Contextual success and pitfalls of mHealth service for maternal and child health in Africa: An Intervention, Context, Actors, Mechanism, and Outcome (ICAMO) framework guided systematic review of qualitative evidence.

IF 2.8 2区 医学 Q1 OBSTETRICS & GYNECOLOGY BMC Pregnancy and Childbirth Pub Date : 2024-10-22 DOI:10.1186/s12884-024-06885-2
Girma Gilano, Eshetu Andarge Zeleke, Andre Dekker, Rianne Fijten
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Abstract

Introduction: Mobile health (mHealth) interventions have shown potential to improve maternal and child health outcomes in Africa, but their effectiveness depends on specific interventions, context, and implementation quality. Challenges such as limited infrastructure, low digital literacy, and sustainability need to be addressed. Further evaluation studies are essential to summarize the impact of mHealth interventions. Thus, this synthesis focuses on qualitative evidence of the impact of mHealth on maternal and child health in Africa to summarize such evidence to help policy decisions.

Methods: A qualitative systematic review guided by the concepts of Intervention, Context, Mechanism, and Outcome (ICAMO) was employed in this study. The GRADE CERQual assessment and methodological constraints tools were utilized in the review to ascertain the level of confidence in the evidence and to examine the methodological limitations. The JBI checklist for qualitative research appraisal was also consulted during the review.

Results: The current review contains 32 eligible studies from databases such as CINAHL, EMBASE, MEDLINE, Scopus, Web of Science, HINARI, and Cochrane Library. The review demonstrated substantial improvements in the HCP-woman relationship, communication system, maternal and child healthcare uptake, health-seeking behavior, and HCP skills. Economic capacities, maternal education, and the low quality of existing services challenged participants.

Conclusion: mHealth significantly improves maternal and child health outcomes in Africa. This review showed it can improve healthcare access, empower women, and contribute to the region's goal of universal health coverage. However, the challenges such as low partner support, high costs for services, and poor quality of current care as narrated by women need commitment from health authorities in the continent. The evidence from this review suggests that mHealth can be implemented to improve maternal and child health in Africa.

Trial registration: PROSPERO: CRD42023461425.

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非洲母婴健康移动医疗服务的成功背景与陷阱:以 "干预、背景、行为者、机制和结果"(ICAMO)框架为指导,对定性证据进行系统审查。
导言:移动医疗(mHealth)干预措施已显示出改善非洲妇幼保健成果的潜力,但其有效性取决于具体的干预措施、环境和实施质量。需要应对的挑战包括基础设施有限、数字扫盲率低以及可持续性等。进一步的评估研究对于总结移动医疗干预措施的影响至关重要。因此,本综述侧重于移动医疗对非洲母婴健康影响的定性证据,以总结此类证据,帮助决策:本研究采用了以干预、背景、机制和结果(ICAMO)概念为指导的定性系统综述。审查中使用了 GRADE CERQual 评估和方法限制工具,以确定证据的可信度并检查方法限制。综述期间还参考了 JBI 定性研究评估清单:本次综述包含 32 项符合条件的研究,这些研究来自 CINAHL、EMBASE、MEDLINE、Scopus、Web of Science、HINARI 和 Cochrane Library 等数据库。研究结果表明,医疗保健人员与妇女的关系、沟通系统、孕产妇和儿童接受医疗保健的情况、寻求健康的行为以及医疗保健人员的技能都有了很大改善。结论:移动医疗极大地改善了非洲孕产妇和儿童的健康状况。本次研究表明,移动医疗可以改善医疗服务的可及性,增强妇女的能力,并有助于实现该地区全民医疗覆盖的目标。然而,妇女们提出的合作伙伴支持少、服务成本高、当前医疗质量差等挑战需要非洲大陆卫生当局做出承诺。本综述的证据表明,移动医疗可用于改善非洲的母婴健康:试验注册:PROCROPERO:CRD42023461425。
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来源期刊
BMC Pregnancy and Childbirth
BMC Pregnancy and Childbirth OBSTETRICS & GYNECOLOGY-
CiteScore
4.90
自引率
6.50%
发文量
845
审稿时长
3-8 weeks
期刊介绍: BMC Pregnancy & Childbirth is an open access, peer-reviewed journal that considers articles on all aspects of pregnancy and childbirth. The journal welcomes submissions on the biomedical aspects of pregnancy, breastfeeding, labor, maternal health, maternity care, trends and sociological aspects of pregnancy and childbirth.
期刊最新文献
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