scholarly journals Use of mHealth Solutions for Improving Access to Adolescents' Sexual and Reproductive Health Services in Resource-Limited Settings: Lessons From Zimbabwe

2021 ◽  
Vol 3 ◽  
Author(s):  
Dominica Dhakwa ◽  
Fungai H. Mudzengerere ◽  
Mulamuli Mpofu ◽  
Emmanuel Tachiwenyika ◽  
Florence Mudokwani ◽  
...  

Background: Gaps still exist in reducing new HIV infections among adolescent girls and young women (AGYW) aged 10–24 years. High Internet coverage and mobile phone penetration rates present opportunities for the use of mobile health (mHealth) to support access to health services. We present results of an FHI 360 and Zimbabwe Health Interventions-implemented mHealth intervention for reproductive health (RH) and HIV testing service (HTS) referral among AGYW aged 10–19 years between October 2019 and September 2020.Methods: Adolescent girls and young women referred for RH and HTS under the Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe (DREAMS) program had automatic reminders sent to their phones to facilitate access to services through short message service (SMS) and also using a paper-based system. These data were captured in a web-based District Health Information System (DHIS) database, which captured the referral completion status of the AGYW. Data for AGYW referred for RH and HTS for the period October 2018 to September 2019 for the paper-based system and October 2018 to September 2020 for the mHealth were extracted from District Health Information System version 2 (DHIS2) database and analyzed using SPSS to generate descriptive statistics. The Chi-square test was used to assess differences in referral completion rates by age-group; marital status, district, and type of service, as well as differences between mHealth and paper-based referral completion rates within each of the groups for the variables above.Results: A total of 8,800 AGYW referred for RH and HTS, where 4,355 and 4,445 were referred through the mHealth and paper-based systems, respectively. About 95.2% (4,148/4,355) and 87.8% (3,903/4,445) referred through mHealth and the paper-based system, respectively completed referrals. The median time for referral completion was 1 day (Range = 0–9 days) for mHealth and 11 days (Range = 0–28 days) for the paper-based system. AGYW referred through mHealth were 17.995 timesmore likely to complete the referral system than those referred through the paper-based system (OR =17.995; p <0.001).Conclusion: Compared to the paper-based referral system the mHealth solution resulted in a higher, service referral completion rates and shorter turnaround time. We recommend expansion of the mHealth solution to all DREAMS supported districts to increase uptake of RH and HTS among AGYW aged 10–19 years.

2016 ◽  
Vol 4 (2) ◽  
pp. 129-138 ◽  
Author(s):  
Viera Juniver Thenu ◽  
Eko Sediyono ◽  
Cahya Tri Purnami

Purworejo District Health Office (DHO) has developed Health Center Management Information System (HCMIS) to provide quick, precise, and accurate information for supporting the process of decision making and the policy of services at Health Center. However, there was still any empty forms and did not use the system. To standardize Health Information System, Ministry of Health has released a concept of Generic SIKDA. Therefore, the system applied by Purworejo DHO needs to be evaluated using the method of HOT fit. This was qualitative research using indepth interview and direct observation. Main informants were nine data operators and informants for triangulation purpose was six persons from health centers and five persons from DHO. Furthermore, data were analyzed using content analysis. The result of this research revealed that the application of HCMIS at Purworejo DHO was equal to Generic SIKDA. The system had been applied routinely but there was no a guidance book and training. Number of human resources was sufficient. However, there needed to make an implementer team of Health Information System in accordance with competency. There was no routine monitoring and current budget was not sufficient to maintain hardware to support the system. Quality of the system used was good, easy to use, and available of menu to communicate data. Unfortunately, quality of resulted information had still been inaccurate and incomplete because it did not cover data of services at Subsidiary Health Centers (SHC) and Village Health Posts (VHP). The lateness of services was related to a funding procedure. HCMIS at Purworejo DHO was equal to Generic SIKDA but it had not been used to make a decision. As a suggestion, DHO needs to conduct training, monitor, and provide hardware and a network. Meanwhile, Health Centers needs to make a commitment for applying the HCMIS maximally by SHC and VHP.


2016 ◽  
Vol 4 (3) ◽  
pp. 222-231
Author(s):  
Endah Sri Lestari ◽  
Sutopo Patria Jati ◽  
Aris Puji Widodo

Evaluasi SIK bertujuan untuk memastikan SIK berjalan secara efisien, mampu mengumpulkan informasi yang relevan dan berkualitas sebagai dasar pengambilan keputusan oleh pemangku kebijakan. Hasil penilaian SIK sangat dibutuhkan dalam meningkatkan kinerja SIK.SIK Provinsi Jawa Tengah merupakan sub sistem dari SIKNAS sehingga pengembangan SIK Provinsi Jawa Tengah akan berpengaruh terhadap penguatan SIKNAS. Tujuan dari penelitian ini adalah untuk mengevaluasi SIK di Provinsi Jawa Tengah dalam rangka Penguatan SIKNAS. Penelitian ini merupakan penelitian deskriptif evaluatif dengan pendekatan kuantitatif dan kualitatif. Subyek penelitian adalah 35 petugas SIK DKK dan enam petugas SIK Dinas Kesehatan Provinsi Jawa Tengah. Pengumpulan data kuantitatif melalui pengisian kuesioner, pengumpulan data kualitatif melalui FGD dan wawancara. Analisis data penelitian dilakukan dengan menggunakan perangkat Evaluasi SIK Provinsi yang merupakan modifikasi dari Assessment Tool HMN Versi 4.00. Modifikasi Assessment Tool HMN Versi 4.00 dilakukan dengan cara menghapus item pertanyaan yang tidak relevan dengan SIK di provinsi dan menambahkan item pertanyaan berdasarkan PP no 46/2016 tentang SIK. Hasil evaluasi terhadap tujuh komponen SIK, empat diantaranya dinilai “ada tapi tidak adekuat” yaitu komponen pengelolaan (54,7%), sumber daya (54,2%), sumber data (58%) dan manajemen data (41,3%). Sementara tiga komponen lainnya dinilai “adekuat”, yaitu komponen indikator (74,3%), produk informasi (71,3%) dan diseminasi dan penggunaan informasi (74,5%).Disimpulkan bahwa secara umum SIK Provinsi Jawa Tengah berada dalam kategori “adekuat”. Untuk meningkatkan pengelolaan SIK di Provinsi Jawa Tengah, direkomendasikan untuk membuat suatu standar tata kelola SIK sebagai acuan pengelolaan SIK di Provinsi Jawa Tengah. Evaluation of Health Information System (HIS) aimed at ascertaining the efficient implementation of HIS that could result relevant and high-quality information to be used as a basis of making a decision by a decision maker. The result of HIS assessment was needed to improve the HIS performance. HIS of Central Java Province was a sub-system of National Health Information System (NHIS) in which the development of HIS there would strengthen the NHIS. The aim of this study was to evaluate HIS in Central Java Province in order to strengthen NHIS. This was a descriptive-evaluative study using quantitative-qualitative approach. Research subjects were 35 HIS officers at District Health Office (DHO) and six HIS officers at Central Java Province Health Office. Quantitative data were collected by filling a questionnaire whereas qualitative data were collected by conducting FGD and indepth interview. Data analysis was performed using a software of Province HIS evaluation that was modified from Assessment Tool HMN version 4.00. Modification of Assessment Tool HMN version 4.00 was performed by deleting questions that were irrelevant with HIS at province and adding questions based on government regulation number 46/2016 about HIS. The results of evaluation of seven components of HIS, four of these seven components indicated “available but inadequate”, namely components of management (54.7%), resource (54.2%), data source (58%), and data management (41.3%). In contrast, three of these seven components were “adequate”, namely components of indicator (74.3%), information product (71.3%), and dissemination and use of information (74.5%). To sum up, generally HIS of Central Java Province was categorised as “adequate”. To improve HIS management in Central Java Province, a standard of HIS management needs to be made as a reference to manage HIS in Central Java Province.


2020 ◽  
Vol 6 (4) ◽  
Author(s):  
Nur Rokhman ◽  
Annisa Maulida Ningtyas ◽  
Marko Ferdian Salim ◽  
Dian Budi Santoso

Health Information System is a system that integrates the collection, processing, reporting of data, and use of information needed to increase the effectiveness and efficiency of health services through better management at all levels of health services. Kulon Progo Health Office is one of the Health Services that has utilized the Health Information System in organizing its health transactions. However, the implementation of the Health Information System still has shortcomings, namely that it was found that a patient has many medical record numbers or often referred to as duplicated medical record data. Community service activities are carried out through the use of appropriate technology at the Kulon Progo Health Office. This activity aims to implement data cleansing techniques using the "RESIK" framework  to help prevent and detect duplication of medical records and provide training to medical recorders in cleaning data. The training was attended by 105 participants, each of whom was a representative of the Puskesmas staff in the Kulon Progo Health Office area. The “RESIK” framework  was then piloted at Puskesmas Sentolo 2 as the location for the implementation of the system. From this activity, duplicate medical record data can be found at Puskesmas Sentolo 2, and then cleaning is carried out. Kulon Progo Health Office is advised to implement data cleansing using the "RESIK" framework  at all Puskesmas in the Kulon Progo area.


2013 ◽  
Vol 21 (1) ◽  
pp. 30 ◽  
Author(s):  
Ahmad Raeisi ◽  
Sakineh Saghaeiannejad ◽  
Saeed Karimi ◽  
Asghar Ehteshami ◽  
Mahtab Kasaei

2021 ◽  
Vol 3 ◽  
Author(s):  
Gabrielle O'Malley ◽  
Kristin M. Beima-Sofie ◽  
Stephanie D. Roche ◽  
Elzette Rousseau ◽  
Danielle Travill ◽  
...  

Background: Successful integration of pre-exposure prophylaxis (PrEP) with existing reproductive health services will require iterative learning and adaptation. The interaction between the problem-solving required to implement new interventions and health worker motivation has been well-described in the public health literature. This study describes structural and motivational challenges faced by health care providers delivering PrEP to adolescent girls and young women (AGYW) alongside other SRH services, and the strategies used to overcome them.Methods: We conducted in-depth interviews (IDIs) and focus group discussions (FGDs) with HCWs from two demonstration projects delivering PrEP to AGYW alongside other SRH services. The Prevention Options for the Women Evaluation Research (POWER) is an open label PrEP study with a focus on learning about PrEP delivery in Kenyan and South African family planning, youth mobile services, and public clinics at six facilities. PrIYA focused on PrEP delivery to AGYW via maternal and child health (MCH) and family planning (FP) clinics in Kenya across 37 facilities. IDIs and FGDs were transcribed verbatim and analyzed using a combination of inductive and deductive methods.Results: We conducted IDIs with 36 participants and 8 FGDs with 50 participants. HCW described a dynamic process of operationalizing PrEP delivery to better respond to patient needs, including modifying patient flow, pill packaging, and counseling. HCWs believed the biggest challenge to sustained integration and scaling of PrEP for AGYW would be lack of health care worker motivation, primarily due to a misalignment of personal and professional values and expectations. HCWs frequently described concerns of PrEP provision being seen as condoning or promoting unprotected sex among young unmarried, sexually active women. Persuasive techniques used to overcome these reservations included emphasizing the social realities of HIV risk, health care worker professional identities, and vocational commitments to keeping young women healthy.Conclusion: Sustained scale-up of PrEP will require HCWs to value and prioritize its incorporation into daily practice. As with the provision of other SRH services, HCWs may have moral reservations about providing PrEP to AGYW. Strategies that strengthen alignment of HCW personal values with professional goals will be important for strengthening motivation to overcome delivery challenges.


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