Impact of using eHealth tools to extend health services to rural areas of Nigeria: protocol for a mixed-method, non-randomised cluster trial.

Autor:	Ebenso B; Nuffield Centre for International Health and Development, University of Leeds, Leeds, UK., Allsop MJ; Nuffield Centre for International Health and Development, University of Leeds, Leeds, UK., Okusanya B; Department of Obstetrics and Gynaecology, College of Medicine, University of Lagos, Lagos, Nigeria., Akaba G; Department of Obstetrics and Gynaecology, University of Abuja, Abuja, Nigeria., Tukur J; Department of Obstetrics and Gynaecology, Aminu Kano Teaching Hospital, Kano, Nigeria., Okunade K; Department of Obstetrics and Gynaecology, College of Medicine, University of Lagos, Lagos, Nigeria., Akeju D; Department of Sociology, University of Lagos, Lagos, Nigeria., Ajepe A; Department of Obstetrics and Gynaecology, College of Medicine, University of Lagos, Lagos, Nigeria., Dirisu O; Department of Research, Population Council, Abuja, Nigeria., Yalma R; Department of Obstetrics and Gynaecology, University of Abuja, Abuja, Nigeria., Sadeeq AI; Department of Obstetrics and Gynaecology, Aminu Kano Teaching Hospital, Kano, Nigeria., Okuzu O; Corporate Office, InStrat Global Health Solutions, Abuja, Nigeria., Ors T; Inmarsat Global Ltd., Inmarsat Solutions Global Limited, London, UK., Jagger T; Inmarsat Global Ltd., Inmarsat Solutions Global Limited, London, UK., Hicks JP; Nuffield Centre for International Health and Development, University of Leeds, Leeds, UK., Mirzoev T; Nuffield Centre for International Health and Development, University of Leeds, Leeds, UK., Newell JN; Nuffield Centre for International Health and Development, University of Leeds, Leeds, UK.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2018 Oct 18; Vol. 8 (10), pp. e022174. Date of Electronic Publication: 2018 Oct 18.
DOI:	10.1136/bmjopen-2018-022174
Abstrakt:	Introduction: eHealth solutions that use internet and related technologies to deliver and enhance health services and information are emerging as novel approaches to support healthcare delivery in sub-Saharan Africa. Using digital technology in this way can support cost-effectiveness of care delivery and extend the reach of services to remote locations. Despite the burgeoning literature on eHealth approaches, little is known about the effectiveness of eHealth tools for improving the quality and efficiency of health systems functions or client outcomes in resource-limited countries. eHealth tools including satellite communications are currently being implemented at scale, to extend health services to rural areas of Nigeria, in Ondo and Kano States and the Federal Capital Territory. This paper shares the protocol for a 2-year project ('EXTEND') that aims to evaluate the impact of eHealth tools on health system functions and health outcomes. Methodology and Analysis: This multisite, mixed-method evaluation includes a non-randomised, cluster trial design. The study comprises three phases-baseline, midline and endline evaluations-that involve: (1) process evaluation of video training and digitisation of health data interventions; (2) evaluation of contextual influences on the implementation of interventions; and (3) impact evaluation of results of the project. A convergent mixed-method model will be adopted to allow integration of quantitative and qualitative findings to achieve study objectives. Multiple quantitative and qualitative datasets will be repeatedly analysed and triangulated to facilitate better understanding of impact of eHealth tools on health worker knowledge, quality and efficiency of health systems and client outcomes. Ethics and Dissemination: Ethics approvals were obtained from the University of Leeds and three States' Ministries of Health in Nigeria. All data collected for this study will be anonymised and reports will not contain information that could identify respondents. Study findings will be presented to Ministries of Health at scientific conferences and published in peer-reviewed journals. Trial Registration Number: ISRCTN32105372; Pre-results. Competing Interests: Competing interests: OO is Co-Founder and CEO of InStrat Global Health Solutions, the company that will implement the eHealth tools used in the outlined research programme. TO is Programme Director and TJ a development consultant for Inmarsat, the company providing satellite communication capability to deliver eHealth tools during the research programme. All other authors declare having no competing interests (BE, MA, BO, GA, JT, KO, DA, AA, OD, RY, JH, AIS, TM and JM). (© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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