Mobile health (mHealth) approaches and lessons for increased performance and retention of community health workers in low- and middle-income countries: a review.
Mobile health (mHealth) approaches and lessons for increased performance and retention of community health workers in low- and middle-income countries: a review.
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DOI：
10.2196/jmir.2130
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发表时间：
2013-01-25
影响因子：
7.4
通讯作者：
Meek SR
中科院分区：
文献类型：
--
作者：
Källander K;Tibenderana JK;Akpogheneta OJ;Strachan DL;Hill Z;ten Asbroek AH;Conteh L;Kirkwood BR;Meek SR
移动健康（mHealth）是指利用带有软件应用程序的便携式电子设备来提供健康服务和管理患者信息。全球约有50亿手机用户，移动技术在健康服务中发挥正式作用的机会，尤其是在中低收入国家，正日益受到认可。移动健康还可以通过传播临床最新信息、学习资料和提醒来支持医护人员的工作表现，特别是在中低收入国家服务不足的农村地区，那里的社区卫生工作者为腹泻、肺炎和疟疾患儿提供综合社区病例管理。
我们的目的是对中低收入国家的移动健康项目如何处理移动技术与公共卫生的交叉问题进行专题综述，并确定有前景的实践和经验教训，以及移动健康如何支持社区卫生工作者的新颖创新方法。
在本次综述中，利用来自同行评审期刊、网站和重要报告的信息，对移动健康举措的6个主题进行了研究。所研究的主要移动健康技术包括手机、个人数字助理（PDA）和智能手机、患者监测设备以及移动远程医疗设备。我们研究了这些工具如何用于教育和宣传、数据获取以及加强健康信息系统。我们还考虑了移动健康如何支持患者监测、临床决策以及药品和物资的追踪。总结了移动健康试验和研究的经验教训，重点关注中低收入国家和社区卫生工作者。
综述显示，在低收入国家对移动健康进行正式的成果评估非常少。尽管有大量项目过程评估的文献，但很少有研究表明对临床结果有影响。在中低收入国家，大规模运行的移动健康应用和服务也很缺乏。移动健康最常见的记录用途是单向短信和电话提醒，以鼓励后续就诊、健康行为和数据收集。针对社区卫生工作者的创新移动健康应用包括将手机用作工作助手、临床决策支持工具，以及用于数据提交和工作表现的即时反馈。
随着政府、技术专家、非政府组织、学术界和企业之间建立合作关系，在中低收入国家利用移动健康改善健康服务提供具有巨大潜力。与许多其他健康改善项目一样，一个关键挑战是在让医护人员和社区适当参与这一过程的同时，将移动健康方法从试点项目转变为全国可扩展的项目。通过利用不同人群中手机日益普及的情况，有希望的证据表明，移动健康可用于为个人和社区提供更多更好的医疗保健服务，同时有助于加强卫生系统。
Mobile health (mHealth) describes the use of portable electronic devices with software applications to provide health services and manage patient information. With approximately 5 billion mobile phone users globally, opportunities for mobile technologies to play a formal role in health services, particularly in low- and middle-income countries, are increasingly being recognized. mHealth can also support the performance of health care workers by the dissemination of clinical updates, learning materials, and reminders, particularly in underserved rural locations in low- and middle-income countries where community health workers deliver integrated community case management to children sick with diarrhea, pneumonia, and malaria. Our aim was to conduct a thematic review of how mHealth projects have approached the intersection of cellular technology and public health in low- and middle-income countries and identify the promising practices and experiences learned, as well as novel and innovative approaches of how mHealth can support community health workers. In this review, 6 themes of mHealth initiatives were examined using information from peer-reviewed journals, websites, and key reports. Primary mHealth technologies reviewed included mobile phones, personal digital assistants (PDAs) and smartphones, patient monitoring devices, and mobile telemedicine devices. We examined how these tools could be used for education and awareness, data access, and for strengthening health information systems. We also considered how mHealth may support patient monitoring, clinical decision making, and tracking of drugs and supplies. Lessons from mHealth trials and studies were summarized, focusing on low- and middle-income countries and community health workers. The review revealed that there are very few formal outcome evaluations of mHealth in low-income countries. Although there is vast documentation of project process evaluations, there are few studies demonstrating an impact on clinical outcomes. There is also a lack of mHealth applications and services operating at scale in low- and middle-income countries. The most commonly documented use of mHealth was 1-way text-message and phone reminders to encourage follow-up appointments, healthy behaviors, and data gathering. Innovative mHealth applications for community health workers include the use of mobile phones as job aides, clinical decision support tools, and for data submission and instant feedback on performance. With partnerships forming between governments, technologists, non-governmental organizations, academia, and industry, there is great potential to improve health services delivery by using mHealth in low- and middle-income countries. As with many other health improvement projects, a key challenge is moving mHealth approaches from pilot projects to national scalable programs while properly engaging health workers and communities in the process. By harnessing the increasing presence of mobile phones among diverse populations, there is promising evidence to suggest that mHealth can be used to deliver increased and enhanced health care services to individuals and communities, while helping to strengthen health systems.
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影响因子：
--
作者：
DeRenzi, Brian;Borriello, Gaetano;Lesh, Neal
通讯作者：
Lesh, Neal
影响因子：
15.8
作者：
Bengtsson L;Lu X;Thorson A;Garfield R;von Schreeb J
通讯作者：
von Schreeb J
DOI：
10.4269/ajtmh.2011.10-0528
发表时间：
2011-07
期刊：
The American journal of tropical medicine and hygiene
影响因子：
--
作者：
Asiimwe C;Gelvin D;Lee E;Ben Amor Y;Quinto E;Katureebe C;Sundaram L;Bell D;Berg M
通讯作者：
Berg M
影响因子：
7.4
作者：
Déglise C;Suggs LS;Odermatt P
通讯作者：
Odermatt P
影响因子：
4.4
作者：
Chang, Larry W.;Kagaayi, Joseph;Reynolds, Steven J.
通讯作者：
Reynolds, Steven J.