Qualitative Assessment of the Feasibility, Usability, and Acceptability of a Mobile Client Data App for Community-Based Maternal, Neonatal, and Child Care in Rural Ghana
Identifieur interne : 000A67 ( Ncbi/Merge ); précédent : 000A66; suivant : 000A68Qualitative Assessment of the Feasibility, Usability, and Acceptability of a Mobile Client Data App for Community-Based Maternal, Neonatal, and Child Care in Rural Ghana
Auteurs : Jessica D. Rothstein [États-Unis] ; Larissa Jennings [États-Unis] ; Anitha Moorthy [Ghana] ; Fan Yang [États-Unis] ; Lisa Gee [États-Unis] ; Karen Romano [Ghana] ; David Hutchful [Ghana] ; Alain B. Labrique [États-Unis] ; Amnesty E. Lefevre [États-Unis]Source :
- International Journal of Telemedicine and Applications [ 1687-6415 ] ; 2016.
Abstract
Mobile phone applications may enhance the delivery of critical health services and the accuracy of health service data. Yet, the opinions and experiences of frontline health workers on using mobile apps to track pregnant and recently delivered women are underreported. This evaluation qualitatively assessed the feasibility, usability, and acceptability of a mobile Client Data App for maternal, neonatal, and child client data management by community health nurses (CHNs) in rural Ghana. The mobile app enabled CHNs to enter, summarize, and query client data. It also sent visit reminders for clients and provided a mechanism to report level of care to district officers. Fourteen interviews and two focus groups with CHNs, midwives, and district health officers were conducted, coded, and thematically analyzed. Results indicated that the app was easily integrated into care, improved CHN productivity, and was acceptable due to its capacity to facilitate client follow-up, data reporting, and decision-making. However, the feasibility and usability of the app were hindered by high client volumes, staff shortages, and software and device challenges. Successful integration of mobile client data apps for frontline health workers in rural and resource-poor settings requires real-time monitoring, program investments, and targeted changes in human resources.
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DOI: 10.1155/2016/2515420
PubMed: 28070186
PubMed Central: 5192299
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Labrique</name><affiliation wicri:level="2"><nlm:aff id="I1">Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room E5030, Baltimore, MD 21205, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room E5030, Baltimore, MD 21205</wicri:regionArea><placeName><region type="state">Maryland</region></placeName></affiliation><affiliation wicri:level="2"><nlm:aff id="I2">Johns Hopkins University Global mHealth Initiative, 615 N. Wolfe Street, Room 5635, Baltimore, MD 21205, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Johns Hopkins University Global mHealth Initiative, 615 N. Wolfe Street, Room 5635, Baltimore, MD 21205</wicri:regionArea><placeName><region type="state">Maryland</region></placeName></affiliation></author><author><name sortKey="Lefevre, Amnesty E" sort="Lefevre, Amnesty E" uniqKey="Lefevre A" first="Amnesty E." last="Lefevre">Amnesty E. Lefevre</name><affiliation wicri:level="2"><nlm:aff id="I1">Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room E5030, Baltimore, MD 21205, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room E5030, Baltimore, MD 21205</wicri:regionArea><placeName><region type="state">Maryland</region></placeName></affiliation><affiliation wicri:level="2"><nlm:aff id="I2">Johns Hopkins University Global mHealth Initiative, 615 N. Wolfe Street, Room 5635, Baltimore, MD 21205, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Johns Hopkins University Global mHealth Initiative, 615 N. Wolfe Street, Room 5635, Baltimore, MD 21205</wicri:regionArea><placeName><region type="state">Maryland</region></placeName></affiliation></author></analytic><series><title level="j">International Journal of Telemedicine and Applications</title><idno type="ISSN">1687-6415</idno><idno type="eISSN">1687-6423</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Mobile phone applications may enhance the delivery of critical health services and the accuracy of health service data. Yet, the opinions and experiences of frontline health workers on using mobile apps to track pregnant and recently delivered women are underreported. This evaluation qualitatively assessed the feasibility, usability, and acceptability of a mobile Client Data App for maternal, neonatal, and child client data management by community health nurses (CHNs) in rural Ghana. The mobile app enabled CHNs to enter, summarize, and query client data. It also sent visit reminders for clients and provided a mechanism to report level of care to district officers. Fourteen interviews and two focus groups with CHNs, midwives, and district health officers were conducted, coded, and thematically analyzed. Results indicated that the app was easily integrated into care, improved CHN productivity, and was acceptable due to its capacity to facilitate client follow-up, data reporting, and decision-making. However, the feasibility and usability of the app were hindered by high client volumes, staff shortages, and software and device challenges. Successful integration of mobile client data apps for frontline health workers in rural and resource-poor settings requires real-time monitoring, program investments, and targeted changes in human resources. </p></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Bhutta, Z A" uniqKey="Bhutta Z">Z. A. Bhutta</name></author><author><name sortKey="Black, R E" uniqKey="Black R">R. E. Black</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Liu, L" uniqKey="Liu L">L. Liu</name></author><author><name sortKey="Oza, S" uniqKey="Oza S">S. Oza</name></author><author><name sortKey="Hogan, D" uniqKey="Hogan D">D. Hogan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bhutta, Z A" uniqKey="Bhutta Z">Z. A. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Int J Telemed Appl</journal-id><journal-id journal-id-type="iso-abbrev">Int J Telemed Appl</journal-id><journal-id journal-id-type="publisher-id">IJTA</journal-id><journal-title-group><journal-title>International Journal of Telemedicine and Applications</journal-title></journal-title-group><issn pub-type="ppub">1687-6415</issn><issn pub-type="epub">1687-6423</issn><publisher><publisher-name>Hindawi Publishing Corporation</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">28070186</article-id><article-id pub-id-type="pmc">5192299</article-id><article-id pub-id-type="doi">10.1155/2016/2515420</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title>Qualitative Assessment of the Feasibility, Usability, and Acceptability of a Mobile Client Data App for Community-Based Maternal, Neonatal, and Child Care in Rural Ghana</article-title></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="false">http://orcid.org/0000-0002-8503-2233</contrib-id><name><surname>Rothstein</surname><given-names>Jessica D.</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref><xref ref-type="aff" rid="I2"><sup>2</sup></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib><contrib contrib-type="author"><name><surname>Jennings</surname><given-names>Larissa</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref><xref ref-type="aff" rid="I2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Moorthy</surname><given-names>Anitha</given-names></name><xref ref-type="aff" rid="I3"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Yang</surname><given-names>Fan</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Gee</surname><given-names>Lisa</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Romano</surname><given-names>Karen</given-names></name><xref ref-type="aff" rid="I3"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Hutchful</surname><given-names>David</given-names></name><xref ref-type="aff" rid="I3"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Labrique</surname><given-names>Alain B.</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref><xref ref-type="aff" rid="I2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>LeFevre</surname><given-names>Amnesty E.</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref><xref ref-type="aff" rid="I2"><sup>2</sup></xref></contrib></contrib-group><aff id="I1"><sup>1</sup>Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room E5030, Baltimore, MD 21205, USA</aff><aff id="I2"><sup>2</sup>Johns Hopkins University Global mHealth Initiative, 615 N. Wolfe Street, Room 5635, Baltimore, MD 21205, USA</aff><aff id="I3"><sup>3</sup>Grameen Foundation, No. 25 Labone Crescent, Accra, Ghana</aff><author-notes><corresp id="cor1">*Jessica D. Rothstein: <email>jrothstein@jhu.edu</email></corresp><fn fn-type="other"><p>Academic Editor: Malcolm Clarke</p></fn></author-notes><pub-date pub-type="ppub"><year>2016</year></pub-date><pub-date pub-type="epub"><day>14</day><month>12</month><year>2016</year></pub-date><volume>2016</volume><elocation-id>2515420</elocation-id><history><date date-type="received"><day>16</day><month>7</month><year>2016</year></date><date date-type="accepted"><day>14</day><month>11</month><year>2016</year></date></history><permissions><copyright-statement>Copyright © 2016 Jessica D. Rothstein et al.</copyright-statement><copyright-year>2016</copyright-year><license xlink:href="https://creativecommons.org/licenses/by/4.0/"><license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><p>Mobile phone applications may enhance the delivery of critical health services and the accuracy of health service data. Yet, the opinions and experiences of frontline health workers on using mobile apps to track pregnant and recently delivered women are underreported. This evaluation qualitatively assessed the feasibility, usability, and acceptability of a mobile Client Data App for maternal, neonatal, and child client data management by community health nurses (CHNs) in rural Ghana. The mobile app enabled CHNs to enter, summarize, and query client data. It also sent visit reminders for clients and provided a mechanism to report level of care to district officers. Fourteen interviews and two focus groups with CHNs, midwives, and district health officers were conducted, coded, and thematically analyzed. Results indicated that the app was easily integrated into care, improved CHN productivity, and was acceptable due to its capacity to facilitate client follow-up, data reporting, and decision-making. However, the feasibility and usability of the app were hindered by high client volumes, staff shortages, and software and device challenges. Successful integration of mobile client data apps for frontline health workers in rural and resource-poor settings requires real-time monitoring, program investments, and targeted changes in human resources. </p></abstract><funding-group><award-group><funding-source>National Institute of Mental Health</funding-source><award-id>K01MH107310</award-id></award-group><award-group><funding-source>World Health Organization</funding-source></award-group><award-group><funding-source>Norwegian Agency for Development Cooperation</funding-source></award-group></funding-group></article-meta></front><floats-group><fig id="fig1" orientation="portrait" position="float"><label>Figure 1</label><caption><p>Functional summary of MOTECH's mobile Client Data App.</p></caption><graphic xlink:href="IJTA2016-2515420.001"></graphic></fig><fig id="fig2" orientation="portrait" position="float"><label>Figure 2</label><caption><p>Screen shots of the MOTECH Client Data App's saving, uploading, and query forms.</p></caption><graphic xlink:href="IJTA2016-2515420.002"></graphic></fig><fig id="fig3" orientation="portrait" position="float"><label>Figure 3</label><caption><p>Summary of key qualitative findings by assessment area.</p></caption><graphic xlink:href="IJTA2016-2515420.003"></graphic></fig><table-wrap id="tab1" orientation="portrait" position="float"><label>Table 1</label><caption><p>Number and type of users enrolled in the evaluation by qualitative method and by total.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">User characteristics</th><th align="center" rowspan="1" colspan="1">Individual interviews</th><th align="center" rowspan="1" colspan="1">Focus groups</th><th align="center" rowspan="1" colspan="1">Total</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">Total number of interviews or discussions</td><td align="center" rowspan="1" colspan="1">14</td><td align="center" rowspan="1" colspan="1">2</td><td align="center" rowspan="1" colspan="1">16</td></tr><tr><td align="center" colspan="4" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Number of interviews or discussions by health system level</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1"> Health center</td><td align="center" rowspan="1" colspan="1">4</td><td align="center" rowspan="1" colspan="1">0</td><td align="center" rowspan="1" colspan="1">4</td></tr><tr><td align="left" rowspan="1" colspan="1"> Community health post</td><td align="center" rowspan="1" colspan="1">6</td><td align="center" rowspan="1" colspan="1">2</td><td align="center" rowspan="1" colspan="1">8</td></tr><tr><td align="left" rowspan="1" colspan="1"> District health directorate</td><td align="center" rowspan="1" colspan="1">4</td><td align="center" rowspan="1" colspan="1">0</td><td align="center" rowspan="1" colspan="1">4</td></tr><tr><td align="center" colspan="4" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Total number of enrolled users</td><td align="center" rowspan="1" colspan="1">14</td><td align="center" rowspan="1" colspan="1">15</td><td align="center" rowspan="1" colspan="1">29</td></tr><tr><td align="center" colspan="4" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Number of enrolled users by health worker type</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1"> Community health nurse</td><td align="center" rowspan="1" colspan="1">8</td><td align="center" rowspan="1" colspan="1">15</td><td align="center" rowspan="1" colspan="1">23</td></tr><tr><td align="left" rowspan="1" colspan="1"> Midwife</td><td align="center" rowspan="1" colspan="1">2</td><td align="center" rowspan="1" colspan="1">0</td><td align="center" rowspan="1" colspan="1">2</td></tr><tr><td align="left" rowspan="1" colspan="1"> District health director</td><td align="center" rowspan="1" colspan="1">2</td><td align="center" rowspan="1" colspan="1">0</td><td align="center" rowspan="1" colspan="1">2</td></tr><tr><td align="left" rowspan="1" colspan="1"> District health information officer</td><td align="center" rowspan="1" colspan="1">2</td><td align="center" rowspan="1" colspan="1">0</td><td align="center" rowspan="1" colspan="1">2</td></tr><tr><td align="left" rowspan="1" colspan="1">Number of enrolled users by age (in years)</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1"> <26</td><td align="center" rowspan="1" colspan="1">0</td><td align="center" rowspan="1" colspan="1">2</td><td align="center" rowspan="1" colspan="1">2</td></tr><tr><td align="left" rowspan="1" colspan="1"> 26–29</td><td align="center" rowspan="1" colspan="1">7</td><td align="center" rowspan="1" colspan="1">13</td><td align="center" rowspan="1" colspan="1">20</td></tr><tr><td align="left" rowspan="1" colspan="1"> ≥30</td><td align="center" rowspan="1" colspan="1">7</td><td align="center" rowspan="1" colspan="1">0</td><td align="center" rowspan="1" colspan="1">7</td></tr><tr><td align="left" rowspan="1" colspan="1">Number of enrolled users by gender</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1"> Female</td><td align="center" rowspan="1" colspan="1">11</td><td align="center" rowspan="1" colspan="1">13</td><td align="center" rowspan="1" colspan="1">24</td></tr><tr><td align="left" rowspan="1" colspan="1"> Male</td><td align="center" rowspan="1" colspan="1">3</td><td align="center" rowspan="1" colspan="1">2</td><td align="center" rowspan="1" colspan="1">5</td></tr></tbody></table></table-wrap></floats-group></pmc><affiliations><list><country><li>Ghana</li><li>États-Unis</li></country><region><li>Maryland</li><li>Région du Grand Accra</li></region><settlement><li>Accra</li></settlement></list><tree><country name="États-Unis"><region name="Maryland"><name sortKey="Rothstein, Jessica D" sort="Rothstein, Jessica D" uniqKey="Rothstein J" first="Jessica D." last="Rothstein">Jessica D. Rothstein</name></region><name sortKey="Gee, Lisa" sort="Gee, Lisa" uniqKey="Gee L" first="Lisa" last="Gee">Lisa Gee</name><name sortKey="Jennings, Larissa" sort="Jennings, Larissa" uniqKey="Jennings L" first="Larissa" last="Jennings">Larissa Jennings</name><name sortKey="Jennings, Larissa" sort="Jennings, Larissa" uniqKey="Jennings L" first="Larissa" last="Jennings">Larissa Jennings</name><name sortKey="Labrique, Alain B" sort="Labrique, Alain B" uniqKey="Labrique A" first="Alain B." last="Labrique">Alain B. Labrique</name><name sortKey="Labrique, Alain B" sort="Labrique, Alain B" uniqKey="Labrique A" first="Alain B." last="Labrique">Alain B. Labrique</name><name sortKey="Lefevre, Amnesty E" sort="Lefevre, Amnesty E" uniqKey="Lefevre A" first="Amnesty E." last="Lefevre">Amnesty E. Lefevre</name><name sortKey="Lefevre, Amnesty E" sort="Lefevre, Amnesty E" uniqKey="Lefevre A" first="Amnesty E." last="Lefevre">Amnesty E. Lefevre</name><name sortKey="Rothstein, Jessica D" sort="Rothstein, Jessica D" uniqKey="Rothstein J" first="Jessica D." last="Rothstein">Jessica D. Rothstein</name><name sortKey="Yang, Fan" sort="Yang, Fan" uniqKey="Yang F" first="Fan" last="Yang">Fan Yang</name></country><country name="Ghana"><region name="Région du Grand Accra"><name sortKey="Moorthy, Anitha" sort="Moorthy, Anitha" uniqKey="Moorthy A" first="Anitha" last="Moorthy">Anitha Moorthy</name></region><name sortKey="Hutchful, David" sort="Hutchful, David" uniqKey="Hutchful D" first="David" last="Hutchful">David Hutchful</name><name sortKey="Romano, Karen" sort="Romano, Karen" uniqKey="Romano K" first="Karen" last="Romano">Karen Romano</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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