Effectiveness of mHealth Interventions Targeting Health Care Workers to Improve Pregnancy Outcomes in Low- and Middle-Income Countries: A Systematic Review.
Effectiveness of mHealth Interventions Targeting Health Care Workers to Improve Pregnancy Outcomes in Low- and Middle-Income Countries: A Systematic Review.
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DOI：
10.2196/jmir.5533
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发表时间：
2016-08-19
影响因子：
7.4
通讯作者：
Klipstein-Grobusch K
中科院分区：
文献类型：
--
作者：
Amoakoh-Coleman M;Borgstein AB;Sondaal SF;Grobbee DE;Miltenburg AS;Verwijs M;Ansah EK;Browne JL;Klipstein-Grobusch K
低收入和中等收入国家面临着孕产妇和新生儿死亡的最大负担。同时，他们的医生人数最少。创新方法，如使用移动的设备（mHealth）交换与健康相关的信息，可以支持卫生保健工作者提供产前、分娩和产后护理，以改善低收入国家的孕产妇和新生儿结局。我们进行了一项系统性综述，评估针对医护人员的移动健康干预措施的有效性，以改善LMIC的孕产妇和新生儿结局。使用预定的检索和索引词检索了科克伦图书馆、PubMed、EMBASE、全球健康图书馆和Popline。使用改良的科克伦偏倚风险工具进行质量评估。对每篇纳入的论文进行了优势、劣势、机会和威胁分析。本次系统性综述共纳入19项研究，其中10项为干预性研究，9项为描述性研究。移动健康干预措施主要在社区一级的保健提供者在提供产前、分娩和产后护理时用作沟通、数据收集或教育工具。采取干预措施跟踪孕妇，以改善产前和分娩护理，并为转诊提供便利。这些研究都没有直接评估移动健康对孕产妇和新生儿死亡率的影响。移动保健干预措施在协助保健工作者方面面临的挑战主要包括技术问题，如移动的网络覆盖、互联网接入、电力供应和移动的电话维护。针对卫生保健工作者的移动保健干预措施有可能改善中低收入国家的孕产妇和新生儿保健服务。然而，在移动健康干预措施是否直接影响孕产妇和新生儿结局的知识方面存在差距，未来的研究应采用具有相关结局措施的实验设计来解决这一差距。
Low- and middle-income countries (LMICs) face the highest burden of maternal and neonatal deaths. Concurrently, they have the lowest number of physicians. Innovative methods such as the exchange of health-related information using mobile devices (mHealth) may support health care workers in the provision of antenatal, delivery, and postnatal care to improve maternal and neonatal outcomes in LMICs. We conducted a systematic review evaluating the effectiveness of mHealth interventions targeting health care workers to improve maternal and neonatal outcomes in LMIC. The Cochrane Library, PubMed, EMBASE, Global Health Library, and Popline were searched using predetermined search and indexing terms. Quality assessment was performed using an adapted Cochrane Risk of Bias Tool. A strength, weakness, opportunity, and threat analysis was performed for each included paper. A total of 19 studies were included for this systematic review, 10 intervention and 9 descriptive studies. mHealth interventions were used as communication, data collection, or educational tool by health care providers primarily at the community level in the provision of antenatal, delivery, and postnatal care. Interventions were used to track pregnant women to improve antenatal and delivery care, as well as facilitate referrals. None of the studies directly assessed the effect of mHealth on maternal and neonatal mortality. Challenges of mHealth interventions to assist health care workers consisted mainly of technical problems, such as mobile network coverage, internet access, electricity access, and maintenance of mobile phones. mHealth interventions targeting health care workers have the potential to improve maternal and neonatal health services in LMICs. However, there is a gap in the knowledge whether mHealth interventions directly affect maternal and neonatal outcomes and future research should employ experimental designs with relevant outcome measures to address this gap.
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影响因子：
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作者：
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