| Title | Digital Health Care Services to Control and Eliminate Malaria in India. |
| Authors | Nema, S; Verma, AK; Tiwari, A; Bharti, PK |
| Journal | Trends in parasitology |
| Publication Date | 1 Feb 2021 |
| Date Added to PubMed | 3 Dec 2020 |
| Abstract | In the rural and tribal areas of India, poor healthcare services for malaria are posing a great challenge to malaria control and elimination. Digitisation in malaria healthcare services, including surveillance, diagnosis, and treatment, may be helpful in malaria control and, subsequently, may move towards the elimination goal of India by 2030. |
| Link | http://doi.org/10.1016/j.pt.2020.11.002 |
| Title | Review of Telemicrobiology. |
| Authors | Rhoads, DD; Mathison, BA; Bishop, HS; da Silva, AJ; Pantanowitz, L |
| Journal | Archives of pathology & laboratory medicine |
| Publication Date | 1 Apr 2016 |
| Date Added to PubMed | 1 Sep 2015 |
| Abstract | Microbiology laboratories are continually pursuing means to improve quality, rapidity, and efficiency of specimen analysis in the face of limited resources. One means by which to achieve these improvements is through the remote analysis of digital images. Telemicrobiology enables the remote interpretation of images of microbiology specimens. To date, the practice of clinical telemicrobiology has not been thoroughly reviewed. To identify the various methods that can be employed for telemicrobiology, including emerging technologies that may provide value to the clinical laboratory. Peer-reviewed literature, conference proceedings, meeting presentations, and expert opinions pertaining to telemicrobiology have been evaluated. A number of modalities have been employed for telemicroscopy, including static capture techniques, whole slide imaging, video telemicroscopy, mobile devices, and hybrid systems. Telemicrobiology has been successfully implemented for several applications, including routine primary diagnosis, expert teleconsultation, and proficiency testing. Emerging areas of telemicrobiology include digital plate reading of bacterial cultures, mobile health applications, and computer-augmented analysis of digital images. To date, static image capture techniques have been the most widely used modality for telemicrobiology, despite newer technologies being available that may produce better quality interpretations. Telemicrobiology adds value, quality, and efficiency to the clinical microbiology laboratory, and increased adoption of telemicrobiology is anticipated. |
| Link | http://doi.org/10.5858/arpa.2015-0116-RA |
| Title | Digital Technologies for Health Workforce Development in Low- and Middle-Income Countries: A Scoping Review. |
| Authors | Long, LA; Pariyo, G; Kallander, K |
| Journal | Global health, science and practice |
| Publication Date | 10 Oct 2018 |
| Date Added to PubMed | 12 Oct 2018 |
| Abstract | The collection of journal articles, systematic reviews, and reports published over the last decade that attest to the potential of digital technologies to achieve health workforce improvements across all aspects of the health system is vast. As a capacity-building mechanism, digital technology has potential for low- and middle-income countries (LMICs) to support development of the health workforce, including those health workers based in remote or rural areas, to train, motivate, support, monitor, and pay them. The purpose of this scoping review to present, at a high level, the state of the evidence and best practices in digital strategies for human resources for health and to propose a roadmap for a research agenda to fill identified gaps in the evidence. A variety of peer-reviewed and gray literature sources were searched using selected key terms related to digital health and health workforce, limited to materials published from 2010 to 2018. More than 70 articles, reports, and blog posts were reviewed, with in-depth analysis of 29 articles. Findings show that a range of digital health solutions for health workforce development have been tested and used, such as for health worker training, provider-to-provider communication and professional networking, and supervision of and performance feedback to health workers. There is some evidence of improved efficiency and effectiveness, at least at the level of pilots or small-scale projects. There is, however, a growing urgency in global health to move beyond small-scale demonstration projects and to define the capital and recurring costs of implementation and scale up of digital health interventions, including the return on investment. The next frontier is to select, adapt, and implement at scale those digital health interventions for health worker development and management found to be most promising. |
| Link | http://doi.org/10.9745/GHSP-D-18-00167 |
| Title | Digital health funding for COVID-19 vaccine deployment across four major donor agencies. |
| Authors | Helldén, D; Tesfaye, S; Gachen, C; Lindstrand, A; Källander, K |
| Journal | The Lancet. Digital health |
| Publication Date | 1 Sep 2023 |
| Date Added to PubMed | 26 Aug 2023 |
| Abstract | The international response to the COVID-19 pandemic provided opportunities for countries to use digital technologies for vaccine deployment and associated activities, but misaligned digital investments could weaken or fragment national systems. In this review of 311 funding applications from 120 country governments to four donor agencies (UNICEF; Gavi, the Vaccine Alliance; the Global Fund to Fight AIDS, Tuberculosis and Malaria; and the World Bank) up to May 1, 2022, we found that 272 (87%) of the applications included at least one digital aspect and that substantial funding has been dedicated towards digital aspects from donors. The majority of digital aspects concerned immunisation information systems, vaccine acceptance and uptake, and COVID-19 surveillance. As the global community sets its sights on a COVID-19-free world, continued coordinated investments in digital health and health information systems for pandemic preparedness and response will be key to strengthening the resilience of health systems. |
| Link | http://doi.org/10.1016/S2589-7500(23)00134-6 |
| Title | mHealth in Sub-Saharan Africa and Europe: Context of current health, healthcare status, and demographic structure. |
| Authors | Aboye, GT; Vande Walle, M; Simegn, GL; Aerts, JM |
| Journal | Digital health |
| Publication Date | 1 Dec 2023 |
| Date Added to PubMed | 7 Jun 2023 |
| Abstract | The advent of digital systems and global mobile phone availability presents an opportunity for better healthcare access and equity. However, the disparity in the usage and availability of mHealth systems between Europe and Sub-Saharan Africa (SSA) has not been explored in relation to current health, healthcare status, and demographics. This study aimed to compare mHealth system availability and use in SSA and Europe in the above-mentioned context. The study analyzed health, healthcare status, and demographics in both regions. It assessed mortality, disease burden, and universal health coverage. A systematic narrative review was conducted to thoroughly assess available data on mHealth availability and use, guiding future research in the field. SSA is on the verge of stages 2 and 3 in the demographic transition with a youthful population and high birth rate. Communicable, maternal, neonatal, and nutritional diseases contribute to high mortality and disease burden, including child mortality. Europe is on the verge of stages 4 and 5 in the demographic transition with low birth and death rates. Europe's population is old, and non-communicable diseases (NCDs) pose major health challenges. The mHealth literature adequately covers cardiovascular disease/heart failure, and cancer. However, it lacks approaches for respiratory/enteric infections, malaria, and NCDs. mHealth systems in SSA are underutilized than in Europe, despite alignment with the region's demographics and major health issues. Most initiatives in SSA lack implementation depth, with only pilot tests or small-scale implementations. Europe's reported cases highlight actual implementation and acceptability, indicating a strong implementation depth of mHealth systems. |
| Link | http://doi.org/10.1177/20552076231178420 |
| Title | Introducing field digital data collection systems into seasonal malaria chemoprevention campaigns: opportunities for robust evidence development and national e-health strategies. |
| Authors | Balla, K; Malm, K; Njie, O; Hounto Ogouyemi, A; Uhomoibhi, P; Poku-Awuku, A; Tchouatieu, AM; Aikpon, R; Bah, A; Kolley, O; Ogbulafor, N; Oppong, S; Adomako, K; Houndjo, W; Jah, H; Banerji, J; Nikau, J; Affoukou, C; Egwu, E; Houtohossou, C; Van Hulle, S |
| Journal | BMJ global health |
| Publication Date | 1 Mar 2022 |
| Date Added to PubMed | 18 Mar 2022 |
| Abstract | Seasonal malaria chemoprevention (SMC) is a World Health Organization-recommended intervention to protect children under the age of 5 in Africa's Sahel region. While SMC remains highly effective in decreasing malaria cases, implementing countries face several challenges regarding collecting quality data; monitoring coverage and compliance and overcoming delays in campaigns due to late payment to field distributors.To address these challenges, the National Malaria Control Programmes of Benin, The Gambia, Ghana and Nigeria introduced digital data collection (DDC) tools to support their SMC campaigns. To facilitate cross-country learning, this paper investigates the impact of using DDCs in SMC campaigns by comparing country responses.Country experience suggests that in comparison to paper-based data collection systems, using DDC tools help to overcome data quality and operational challenges; cloud-based features also made data more accessible. Thus, scaling up DDC tools and linking them with routine national health management systems could help generate robust evidence for malaria policy development and programming. Of note, evidence from Benin showed that using digital tools reduced the time to pay staff and volunteers by 5 weeks. In Benin's experience, DDC also offered cost benefits (1.5 times cheaper) versus the use of paper-based tools.The authors note that no application offers greater benefits than the other-countries will select a technology that best suits their needs. Several applications are currently being used and newer ones are also being developed. Another option is to develop in-house applications that can be adjusted to local health programmes.Cost-effectiveness studies to inform on whether DDCs offer cost advantages would be beneficial. More studies on DDC are needed from SMC-implementing countries to identify additional benefits and drawbacks of digital applications. These will similarly help national malaria policy and programming efforts. |
| Link | http://doi.org/10.1136/bmjgh-2021-007899 |
| Title | Mapping digital health ecosystems in Africa in the context of endemic infectious and non-communicable diseases. |
| Authors | Manyazewal, T; Ali, MK; Kebede, T; Magee, MJ; Getinet, T; Patel, SA; Hailemariam, D; Escoffery, C; Woldeamanuel, Y; Makonnen, N; Solomon, S; Amogne, W; Marconi, VC; Fekadu, A |
| Journal | NPJ digital medicine |
| Publication Date | 26 May 2023 |
| Date Added to PubMed | 27 May 2023 |
| Abstract | Investments in digital health technologies such as artificial intelligence, wearable devices, and telemedicine may support Africa achieve United Nations (UN) Sustainable Development Goal for Health by 2030. We aimed to characterize and map digital health ecosystems of all 54 countries in Africa in the context of endemic infectious and non-communicable diseases (ID and NCD). We performed a cross-national ecological analysis of digital health ecosystems using 20-year data from the World Bank, UN Economic Commission for Africa, World Health Organization, and Joint UN Programme on HIV/AIDS. Spearman's rank correlation coefficients were used to characterize ecological correlations between exposure (technology characteristics) and outcome (IDs and NCDs incidence/mortality) variables. Weighted linear combination model was used as the decision rule, combining disease burden, technology access, and economy, to explain, rank, and map digital health ecosystems of a given country. The perspective of our analysis was to support government decision-making. The 20-year trend showed that technology characteristics have been steadily growing in Africa, including internet access, mobile cellular and fixed broadband subscriptions, high-technology manufacturing, GDP per capita, and adult literacy, while many countries have been overwhelmed by a double burden of IDs and NCDs. Inverse correlations exist between technology characteristics and ID burdens, such as fixed broadband subscription and incidence of tuberculosis and malaria, or GDP per capita and incidence of tuberculosis and malaria. Based on our models, countries that should prioritize digital health investments were South Africa, Nigeria, and Tanzania for HIV; Nigeria, South Africa, and Democratic Republic of the Congo (DROC) for tuberculosis; DROC, Nigeria, and Uganda for malaria; and Egypt, Nigeria, and Ethiopia for endemic NCDs including diabetes, cardiovascular disease, respiratory diseases, and malignancies. Countries such as Kenya, Ethiopia, Zambia, Zimbabwe, Angola, and Mozambique were also highly affected by endemic IDs. By mapping digital health ecosystems in Africa, this study provides strategic guidance about where governments should prioritize digital health technology investments that require preliminary analysis of country-specific contexts to bring about sustainable health and economic returns. Building digital infrastructure should be a key part of economic development programs in countries with high disease burdens to ensure more equitable health outcomes. Though infrastructure developments alongside digital health technologies are the responsibility of governments, global health initiatives can cultivate digital health interventions substantially by bridging knowledge and investment gaps, both through technology transfer for local production and negotiation of prices for large-scale deployment of the most impactful digital health technologies. |
| Link | http://doi.org/10.1038/s41746-023-00839-2 |
| Title | A comparative review of mobile health and electronic health utilization in sub-Saharan African countries. |
| Authors | Bervell, B; Al-Samarraie, H |
| Journal | Social science & medicine (1982) |
| Publication Date | 1 Jul 2019 |
| Date Added to PubMed | 30 Apr 2019 |
| Abstract | This study distinguished between the application of e-health and m-health technologies in sub-Saharan African (SSA) countries based on the dimensions of use, targeted diseases or health conditions, locations of use, and beneficiaries (types of patients or health workers) in a country specific context. It further characterized the main opportunities and challenges associated with these dimensions across the sub-region. A systematic review of the literature was conducted on 66 published peer reviewed articles. The review followed the scientific process of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines of identification, selection, assessment, synthesis and interpretation of findings. The results of the study showed that m-health was prevalent in usage for promoting information for treatment and prevention of diseases as well as serving as an effective technology for reminders towards adherence. For e-health, the uniqueness lay in data acquisition and patients' records management; diagnosis; training and recruitment. While m-health was never used for monitoring or training and recruitment, e-health on the other hand could not serve the purpose of reminders or for reporting cases from the field. Both technologies were however useful for adherence, diagnosis, disease control mechanisms, information provision, and decision-making/referrals. HIV/AIDS, malaria, and maternal (postnatal and antenatal) healthcare were important in both m-health and e-health interventions mostly concentrated in the rural settings of South Africa and Kenya. ICT infrastructure, trained personnel, illiteracy, lack of multilingual text and voice messages were major challenges hindering the effective usage of both m-health and e-health technologies. |
| Link | http://doi.org/10.1016/j.socscimed.2019.04.024 |
| Title | Community health worker-based mobile health (mHealth) approaches for improving management and caregiver knowledge of common childhood infections: A systematic review. |
| Authors | Mahmood, H; Mckinstry, B; Luz, S; Fairhurst, K; Nasim, S; Hazir, T |
| Journal | Journal of global health |
| Publication Date | 1 Dec 2020 |
| Date Added to PubMed | 14 Jan 2021 |
| Abstract | Children in lower middle-income countries (LMICs) are more at risk of dying, than those in High Income Countries (HICs), due to highly prevalent deadly yet preventable childhood infections. Alongside concerns about the incidence of these infections, there has been a renewed interest in involving community health workers (CHWs) in various public health programs. However, as CHWs are increasingly asked to take on different tasks there is a risk that their workload may become unmanageable. One solution to help reduce this burden is the use of mobile health (mHealth) technology in the community through behaviour change. Considering there are various CHWs based mHealth approaches on illness management and education, therefore, we aimed to appraise the available literature on effectiveness of these mHealth approaches for caregivers to improve knowledge and management about common under-five childhood infections with respect to behaviour change. We searched six databases between October to December 2019 using subject heading (Mesh) and free text terms in title or abstract in US English. We included multiple study types of children under-five or their caregivers who have been counselled, educated, or provided any health care service by CHWs for any common paediatric infectious diseases using mHealth. We excluded articles published prior to 1990 and those including mHealth technology not coming under the WHO definition. A data extraction sheet was developed and titles, abstracts, and selected full text were reviewed by two reviewers. Quality assessment was done using JBI tools. We included 23 articles involving around 300 000 individuals with eight types of study designs. 20 studies were conducted in Africa, two in Asia, and one in Latin America mainly on pneumonia or respiratory tract infections followed by malaria and diarrhoea in children. The most common types of Health approaches were mobile applications for decision support, text message reminders and use of electronic health record systems. None of the studies employed the use of any behaviour change model or any theoretical framework for selection of models in their studies. Coupling mhealth with CHWs has the potential to benefit communities in improving management of illnesses in children under-five. High quality evidence on impact of such interventions on behaviour is relatively sparse and further studies should be conducted using theoretically informed behaviour change frameworks/models. PROPSERO Registration number: CRD42018117679. |
| Link | http://doi.org/10.7189/jogh.10.020438 |
| Title | Improving community health worker treatment for malaria, diarrhoea, and pneumonia in Uganda through inSCALE community and mHealth innovations: A cluster randomised controlled trial. |
| Authors | Källander, K; Soremekun, S; Strachan, DL; Hill, Z; Kasteng, F; Kertho, E; Nanyonjo, A; Ten Asbroek, G; Nakirunda, M; Lumumba, P; Ayebale, G; Bagorogoza, B; Vassall, A; Meek, S; Tibenderana, J; Lingam, R; Kirkwood, B |
| Journal | PLOS digital health |
| Publication Date | 1 Jun 2023 |
| Date Added to PubMed | 12 Jun 2023 |
| Abstract | The inSCALE cluster randomised controlled trial in Uganda evaluated two interventions, mHealth and Village Health Clubs (VHCs) which aimed to improve Community Health Worker (CHW) treatment for malaria, diarrhoea, and pneumonia within the national Integrated Community Case Management (iCCM) programme. The interventions were compared with standard care in a control arm. In a cluster randomised trial, 39 sub-counties in Midwest Uganda, covering 3167 CHWs, were randomly allocated to mHealth; VHC or usual care (control) arms. Household surveys captured parent-reported child illness, care seeking and treatment practices. Intention-to-treat analysis estimated the proportion of appropriately treated children with malaria, diarrhoea, and pneumonia according to WHO informed national guidelines. The trial was registered at ClinicalTrials.gov (NCT01972321). Between April-June 2014, 7679 households were surveyed; 2806 children were found with malaria, diarrhoea, or pneumonia symptoms in the last one month. Appropriate treatment was 11% higher in the mHealth compared to the control arm (risk ratio [RR] 1.11, 95% CI 1.02, 1.21; p = 0.018). The largest effect was on appropriate treatment for diarrhoea (RR 1.39; 95% CI 0.90, 2.15; p = 0.134). The VHC intervention increased appropriate treatment by 9% (RR 1.09; 95% CI 1.01, 1.18; p = 0.059), again with largest effect on treatment of diarrhoea (RR 1.56, 95% CI 1.04, 2.34, p = 0.030). CHWs provided the highest levels of appropriate treatment compared to other providers. However, improvements in appropriate treatment were observed at health facilities and pharmacies, with CHW appropriate treatment the same across the arms. The rate of CHW attrition in both intervention arms was less than half that of the control arm; adjusted risk difference mHealth arm -4.42% (95% CI -8.54, -0.29, p = 0.037) and VHC arm -4.75% (95% CI -8.74, -0.76, p = 0.021). Appropriate treatment by CHWs was encouragingly high across arms. The inSCALE mHealth and VHC interventions have the potential to reduce CHW attrition and improve the care quality for sick children, but not through improved CHW management as we had hypothesised. Trial Registration:ClinicalTrials.gov (NCT01972321). |
| Link | http://doi.org/10.1371/journal.pdig.0000217 |