Oxford open digital health最新文献

{"title":"Assessing the adoption and utilization of the Rwanda COVID-19 data analytics system: a mixed methods approach.","authors":"Hassan Mugabo, Gilbert Rukundo, Jean Claude S Ngabonziza, Jean-Baptiste Mazarati, Joseph Aghatise, Olukunle Akinwusi","doi":"10.1093/oodh/oqae034","DOIUrl":"https://doi.org/10.1093/oodh/oqae034","url":null,"abstract":"<p><strong>Introduction: </strong>Rwanda has been widely lauded for its exceptional response to the COVID-19 pandemic. However, although Rwanda established a national system for COVID-19 testing and vaccination data, concerns have been raised about data fragmentation which requires linkage of various data sources, access to data for real-time decision-making, and data completeness.</p><p><strong>Methods: </strong>We assessed the adoption of the Rwanda COVID-19 data Analytics System (RCAS) for public health staff that employ data from various platforms to generate evidence for policy- and decision-making. A random sample of 56 participants was drawn from the 98 who attended the 2022 RCAS training for data managers from the Rwanda Biomedical Center, technical partners, and health facilities. Of the selected participants, 42 completed the online self-administered questionnaire within the 14-day data collection period. Key informant interviews were then conducted with a subset of 14 respondents.</p><p><strong>Results: </strong>A strong positive relationship (χ² = 9.1049, <i>P</i> < 0.05) emerged between respondents' decision-making regarding RCAS and their support for its sustainability. There was a marginal association (χ² = 3.3358, <i>P</i> = 0.059) suggesting a link between users' ease of data exchange through RCAS and their support for its long-term sustainability, warranting further exploration.</p><p><strong>Conclusion: </strong>RCAS had a positive impact on improvements in data linkage, access to individual-level data for analyses, and progress toward harmonization of health data beyond COVID-19 in Rwanda. Users noted the usability, acceptability, and interoperability of the system. Recommendations for further improvement and scaling of the intervention are discussed.</p>","PeriodicalId":520498,"journal":{"name":"Oxford open digital health","volume":"2 ","pages":"oqae034"},"PeriodicalIF":0.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Task sharing for increasing access to obstetric ultrasonography: a formative qualitative study of nurse-led scanning with telemedicine review in Kenya.","authors":"Meghan Bruce Kumar, Caleb Mike Mulongo, Lucia Pincerato, Maria Vittoria De Vita, Salima Saidi, Yvonne Gakii, GianFranco Morino, Pratap Kumar","doi":"10.1093/oodh/oqae037","DOIUrl":"https://doi.org/10.1093/oodh/oqae037","url":null,"abstract":"<p><p>The informal settlements of Nairobi have higher neonatal and infant mortality rates than the average for Nairobi. Universal access to important diagnostics like ultrasonography is poor and inequitable due to the high cost of devices and limited availability of skilled sonographers. Recent advances of mobile ultrasound probes connected to smartphones, with or without artificial intelligence support, have improved access to devices; but skills to perform and interpret scans continue to be limited. The SonoMobile intervention involved training nurse-midwives to conduct point-of-care obstetric ultrasound scans in antenatal care clinics in urban informal settlements. Scan data and images were shared, using telemedicine technology, with remote sonographers, who reviewed scan images and data, and provided reports. This study of 61 respondents from diverse stakeholder groups describes the acceptability, utility and considerations for sustainability of nurse-led, point-of-care obstetric ultrasonography with telemedicine review. Perceived value of nurse-led obstetric ultrasonography includes improving access and affordability of obstetric ultrasonography services, timely identification and referral of high-risk pregnancies, and improving awareness of appropriate antenatal care among underserved populations. The relative affordability of SonoMobile was described as a critical enabler for a business model targeting low- and middle-income segments of the population, and for increasing quality and equity of antenatal care coverage. Areas highlighted for improvement include strengthening supervision of nurse trainees, broadening the scope of nurse training and development of clear regulatory guidelines for nurse-led obstetric ultrasonography. The study highlights the complex task shifting required to provide universal access to a life-saving technology in a low- and middle-income country health system.</p>","PeriodicalId":520498,"journal":{"name":"Oxford open digital health","volume":"2 ","pages":"oqae037"},"PeriodicalIF":0.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating complexities: agile digital health initiatives in developing countries.","authors":"Indu Bhushan, Kiran Anandampillai, Smisha Agarwal","doi":"10.1093/oodh/oqae032","DOIUrl":"https://doi.org/10.1093/oodh/oqae032","url":null,"abstract":"","PeriodicalId":520498,"journal":{"name":"Oxford open digital health","volume":"2 ","pages":"oqae032"},"PeriodicalIF":0.0,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: The ATIPAN project: a community-based digital health strategy toward UHC.","authors":"","doi":"10.1093/oodh/oqae024","DOIUrl":"https://doi.org/10.1093/oodh/oqae024","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/oodh/oqae011.].</p>","PeriodicalId":520498,"journal":{"name":"Oxford open digital health","volume":"2 ","pages":"oqae024"},"PeriodicalIF":0.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of digital health interventions for perinatal depression: a systematic review and meta-analysis.","authors":"Ifunanya Stellamaris Anyanwu, Judy Jenkins","doi":"10.1093/oodh/oqae026","DOIUrl":"https://doi.org/10.1093/oodh/oqae026","url":null,"abstract":"<p><p>Pregnant women and new mothers within 1 year after delivery are at a high risk of depression, yet many do not get the help they need due to wide reasons heralding stigma, access, cost, time, and shortage of human resources. Hence, compelling the exploration of alternate and potentially cost-effective means of delivering care, including the leverage of digital tools. This review aimed to evaluate the effectiveness of digital health interventions in reducing depressive symptoms among perinatal women. Literatures were sought from seven academic databases alongside the references of previous reviews. Included studies were all quantitative study types involving the use of digital health interventions for perinatal women not more than 1-year post-delivery. Standardized mean difference and standard error were used to perform random-effect model meta-analysis. Sensitivity and subgroup analyses were performed to determine certainty and modifiers of the findings, respectively. Forty-eight studies were included in this review with 28 studies used for meta-analyses. Numerous digital channels were identified; however, none specified the use of a digital health theory in its development. The digital health interventions showed a small positive significant effect over the controls (standardized mean difference = 0.29, <i>P</i> = 0.003, <i>I</i> ² = 34%), and this was significantly influenced by intervention delivery and facilitation modes, time of initiation of the intervention, and period covered by the intervention. Although digital health interventions may hold some potential for perinatal depression, scaling the interventions may be challenging sequel to overlooked influences from the interactions within the human-computer-society complex.</p>","PeriodicalId":520498,"journal":{"name":"Oxford open digital health","volume":"2 ","pages":"oqae026"},"PeriodicalIF":0.0,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mixed-methods, cross-sectional assessment of a client-facing, family planning counseling chatbot in Côte d'Ivoire.","authors":"Kristen M Little, Ndola Prata, Kpebo Djoukou Olga Denise, Nadia Tefouet, Jean Christophe Fotso, Alexandra Angel, Sarah Brittingham, Paul Bouanchaud, Amadou Donapoho Soro, Lisa Dulli","doi":"10.1093/oodh/oqae027","DOIUrl":"https://doi.org/10.1093/oodh/oqae027","url":null,"abstract":"<p><p>Evidence is limited about the feasibility, acceptability and effects on family planning (FP) intentions of digital tools, such as chatbots. To help fill this gap, we assessed a chatbot in Côte d'Ivoire with three components: (i) menstrual health information; (ii) FP information and (iii) method recommendations and referrals. We conducted a cross-sectional study to describe user characteristics and perceptions of chatbot usability, content and relevance, and perceived effects on FP-related self-efficacy. We used a mixed-methods approach, including an online survey and in-depth interviews (IDI) with chatbot users, and chatbot back-end data. Qualitative data were analyzed thematically. Quantitative data were analyzed descriptively. Between 11 January 2022 and 15 July 2022, we recruited 280 chatbot users for the survey, of whom 28 completed an in-depth interview. Survey participants averaged 22 years old, were majority female (96%), resided in Abidjan (71%) and had some university education (61%). Less than half (48%) were currently using a method to delay/avoid pregnancy. Participants primarily accessed the chatbot to get information for themselves (73%) and felt it was 'easy' (29%) or 'very easy' to use (65%). Most respondents somewhat or strongly agreed that the information provided was accurate/reliable (97%) and was useful to them (96%). Respondents reported feeling more confident in discussing FP topics with their partners and providers after interacting with the chatbot. Our findings suggest that chatbots may be a feasible and acceptable approach to sharing tailored FP information with end-users in a West African context, especially for young women in urban areas.</p>","PeriodicalId":520498,"journal":{"name":"Oxford open digital health","volume":"2 ","pages":"oqae027"},"PeriodicalIF":0.0,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the effects of digital technologies in health financing for universal health coverage: a synthesis of country experiences and lessons.","authors":"Maarten Oranje, Inke Mathauer","doi":"10.1093/oodh/oqae016","DOIUrl":"10.1093/oodh/oqae016","url":null,"abstract":"<p><p>The use of digital technologies (DTs) for health financing receives increased attention in policy, practice and research. However, not much robust evidence exists on their effects on the intermediate and final universal health coverage objectives. This paper seeks to contribute to evidence gathering, by synthesizing the findings from nine country case studies which covered diverse applications of DTs and identified their effects on health financing and universal health coverage objectives. This paper also draws on review papers on the use of DTs for health financing. Our synthesis reveals that DTs can support and simplify health financing tasks and thus contribute to enhanced efficiency and transparency and more equitable resource distribution. If well designed, DTs can help overcome challenges inherent in paper-based data systems and enable otherwise hardly implementable policy options, especially options that rely on near real-time exchange of data. Yet, the studies also point to various risks. Caution is for instance required when the use of DTs enhances inequities between population groups due to various digital divides. The findings point to a number of policy orientations. There is need to include the application of DTs for health financing in national digital health strategies and to develop health financing specific guidance and regulation. This is for instance necessary to avoid that DTs negatively affect financial protection. Clear stipulations related to equity will serve to ensure that positive effects accrue to vulnerable population groups. The future research agenda calls for more and methodologically robust evidence generation with a clear universal health coverage orientation.</p>","PeriodicalId":520498,"journal":{"name":"Oxford open digital health","volume":"2 ","pages":"oqae016"},"PeriodicalIF":0.0,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Users involvement in the electronic health information systems development process in Uganda: what is missing in relation to requirements gathering and analysis.","authors":"Christine Kalumera Akello, Josephine Nabukenya","doi":"10.1093/oodh/oqae020","DOIUrl":"https://doi.org/10.1093/oodh/oqae020","url":null,"abstract":"<p><p>User involvement in the electronic health information systems (eHIS) development process is crucial for gathering and analysing requirements that accurately reflect user needs. This is because their involvement is linked to the gathering and analysis of requirements that align with user needs. However, several studies reveal that there is still limited user involvement during these crucial phases, leading to the development of ineffective and inefficient systems that do not reflect user needs. Thus, this study explored how users were involved in the requirements gathering and analysis phases during eHIS development, with an aim of identifying the missing elements that hindered the design of more effective and effective eHIS. A cross-sectional survey, encompassing secondary and primary users, explored their involvement in the requirements gathering, analysis and design phases, using both open-ended and close ended questionnaires. Respondents (<i>n</i> = 140) were purposively selected from 20 organizations in northern and central Uganda. Data were cleaned and analysed using Microsoft Excel. The findings revealed a dominant use of a top-down approach, favouring the capture of high-level requirements at the Ministry of Health level, and among implementing partners. However, less attention was given to gathering and analysing requirements from facility-level users. Even when collected, primary users reported that their opinions and recommendations were often ignored/disregarded, resulting in eHIS designs with usability-related challenges. This study underscores the critical need for active user involvement in the early stages of eHIS development to ensure alignment with user needs and work practices.</p>","PeriodicalId":520498,"journal":{"name":"Oxford open digital health","volume":"2 ","pages":"oqae020"},"PeriodicalIF":0.0,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of a data use strategy in situation rooms in two metropolitan areas of Honduras in the context of COVID-19.","authors":"Freddy Hidalgo, Liziem Valladares, Diana Gonzalez, Lorenzo Pavón","doi":"10.1093/oodh/oqae007","DOIUrl":"https://doi.org/10.1093/oodh/oqae007","url":null,"abstract":"&lt;p&gt;&lt;p&gt;The U.S. Agency for International Development's Data for Implementation project supported the Ministry of Health in Honduras' Central District and San Pedro Sula health regions to implement a new situation room methodology to analyze data and make timely, informed decisions during the pandemic. This mixed-methods study explored if the new methodology contributed to increased workforce capacity in data use and improved leadership and governance at the regional level from 2022 to 2023. We administered a self-assessment questionnaire and semi-structured interviews to situation room participants, regional health authorities and Data.FI staff to unveil perceptions around mastery, proficiency and confidence of data use knowledge and skills and to explore any perceived changes in the digital health enabling environment. After one year of situation room implementation, most participants reported being 'competent' or 'expert' in analysis and data visualization (59%) and being 'very confident' or 'confident' in applying data use competencies (83-93%). The thematic analysis revealed five themes indicating changes in the enabling environment. Three of the themes-data analysis and visualization, peer collaboration and replicability-fall under the World Health Organization's workforce eHealth building block; two of the themes-leadership and governance of health data-fall under the leadership and governance eHealth building block. This study demonstrates the value of situation rooms as a capacity strengthening intervention and as an opportunity for use during new health emergencies. Abrégé Le projet « Data for Implementation » de l'Agence des États-Unis pour le développement international (USAID) a permis au département de la santé des régions sanitaires du district central et de San Pedro Sula du Honduras de mettre en œuvre une nouvelle méthodologie des centres opérationnels stratégiques pour analyser les données et prendre des décisions éclairées et opportunes pendant la pandémie. Cette étude à méthodes mixtes visait à déterminer si la nouvelle méthodologie avait contribué à accroître les capacités des effectifs en matière d'utilisation des données et à améliorer le leadership et la gouvernance à l'échelle régionale de 2022 à 2023. Nous avons soumis aux participants des centres opérationnels stratégiques, aux autorités sanitaires régionales et au personnel de Data.FI un questionnaire d'autoévaluation et nous avons mené des entretiens semi-structurés auprès d'eux pour cerner leurs perceptions concernant la maîtrise, l'aptitude et la confiance des connaissances et des compétences en matière d'utilisation des données et pour étudier tout changement perçu dans l'environnement propice à la santé numérique. Après un an de mise en œuvre en centre opérationnel stratégique, la plupart des participants se sont déclarés « compétents » ou « experts » en analyse et visualisation de données (59%) et « très confiants » ou « confiants » dans l'application de leurs comp","PeriodicalId":520498,"journal":{"name":"Oxford open digital health","volume":"2 Suppl 1","pages":"i40-i51"},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does investment in COVID-19 information systems strengthen national digital health architecture? Lessons learned from Burkina Faso, Indonesia, Mali and Suriname.","authors":"Colleen Boyle, Caitlin Madevu-Matson, Agus Rachmanto, Derek Kunaka, Lauren Gilliss, Leah McManus, Madina Kouyate, Maria Aruan, Nony Parmawaty, Rahim Kebe, Vijay Sewradj, Stephanie Watson-Grant","doi":"10.1093/oodh/oqae001","DOIUrl":"https://doi.org/10.1093/oodh/oqae001","url":null,"abstract":"&lt;p&gt;&lt;p&gt;There is limited research on how emergency investments can support national health information system strengthening both for a given health emergency response and for routine health program areas. This study examined the effect of COVID-19 vaccine digital investments on advancing national digital health system architectures in Burkina Faso, Indonesia, Mali and Suriname. Primary qualitative data were collected through purposively sampled key informant interviews and focus group discussions with 67 key stakeholders from government institutions, donors and implementing partners from February to May 2023. Primary data were triangulated with secondary data collected through desk review and were analyzed deductively and inductively using thematic coding. The study found that although USAID's COVID-19 vaccine digital investments in Burkina Faso, Indonesia, Mali and Suriname did not contribute to the development of formal national digital health architecture documentation, progress was made in strengthening components of national digital health architectures, specifically around standards and interoperability and around governance. Progress was also made in motivating government stakeholders to invest in formal digital health transformation efforts. Lessons learned from this study suggest that connecting investments in system development and enhancement with investments in governance and infrastructure can improve country data management processes and data use for decision-making in routine health and emergency responses. Abrégé Peu de recherches ont été effectuées sur la façon dont les investissements fournis dans les situations d'urgence peuvent appuyer le renforcement du système national d'information sur la santé, tant pour une intervention d'urgence sanitaire donnée que pour les secteurs de programmes de santé courants. Cette étude examine l'effet des investissements numériques dans le vaccin contre la COVID-19 sur le développement des architectures nationales des systèmes de santé numériques au Burkina Faso, en Indonésie, au Mali et au Suriname. Les données qualitatives primaires ont été recueillies au moyen d'entretiens auprès d'informateurs clés échantillonnés de manière ciblée et de discussions de groupes avec 67 parties prenantes clés issues d'organismes gouvernementaux, de donateurs et de partenaires de mise en œuvre entre les mois de Février et Mai 2023. Les données primaires ont été triangulées avec les données secondaires recueillies par le biais d'une étude documentaire et ont été analysées de manière déductive et inductive à l'aide d'un codage thématique. L'étude a révélé que, bien que les investissements numériques de l'USAID en faveur du vaccin contre la COVID-19 réalisés au Burkina Faso, en Indonésie, au Mali et au Suriname n'aient pas contribué au développement d'une documentation officielle sur l'architecture numérique de la santé, des progrès ont été réalisés dans le renforcement de certains éléments des architectures numériqu","PeriodicalId":520498,"journal":{"name":"Oxford open digital health","volume":"2 Suppl 1","pages":"i29-i39"},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11935742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}