Contextual barriers to mobile health technology in African countries: a perspective piece

On a global scale, healthcare practitioners are now beginning to move from traditional desktop-based computer technologies towards mobile computing environments[1]. Consequently, such environments have received immense attention from both academia and industry, in order to explore these promising opportunities, apparent limitations, and implications for both theory and practice[2]. The application of mobile IT within a medical context, referred to as mobile health or mHealth, has revolutionised the delivery of healthcare services as mobile technologies offer the potential of retrieving, modifying and entering patient-related data/information at the point-of-care. As a component of the larger health informatics domain mHealth may be referred as all portable computing devices (e.g. mobile phones, mobile clinical assistants and medical sensors) used in a healthcare context to support the delivery of healthcare services

Mobile Health Technologies

Mobile Health Technologies, also known as mHealth technologies, have emerged, amongst healthcare providers, as the ultimate Technologies-of-Choice for the 21st century in delivering not only transformative change in healthcare delivery, but also critical health information to different communities of practice in integrated healthcare information systems. mHealth technologies nurture seamless platforms and pragmatic tools for managing pertinent health information across the continuum of different healthcare providers. mHealth technologies commonly utilize mobile medical devices, monitoring and wireless devices, and/or telemedicine in healthcare delivery and health research. Today, mHealth technologies provide opportunities to record and monitor conditions of patients with chronic diseases such as asthma, Chronic Obstructive Pulmonary Diseases (COPD) and diabetes mellitus. The intent of this book is to enlighten readers about the theories and applications of mHealth technologies in the healthcare domain

Wearable Sensors For Continuous Pregnancy Health And Environmental Monitoring: From A Patient And Provider Perspective

Mobile health (mHealth) is an emerging field that uses mobile technology (i.e., mobile phones and various wireless technologies) to track and monitor a patient’s medical health. Few studies have examined the perception of providers and patients with in the use of mHealth technology, particularly among pregnant women. This study evaluated the perception of both patients’ and providers’ attitudes towards mHealth and wearable technologies. Perception was gauged through a survey distributed November 15 through December 31, 2016 at Mountain Area Health Education Center (MAHEC) in western North Carolina in a rural, medically underserved area. Very few providers were currently using mHealth in their clinical practice. Results  found that patients had a positive perception towards mHealth and welcomed its implementation into clinical practice while providers were more  positive with regards to mHealth’s potential in the future

‘The Phone is My Boss and My Helper’ – A Gender Analysis of an mHealth Intervention with Health Extension Workers in Southern Ethiopia

Mobile health (mHealth) provides health services and information via mobile technologies, including mobile phones. There is considerable optimism in mHealth’s potential to overcome health systems’ deficiencies to ensure access to safe, effective and affordable health services. This has led to an ‘explosion of mHealth activities’ and ‘large-scale adoption and deployment of mobile phones’ by Community Health Worker (CHW) programmes. MHealth innovation in relation to CHWs, on which low- and middle-income countries (LMICs) disproportionately depend, has been reported to be ‘particularly promising’. CHWs’ use of mHealth has the potential to improve their motivation; decision-making; training; adherence to guidelines; data entry and quality; planning and efficiency; and communication and health promotion; while also enhancing coverage and timeliness of services and reducing costs. MHealth also allows the monitoring and tracking of health indicators in real time, providing crucial insights to policy makers and enabling CHWs to better serve communities

Mobile health (mHealth) approaches and lessons for increased performance and retention of community health workers in low- and middle-income countries: a review.

BACKGROUND: Mobile health (mHealth) describes the use of portable electronic devices with software applications to provide health services and manage patient information. With approximately 5 billion mobile phone users globally, opportunities for mobile technologies to play a formal role in health services, particularly in low- and middle-income countries, are increasingly being recognized. mHealth can also support the performance of health care workers by the dissemination of clinical updates, learning materials, and reminders, particularly in underserved rural locations in low- and middle-income countries where community health workers deliver integrated community case management to children sick with diarrhea, pneumonia, and malaria. OBJECTIVE: Our aim was to conduct a thematic review of how mHealth projects have approached the intersection of cellular technology and public health in low- and middle-income countries and identify the promising practices and experiences learned, as well as novel and innovative approaches of how mHealth can support community health workers. METHODS: In this review, 6 themes of mHealth initiatives were examined using information from peer-reviewed journals, websites, and key reports. Primary mHealth technologies reviewed included mobile phones, personal digital assistants (PDAs) and smartphones, patient monitoring devices, and mobile telemedicine devices. We examined how these tools could be used for education and awareness, data access, and for strengthening health information systems. We also considered how mHealth may support patient monitoring, clinical decision making, and tracking of drugs and supplies. Lessons from mHealth trials and studies were summarized, focusing on low- and middle-income countries and community health workers. RESULTS: The review revealed that there are very few formal outcome evaluations of mHealth in low-income countries. Although there is vast documentation of project process evaluations, there are few studies demonstrating an impact on clinical outcomes. There is also a lack of mHealth applications and services operating at scale in low- and middle-income countries. The most commonly documented use of mHealth was 1-way text-message and phone reminders to encourage follow-up appointments, healthy behaviors, and data gathering. Innovative mHealth applications for community health workers include the use of mobile phones as job aides, clinical decision support tools, and for data submission and instant feedback on performance. CONCLUSIONS: With partnerships forming between governments, technologists, non-governmental organizations, academia, and industry, there is great potential to improve health services delivery by using mHealth in low- and middle-income countries. As with many other health improvement projects, a key challenge is moving mHealth approaches from pilot projects to national scalable programs while properly engaging health workers and communities in the process. By harnessing the increasing presence of mobile phones among diverse populations, there is promising evidence to suggest that mHealth can be used to deliver increased and enhanced health care services to individuals and communities, while helping to strengthen health systems

Incorporating mHealth Interventions into Kenya’s Health Infrastructure to Augment Universal Health Coverage, Service Delivery Improvement Approach

mHealth is the use of mobile and wireless devices to improve health outcomes, healthcare services, and health research. An estimated 68% of the world’s population own mobile phones, with Kenya having approximately 80% of mobile phone penetration. This makes it feasible to accelerate the uptake of mHealth interventions to improve health services delivery. While some evidence has shown how various forms of mHealth interventions have been used to transform health services, health outcomes, and health research in Kenya and globally, many remain largely anecdotal or undocumented. This paper examines the various forms of mHealth interventions that have been incorporated into Kenya’s health infrastructure, and their effectiveness in improving health services delivery in Kenya. A systematic review of peer-reviewed articles, policy briefs, and credible materials published on mHealth have shown that mHealth has succeeded in the health infrastructure such as in collecting and transferring health and patient data, remote diagnosis, treatment, and patient follow-up. The paper also examines the barriers around the uptake of mHealth interventions and recommends how these interventions can be integrated into Kenya’s health infrastructure. Even though there is every reason to believe that mHealth can allow limited resource settings to “leapfrog” over more advanced settings in using mobile technologies to improve health services delivery, mHealth is not a panacea. There are limited will and resources to scale up and integrate mHealth into the health infrastructure with attempted integration met with a negative attitude from the strained health workforce who still view mHealth as additional work, among other challenges. Despite the challenges, there may be an opportunity for Kenya’s Government to leverage mobile and wireless devices to improve the delivery of health services to areas that were previously unreachable, thereby fast-tracking its commitment to achieving Universal Health Coverage. &nbsp

Incorporating mHealth Interventions into Kenya’s Health Infrastructure to Augment Universal Health Coverage, Service Delivery Improvement Approach

mHealth is the use of mobile and wireless devices to improve health outcomes, healthcare services, and health research. An estimated 68% of the world’s population own mobile phones, with Kenya having approximately 80% of mobile phone penetration. This makes it feasible to accelerate the uptake of mHealth interventions to improve health services delivery. While some evidence has shown how various forms of mHealth interventions have been used to transform health services, health outcomes, and health research in Kenya and globally, many remain largely anecdotal or undocumented. This paper examines the various forms of mHealth interventions that have been incorporated into Kenya’s health infrastructure, and their effectiveness in improving health services delivery in Kenya. A systematic review of peer-reviewed articles, policy briefs, and credible materials published on mHealth have shown that mHealth has succeeded in the health infrastructure such as in collecting and transferring health and patient data, remote diagnosis, treatment, and patient follow-up. The paper also examines the barriers around the uptake of mHealth interventions and recommends how these interventions can be integrated into Kenya’s health infrastructure. Even though there is every reason to believe that mHealth can allow limited resource settings to “leapfrog” over more advanced settings in using mobile technologies to improve health services delivery, mHealth is not a panacea. There are limited will and resources to scale up and integrate mHealth into the health infrastructure with attempted integration met with a negative attitude from the strained health workforce who still view mHealth as additional work, among other challenges. Despite the challenges, there may be an opportunity for Kenya’s Government to leverage mobile and wireless devices to improve the delivery of health services to areas that were previously unreachable, thereby fast-tracking its commitment to achieving Universal Health Coverage.   Conflict of interest: None declared

Best practices to establish susccesful mobile health service in a healthcare setting

Alternative healthcare programs have been steadily flooding the health care market, with the most notable being mobile health. Mobile health, more popularly known as mHealth, is expected to generate upward of $59 billion dollars. This is astonishing, considering the mHealth market is still in its infancy as an alternative healthcare model. Still, there are over 100,000 mHealth smartphone applications and platforms on the market. The concept of offering affordable medical services that are accessible to anyone, at any time and in any place appeals to the mission and purpose of healthcare organizations. However, a large number of the studies and publications on mHealth are associated with the technologies behind mHealth and provide very little information on the practices and challenges associated with implementing mHealth, especially within a medical facility. For this reason, it was important to learn from executive health IT professionals who have successfully implemented mHealth services within the US healthcare system. Accordingly, the purpose of this study was to identify the practices used and challenges faced by CIOs in implementing mHealth technologies. The study also obtained recommendations CIOs believe are associated with successful mHealth services. This was a qualitative study that used a phenomenology lens focused on the viewpoint of CIOs and the growing phenomenon of mHealth as a part of the U.S. healthcare system. This approach allowed the research to obtain data on the lived experiences of seven CIOs through semi-structured interviews who were identified as top experts by Becker Hospital Review publications. The analysis of their experiences revealed 13 best practices for mobile health implementation. The findings in this study aimed to identify how mHealth services could expand access to medical services by outlining key considerations and resources required for successful implementation

Determinants of Mobile Health Adoption in Burundi

Mobile health (or mHealth) can be broadly defined as the use of mobile devices and technologies to provide healthcare services. The potential of mHealth interventions to address healthcare issues, particularly in developing countries, is widely recognised. Although mHealth has yielded positive outcomes in various contexts, there is a need for designing mHealth interventions that are specifically tailored to the context of individual countries in order to increase the prospects of adoption. It is in this context that, using the Diffusion of Innovation (DOI) theory, this paper investigates the determinants for the adoption of mobile health by healthcare professionals in Burundi. From a sample of 212 primary healthcare professionals, this paper analyses what can influence Burundi’s primary healthcare workers to adopt mobile health. The results indicate that the relative advantages associated with mHealth interventions are perceived as predictors of mHealth adoption in Burundi. Moreover, work-related factors coupled with one’s experience with mobile devices are the DOI compatibility factors that influence the adoption of mHealth by Burundi’s healthcare professionals. mHealth being a new concept with the Burundi’s healthcare system, trialability and observability were found to have a significant influence on its adoption. However, mHealth complexity was found to have no influence on mHealth adoption. This paper advocates for education and awareness programs tailored specifically towards mHealth adoption by primary healthcare workers. It further recommends that the country leverage its East African Community (EAC) membership by forging partnerships with other EAC members in order to be acquainted with and learn from evidence-based outcomes of successful mHealth interventions within the region