Continuum of Care Services for Maternal and Child Health using mobile technology - a health system strengthening strategy in low and middle income countries.
Continuum of Care Services for Maternal and Child Health using mobile technology - a health system strengthening strategy in low and middle income countries.
复制标题
DOI：
10.1186/s12911-016-0326-z
复制
发表时间：
2016-07-07
影响因子：
3.5
通讯作者：
Chaudhuri I
中科院分区：
文献类型：
--
作者：
Balakrishnan R;Gopichandran V;Chaturvedi S;Chatterjee R;Mahapatra T;Chaudhuri I
移动电话技术用于在全球范围内更好地提供医疗服务。在低收入和中等收入国家，手机现已无处不在。因此，在卫生部门利用移动医疗应用在这些国家迅速流行。评估连续护理服务 (CCS) 移动医疗平台在加强印度资源贫乏邦比哈尔邦一个地区孕产妇和儿童健康 (MCH) 服务提供方面的有效性。 CommCare mHealth 平台是针对 CCS 定制的，作为比尔和梅琳达·盖茨基金会资助的项目的创新之一，旨在改善比哈尔邦的孕产妇和新生儿健康服务。该干预措施于 2012 年 7 月在比哈尔邦的一个项目区推出。总共 3000 名一线工作人员中，有超过 550 名一线工作人员接受了使用移动医疗平台的培训，其中包括经过认证的社会健康活动家、Anganwadi 工作人员、辅助护士助产士和女健康监督员。服务提供的组成部分，即孕妇早期登记、三次产前检查、母亲破伤风类毒素免疫、铁和叶酸片供应、机构分娩、产后家访和及早开始母乳喂养，被用作优质服务的指标。将这些服务在实施地区的覆盖范围与比哈尔邦其他地区以及同一地区去年的统计数据进行了比较。根据 16,000 名受益人的随机样本计算了服务提供与母婴追踪系统 (MCTS) 数据库记录捕获之间的时间差。对边缘化和非边缘化种姓的服务覆盖率进行比较，以表明服务提供的公平性。从服务的覆盖面、质量、公平性和效率的角度来加强卫生系统。与比哈尔邦其他地区和上一年相比，实施区块对所有八项指标服务的覆盖率更高。所有指标均存在跨种姓服务的公平性。与纸质报告相比，还确保了数据的及时捕获。由于其对服务提供的质量、效率和公平、医疗保健人力效率和治理的影响，移动医疗纳入服务提供层面可能成为加强卫生系统的潜在战略之一。
Mobile phone technology is utilized for better delivery of health services worldwide. In low-and-middle income countries mobile phones are now ubiquitous. Thus leveraging mHealth applications in health sector is becoming popular rapidly in these countries. To assess the effectiveness of the Continuum of Care Services (CCS) mHealth platform in terms of strengthening the delivery of maternal and child health (MCH) services in a district in Bihar, a resource-poor state in India. The CommCare mHealth platform was customized to CCS as one of the innovations under a project funded by the Bill and Melinda Gates Foundation to improve the maternal and newborn health services in Bihar. The intervention was rolled out in one project district in Bihar, during July 2012. More than 550 frontline workers out of a total of 3000 including Accredited Social Health Activists, Anganwadi Workers, Auxilliary Nurse Midwives and Lady Health Supervisors were trained to use the mHealth platform. The service delivery components namely early registration of pregnant women, three antenatal visits, tetanus toxoid immunization of the mother, iron and folic acid tablet supply, institutional delivery, postnatal home visits and early initiation of breastfeeding were used as indicators for good quality services. The resultant coverage of these services in the implementation area was compared with rest of Bihar and previous year statistics of the same area. The time lag between delivery of a service and its record capture in the maternal and child tracking system (MCTS) database was computed in a random sample of 16,000 beneficiaries. The coverage of services among marginalized and non-marginalized castes was compared to indicate equity of service delivery. Health system strengthening was viewed from the angle of coverage, quality, equity and efficiency of services. The implementation blocks had higher coverage of all the eight indicator services compared to rest of Bihar and the previous year. There was equity of services across castes for all the indicators. Timely capture of data was also ensured compared to paper-based reporting. By virtue of its impact on quality, efficiency and equity of service delivery, health care manpower efficiency and governance, the mHealth inclusion at service provision level can be one of the potential strategy to strengthen the health system.