Interventions: Scoping Review (Preprint)

2018 ◽  
Author(s):  
Xiomara Skrabal Ross ◽  
Kate M Gunn ◽  
Pandora Patterson ◽  
Ian Olver
Keyword(s):  
Medication Adherence ◽  
Mobile Phone ◽  
Cancer Patients ◽  
Chronic Diseases ◽  
Mobile Phones ◽  
Scoping Review ◽  
Text Messages ◽  
Oral Chemotherapy ◽  
Economic Evaluations ◽  
The Impact

BACKGROUND Adherence to oral chemotherapy is crucial to maximize treatment outcomes and avoid health complications in cancer patients. Mobile phones are widely available worldwide, and evidence that this technology can be successfully employed to increase medication adherence for the treatment of other chronic diseases (eg, diabetes) is well established. However, the extent to which there is evidence that mobile phone–based interventions improve adherence to oral chemotherapy is unknown. OBJECTIVE This scoping review aims to explore what is known about mobile phone–delivered interventions designed to enhance adherence to oral chemotherapy, to examine the reported findings on the utility of these interventions in increasing oral chemotherapy adherence, and to identify opportunities for development of future interventions. METHODS This study followed Arksey and O’Malley’s scoping review methodological framework. RESULTS The review search yielded 5 studies reporting on 4 interventions with adults (aged >18 years) diagnosed with diverse cancer types. All interventions were considered acceptable, useful, and feasible. The following themes were evident: text messages and mobile apps were the main methods of delivering these interventions, the 2 most commonly employed oral chemotherapy adherence–enhancing strategies were management and reporting of drug-related symptoms and reminders to take medication, the importance of stakeholders’ engagement in intervention design, and the overall positive perceptions of delivery features. Areas for future research identified by this review include the need for further studies to evaluate the impact of mobile phone–delivered interventions on adherence to oral chemotherapy as well as the relevance for future studies to incorporate design frameworks and economic evaluations and to explore the moderator effect of high anxiety, poor baseline adherence, and longer time taking prescribed drug on adherence to oral chemotherapy. CONCLUSIONS Despite the increasing body of evidence on the use of mobile phones to deliver medication adherence–enhancing interventions in chronic diseases, literature on the oral chemotherapy context is lacking. This review showed that existing interventions are highly acceptable and useful to cancer patients. The engagement of stakeholders as well as the use of a design framework are important elements in the development of mobile phone–delivered interventions that can be translated into oncology settings.

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