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.
INTRODUCTION: In low-resource settings, community health workers are frontline providers who shoulder the health service delivery burden. Increasingly, mobile technologies are developed, tested, and deployed with community health workers to facilitate tasks and improve outcomes. We reviewed the evidence for the use of mobile technology by community health workers to identify opportunities and challenges for strengthening health systems in resource-constrained settings.
METHODS: We conducted a systematic review of peer-reviewed literature from health, medical, social science, and engineering databases, using PRISMA guidelines. We identified a total of 25 unique full-text research articles on community health workers and their use of mobile technology for the delivery of health services.
RESULTS: Community health workers have used mobile tools to advance a broad range of health aims throughout the globe, particularly maternal and child health, HIV/AIDS, and sexual and reproductive health. Most commonly, community health workers use mobile technology to collect field-based health data, receive alerts and reminders, facilitate health education sessions, and conduct person-to-person communication. Programmatic efforts to strengthen health service delivery focus on improving adherence to standards and guidelines, community education and training, and programmatic leadership and management practices. Those studies that evaluated program outcomes provided some evidence that mobile tools help community health workers to improve the quality of care provided, efficiency of services, and capacity for program monitoring.
DISCUSSION: Evidence suggests mobile technology presents promising opportunities to improve the range and quality of services provided by community health workers. Small-scale efforts, pilot projects, and preliminary descriptive studies are increasing, and there is a trend toward using feasible and acceptable interventions that lead to positive program outcomes through operational improvements and rigorous study designs. Programmatic and scientific gaps will need to be addressed by global leaders as they advance the use and assessment of mobile technology tools for community health workers.
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.
