PDF(Pubmed)
Abstract：
BACKGROUND: Low-quality data presents a significant challenge for community health workers (CHWs) in low and middle-income countries (LMICs). Mobile health (mHealth) applications offer a solution by enabling CHWs to record and submit data electronically. However, the barriers and benefits of mHealth usage among CHWs in informal urban settlements remain poorly understood. This study sought to determine the barriers and benefits of mHealth among CHWs in Banda parish, Kampala.
METHODS: This qualitative study involved 12 key informant interviews (KIIs) among focal persons from Kampala City Council Authority (KCCA) and NGOs involved in data collected by CHWs, and officials from the Ministry of Health (MOH) and two mixed-sex Focused Group Discussions (FGDs) of CHWs from Banda parish, Kampala district. Data analysis utilised Atlas Ti Version 7.5.7. Thematic analysis was conducted, and themes were aligned with the social-ecological model.
RESULTS: Three themes of institutional and policy, community and interpersonal, and individual aligning to the Social ecological model highlighted the factors contributing to barriers and the benefits of mHealth among CHWs for iCCM. The key barriers to usability, acceptability and sustainability included high training costs, CHW demotivation, infrastructure limitations, data security concerns, community awareness deficits, and skill deficiencies. Conversely, mHealth offers benefits such as timely data submission, enhanced data quality, geo-mapping capabilities, improved CHW performance monitoring, community health surveillance, cost-effective reporting, and CHW empowering with technology.
CONCLUSIONS: Despite limited mHealth experience, CHWs expressed enthusiasm for its potential. Implementation was viewed as a solution to multiple challenges, facilitating access to health information, efficient data reporting, and administrative processes, particularly in resource-constrained settings. Successful mHealth implementation requires addressing CHWs\' demotivation, ensuring reliable power and network connectivity, and enhancing capacity for digital data ethics and management. By overcoming these barriers, mHealth can significantly enhance healthcare delivery at the community level, leveraging technology to optimize resource utilization and improve health outcomes. mHealth holds promise for transforming CHW practices, yet its effective integration necessitates targeted interventions to address systemic challenges and ensure sustainable implementation in LMIC contexts.
METHODS: This qualitative study involved 12 key informant interviews (KIIs) among focal persons from Kampala City Council Authority (KCCA) and NGOs involved in data collected by CHWs, and officials from the Ministry of Health (MOH) and two mixed-sex Focused Group Discussions (FGDs) of CHWs from Banda parish, Kampala district. Data analysis utilised Atlas Ti Version 7.5.7. Thematic analysis was conducted, and themes were aligned with the social-ecological model.
RESULTS: Three themes of institutional and policy, community and interpersonal, and individual aligning to the Social ecological model highlighted the factors contributing to barriers and the benefits of mHealth among CHWs for iCCM. The key barriers to usability, acceptability and sustainability included high training costs, CHW demotivation, infrastructure limitations, data security concerns, community awareness deficits, and skill deficiencies. Conversely, mHealth offers benefits such as timely data submission, enhanced data quality, geo-mapping capabilities, improved CHW performance monitoring, community health surveillance, cost-effective reporting, and CHW empowering with technology.
CONCLUSIONS: Despite limited mHealth experience, CHWs expressed enthusiasm for its potential. Implementation was viewed as a solution to multiple challenges, facilitating access to health information, efficient data reporting, and administrative processes, particularly in resource-constrained settings. Successful mHealth implementation requires addressing CHWs\' demotivation, ensuring reliable power and network connectivity, and enhancing capacity for digital data ethics and management. By overcoming these barriers, mHealth can significantly enhance healthcare delivery at the community level, leveraging technology to optimize resource utilization and improve health outcomes. mHealth holds promise for transforming CHW practices, yet its effective integration necessitates targeted interventions to address systemic challenges and ensure sustainable implementation in LMIC contexts.
摘要：
背景：低质量数据对低收入和中等收入国家（LMICs）的社区卫生工作者（CHW）提出了重大挑战。移动健康(mHealth)应用程序通过使CHW能够以电子方式记录和提交数据来提供解决方案。然而,在非正式城市住区CHWs中使用mHealth的障碍和好处仍然知之甚少。这项研究旨在确定班达教区CHWs中mHealth的障碍和益处，坎帕拉.
方法：这项定性研究涉及坎帕拉市议会管理局（KCCA）和参与CHWs收集的数据的非政府组织中的12个关键线人访谈（KII）。以及来自卫生部（MOH）的官员和来自班达教区的CHW的两个混合性别焦点小组讨论（FGD），坎帕拉区。数据分析使用AtlasTi版本7.5.7。进行了专题分析,主题与社会生态模式相一致。
结果：体制和政策三个主题，社区和人际关系，与社会生态模型保持一致的个人强调了导致障碍的因素以及iCCMCHWs中mHealth的益处。可用性的关键障碍，可接受性和可持续性包括高昂的培训成本，CHW失去动力，基础设施限制，数据安全问题，社区意识缺陷，和技能不足。相反，mHealth提供了及时提交数据等好处，提高数据质量，地理映射功能，改进的CHW性能监控，社区卫生监测,具有成本效益的报告，和CHW赋予技术权力。
结论：尽管mHealth经验有限，CHWs表达了对其潜力的热情。实施被视为多种挑战的解决方案，促进获取健康信息，高效的数据报告，和行政程序，特别是在资源受限的环境中。成功的mHealth实施需要解决CHWs的反激励问题，确保可靠的电源和网络连接，增强数字数据伦理和管理能力。通过克服这些障碍，mHealth可以显着增强社区一级的医疗保健服务，利用技术优化资源利用和改善健康结果。mHealth有望改变CHW实践，然而，其有效整合需要有针对性的干预措施来应对系统性挑战，并确保在LMIC背景下可持续实施。
方法：这项定性研究涉及坎帕拉市议会管理局（KCCA）和参与CHWs收集的数据的非政府组织中的12个关键线人访谈（KII）。以及来自卫生部（MOH）的官员和来自班达教区的CHW的两个混合性别焦点小组讨论（FGD），坎帕拉区。数据分析使用AtlasTi版本7.5.7。进行了专题分析,主题与社会生态模式相一致。
结果：体制和政策三个主题，社区和人际关系，与社会生态模型保持一致的个人强调了导致障碍的因素以及iCCMCHWs中mHealth的益处。可用性的关键障碍，可接受性和可持续性包括高昂的培训成本，CHW失去动力，基础设施限制，数据安全问题，社区意识缺陷，和技能不足。相反，mHealth提供了及时提交数据等好处，提高数据质量，地理映射功能，改进的CHW性能监控，社区卫生监测,具有成本效益的报告，和CHW赋予技术权力。
结论：尽管mHealth经验有限，CHWs表达了对其潜力的热情。实施被视为多种挑战的解决方案，促进获取健康信息，高效的数据报告，和行政程序，特别是在资源受限的环境中。成功的mHealth实施需要解决CHWs的反激励问题，确保可靠的电源和网络连接，增强数字数据伦理和管理能力。通过克服这些障碍，mHealth可以显着增强社区一级的医疗保健服务，利用技术优化资源利用和改善健康结果。mHealth有望改变CHW实践，然而，其有效整合需要有针对性的干预措施来应对系统性挑战，并确保在LMIC背景下可持续实施。
