Using mHealth to improve health care delivery in India: A qualitative examination of the perspectives of community health workers and beneficiaries
Using mHealth to improve health care delivery in India: A qualitative examination of the perspectives of community health workers and beneficiaries
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DOI：
10.1371/journal.pone.0227451
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发表时间：
2020-01-15
期刊：
影响因子：
3.7
通讯作者：
Diamond-Smith, Nadia
中科院分区：
文献类型：
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作者：
Gopalakrishnan, Lakshmi;Buback, Laura;Diamond-Smith, Nadia
背景卫生技术在全球范围内迅速发展，以解决社区卫生工作者（CHW）提供卫生保健的质量和及时性问题。本研究旨在检查CHW和受益人对新的移动健康干预措施（印度CHW通用应用软件[CAS]）的看法。这项研究的目的是寻求社区卫生工作者和受益人对采用社区卫生服务的看法，社区卫生工作者与受益人互动的变化，因为社区卫生服务的引入和社区卫生工作者在使用社区卫生服务时面临的潜在障碍。此外，重要的上下文相关的因素CHW受益人接口和动态，可能有一个影响CAS已被描述。MethodsA定性研究进行了两个国家的印度（比哈尔邦和中央邦）从2018年3月至4月与CHW（n = 32）和受益人（n = 55）。所有的采访进行，并记录在印地语，转录和翻译成英语，编码和主题分析使用Dedoose.FindingsThe移动健康干预是可以接受的CHW谁觉得CAS改善他们的地位，他们在社区工作。受益人的看法既有积极的，也有消极的。社区卫生工作者和受益者之间围绕CAS的使用和影响的不同观点突出了潜在的不信任、参与的社会文化障碍和实施中的技术障碍。所有这些背景因素可以影响的看法和摄取CAS. Conclusionsm健康干预措施，针对CHWs和受益人有可能提高CHWs的性能，减少信息的障碍，并可能改变受益人的行为。虽然技术是社区卫生工作者改善其服务提供的一个推动因素，但它不一定有助于克服阻碍社区卫生工作者与受益者互动的社会和文化障碍，以改善知识和健康行为。未来的干预CHW，包括移动健康干预措施应检查上下文的可接受性，可访问性，沿着受益人和社区成员的可用性因素。
BackgroundmHealth technologies are proliferating globally to address quality and timeliness of health care delivery by Community Health Workers (CHWs). This study aimed to examine CHW and beneficiaries' perceptions of a new mHealth intervention (Common Application Software [CAS] for CHWs in India. The objectives of the study were to seek perspectives of CHWs and beneficiaries on the uptake of CAS, changes in CHW-beneficiary interactions since the introduction of CAS and potential barriers faced by CHWs in use of CAS. Further, important contextual factors related to CHW-beneficiary interface and dynamics that may have a bearing on CAS have been described.MethodsA qualitative study was conducted in two states of India (Bihar and Madhya Pradesh) from March-April 2018 with CHWs (n = 32) and beneficiaries (n = 55). All interviews were conducted and recorded in Hindi, transcribed and translated into English, and coded and thematically analysed using Dedoose.FindingsThe mHealth intervention was acceptable to the CHWs who felt that CAS improved their status in the communities where they worked. Beneficiaries' views were a mix of positive and negative perceptions. The divergent views between CHWs and beneficiaries surrounding the use and impact of CAS highlight an underlying mistrust, socio-cultural barriers in engagement, and technological barriers in implementation. All these contextual factors can influence the perception and uptake of CAS.ConclusionsmHealth interventions targeting CHWs and beneficiaries have the potential to improve performance of CHWs, reduce barriers to information and potentially change the behaviors of beneficiaries. While technology is an enabler for CHWs to improve their service delivery, it does not necessarily help overcome social and cultural barriers that impede CHW-beneficiary interactions to bring about improvements in knowledge and health behaviors. Future interventions for CHWs including mHealth interventions should examine contextual factors along with the acceptability, accessibility, and usability by beneficiaries and community members.