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People Welcomed This Innovation with Two Hands: : A Qualitative Report of an mHealth Intervention for Community Case Management in Malawi

Ide, Nicole ; Hardy, Victoria ; Chirambo, Griphin Baxter ; Heavin, Ciara ; O’Connor, Yvonne ; O'Donoghue, John ; Mastellos, Nikolaos ; Dharmayat, Kanika ; Andersson, Bo LU and Carlsson, Sven LU , et al. (2019) In Annals of Global Health 85(1).
Abstract
Introduction: Community Case Management (CCM) aims to improve health outcomes among children under five with malaria, diarrhea, and pneumonia, but its effectiveness in Malawi is limited by inconsistent standards of delivery characteristic of paper-based interventions. This may lead to negative impacts on child health outcomes and inefficient use of health system resources. This study evaluated the acceptability and impact of the Supporting LIFE Community Case Management App (SL eCCM App) by Health Surveillance Assistants (HSAs) and caregivers in two districts of Northern Malawi.
Methods: Data were collected through semi-structured interviews with HSAs and caregivers as part of a nested study within a larger trial. We used deductive and... (More)
Introduction: Community Case Management (CCM) aims to improve health outcomes among children under five with malaria, diarrhea, and pneumonia, but its effectiveness in Malawi is limited by inconsistent standards of delivery characteristic of paper-based interventions. This may lead to negative impacts on child health outcomes and inefficient use of health system resources. This study evaluated the acceptability and impact of the Supporting LIFE Community Case Management App (SL eCCM App) by Health Surveillance Assistants (HSAs) and caregivers in two districts of Northern Malawi.
Methods: Data were collected through semi-structured interviews with HSAs and caregivers as part of a nested study within a larger trial. We used deductive and inductive approaches during data analysis. Relevant constructs were identified from the Consolidated Framework for Implementation Research and combined with emerging concepts from the data. The Framework Method was used to chart and explore data, leading to the development of themes.
Results: Seventeen HSAs and 28 caregivers were interviewed. Participants were generally enthusiastic about the SL eCCM App. Nearly all HSAs expressed a preference for the App over routine paper-based CCM. Most HSAs claimed the App was more reliable and less error prone, facilitated more accurate diagnoses and treatment recommendations, and enhanced professional confidence and respect in the community. Some HSAs believed additional features would improve usability of the App, others identified mobile network or electricity shortages as barriers. Not all caregivers understood the purpose of the App, but most welcomed it as a health and technological advancement.
Conclusion: The SL eCCM App is acceptable to both HSAs and caregivers, and in most cases, preferred, as it was believed to foster improvements in CCM delivery. Our findings suggest that mobile health interventions for CCM, such as the SL eCCM App, may have potential to improve the effectiveness and efficiency of care to children under five. (Less)
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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Annals of Global Health
volume
85
issue
1
article number
61
publisher
Elsevier USA
external identifiers
  • scopus:85065404593
  • pmid:31025838
ISSN
2214-9996
DOI
10.5334/aogh.919
language
English
LU publication?
yes
id
1ce51010-f9f8-4262-b175-fca80a5b60c0
date added to LUP
2019-04-25 17:56:17
date last changed
2020-10-07 06:25:33
@article{1ce51010-f9f8-4262-b175-fca80a5b60c0,
  abstract     = {Introduction: Community Case Management (CCM) aims to improve health outcomes among children under five with malaria, diarrhea, and pneumonia, but its effectiveness in Malawi is limited by inconsistent standards of delivery characteristic of paper-based interventions. This may lead to negative impacts on child health outcomes and inefficient use of health system resources. This study evaluated the acceptability and impact of the Supporting LIFE Community Case Management App (SL eCCM App) by Health Surveillance Assistants (HSAs) and caregivers in two districts of Northern Malawi.<br/>Methods: Data were collected through semi-structured interviews with HSAs and caregivers as part of a nested study within a larger trial. We used deductive and inductive approaches during data analysis. Relevant constructs were identified from the Consolidated Framework for Implementation Research and  combined with emerging concepts from the data. The Framework Method was used to chart and explore data, leading to the development of themes.<br/>Results: Seventeen HSAs and 28 caregivers were interviewed. Participants were generally enthusiastic about the SL eCCM App. Nearly all HSAs expressed a preference for the App over routine paper-based CCM. Most HSAs claimed the App was more reliable and less error prone, facilitated more accurate diagnoses and treatment recommendations, and enhanced professional confidence and respect in the community. Some HSAs believed additional features would improve usability of the App, others identified mobile network or electricity shortages as barriers. Not all caregivers understood the purpose of the App, but most welcomed it as a health and technological advancement. <br/>Conclusion: The SL eCCM App is acceptable to both HSAs and caregivers, and in most cases, preferred, as it was believed to foster improvements in CCM delivery. Our findings suggest that mobile health interventions for CCM, such as the SL eCCM App, may have potential to improve the effectiveness and efficiency of care to children under five.},
  author       = {Ide, Nicole and Hardy, Victoria and Chirambo, Griphin Baxter and Heavin, Ciara and O’Connor, Yvonne and O'Donoghue, John and Mastellos, Nikolaos and Dharmayat, Kanika and Andersson, Bo and Carlsson, Sven and Muula, Adamson and Thompson, Matthew},
  issn         = {2214-9996},
  language     = {eng},
  number       = {1},
  publisher    = {Elsevier USA},
  series       = {Annals of Global Health},
  title        = {People Welcomed This Innovation with Two Hands: : A Qualitative Report of an mHealth Intervention for Community Case Management in Malawi},
  url          = {http://dx.doi.org/10.5334/aogh.919},
  doi          = {10.5334/aogh.919},
  volume       = {85},
  year         = {2019},
}