Evidence on feasibility and effective use of mHealth strategies by frontline health workers in developing countries: systematic review.

OBJECTIVES:

Given the large scale adoption and deployment of mobile phones by health services and frontline health workers (FHW), we aimed to review and synthesize the evidence on the feasibility and effectiveness of mobile-based services on healthcare delivery.

METHODS:

Five databases - Medline, Embase, Global Health, Google Scholar and Scopus - were systematically searched for relevant peer-reviewed articles published between 2000 and 2013. Data were extracted and synthesized across three themes: feasibility of use of mobile tools by FHWs, training required for adoption of mobile tools, and effectiveness of such interventions.

RESULTS:

42 studies were included in this review. With adequate training, FHWs were able to use mobile phones to enhance various aspects of their work activities. Training of FHWs to use mobile phones for healthcare delivery ranged from a few hours to about one week. Five key thematic areas for the use of mobile phones by FHWs were identified: Data collection and reporting, training and decision support, emergency referrals, work planning through alerts and reminders, and improved supervision of and communication between healthcare workers. Data collection by mobile seems to improve promptness of data collection, reduce error rates, and improve data completeness. Two methodologically robust studies suggest that regular access to health information via SMS or mobile-based decision-support systems may improve the adherence of the FHWs to treatment algorithms. The evidence on the effectiveness of the other approaches was largely descriptive and inconclusive.

CONCLUSIONS:

Use of mHealth strategies by FHWs might offer some promising approaches to improving health care delivery; however, the evidence on the effectiveness of such strategies on healthcare outcomes is insufficient. This article is protected by copyright. All rights reserved.