Using mobile phones to improve community health workers performance in low-and-middle-income countries
Using mobile phones to improve community health workers performance in low-and-middle-income countries
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DOI：
10.1186/s12889-020-8173-3
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发表时间：
2020-01-13
影响因子：
4.5
通讯作者：
Saleem, Sarah
中科院分区：
文献类型：
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作者：
Feroz, Anam;Jabeen, Rawshan;Saleem, Sarah
在低收入和中等收入国家，社区卫生工作者是初级保健系统的核心组成部分，因为他们是社区和医疗机构之间的联络人。有证据表明，这些工作人员提供的服务帮助降低了孕产妇和儿童发病率和死亡率，减轻了传染性和非传染性疾病的负担。然而，实现可持续发展目标的覆盖面和总体进展非常缓慢。最近关于目前进展速度的共识是，这与财政和人力资源的限制有关。社区卫生工作者负担过重，因为他们可能得不到履行职责所需的支持，但却被期望完成更多的工作。中低收入国家的卫生系统很少关注社区卫生工作者的工作环境，这对社区卫生工作者的生产力和服务质量产生了负面影响。这场辩论旨在探讨移动的电话技术在中低收入国家的潜力，以提高社区卫生工作者的绩效和有效性。讨论为了提高CHW的工作效率，一些研究涉及使用移动的电话进行数据收集和报告，而其他研究使用移动的技术进行患者与提供者的沟通、患者教育、CHW监督以及监测和评估。使用移动的电话有广泛的好处，包括减少社区卫生工作者的工作量，改善数据收集、报告和监测，提供优质医疗服务，支持性监督，更好地组织社区卫生工作者的任务，改善社区卫生成果。然而，一些研究表明，社区卫生工作者在采用和使用移动的卫生解决方案提供卫生服务时遇到了独特的挑战，例如，社区卫生工作者缺乏关于新的移动卫生解决方案的培训，技术支持薄弱，互联网连接问题和其他行政挑战。未来的研究工作应致力于探索卫生系统是否已做好采用可持续移动医疗解决方案的准备，以改善中低收入国家的社区卫生工作者工作流程。结论未来的研究工作和政策对话应致力于探索卫生系统是否准备好采用可持续的移动医疗解决方案，以改善中低收入国家的CHW工作流程。
Background In low-and-middle-income countries community health workers are the core component of the PHC system as they act as a liaison between the communities and the healthcare facilities. Evidence suggests that the services offered by these workers have helped in the decline of maternal and child morbidity and mortality rates and the burden of communicable and non-communicable diseases. However, the coverage and the overall progress towards achieving the SDG targets is very sluggish. The recent consensus concerning this current pace of progress, is that it relates to financial and human resources constraints. CHWs are overburdened as they are expected to accomplish more although they may not obtain the required support to perform their duties. The health systems of LMICs, have given very little attention to the work environment of CHWs; which has negatively affected CHWs productivity, and quality of services. This debate is intended to explore the potential of mobile phone technology in LMICs for improving CHWs performance and effectiveness. Discussion To improve CHWs productivity, some studies involved the use of mobile phones for data collection and reporting, while other studies used mobile technology for patient to provider communication, patient education, CHWs supervision, and monitoring and evaluation. A wide range of benefits exists for using mobile phones including reduction in CHWs workload, improvement in data collection, reporting and monitoring, provision of quality healthcare services, supportive supervision, better organization of CHWs tasks and improvement in community health outcomes. However, a number of studies suggests that CHWs encounter unique challenges when adopting and using mobile health solutions for health service delivery such as, lack of CHWs training on new mHealth solutions, weak technical support, issues of internet connectivity and other administrative challenges. Future research efforts should be directed to explore health system readiness for adopting sustainable mHealth solutions to improve CHWs workflows in LMICs. Conclusion Future research efforts and policy dialogue should be directed to explore health system readiness for adopting sustainable mHealth solutions to improve CHWs workflows in LMICs.