Mapping national information and communication technology (ICT) infrastructure to the requirements of potential digital health interventions in low- and middle-income countries.
Autor: | Hui CY; NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, University of Edinburgh, UK., Abdulla A; Department of Primary Care Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia., Ahmed Z; Riphah Institute of Healthcare Improvement & Safety and Secretary, Islamabad, Pakistan., Goel H; Centre for Technology Alternatives for Rural Areas (CTARA), Indian Institute of Technology Bombay, Mumbai, India., Monsur Habib GM; Bangladesh Primary Care Respiratory Society (BPCRS), Khulna, Bangladesh., Teck Hock T; Clinical Research Centre, Sibu Hospital, Ministry of Health Malaysia, Kuala Lumpur, Malaysia., Khandakr P; Medinova Medical Services Ltd, Dhaka, Bangladesh., Mahmood H; Neoventive Solutions, Islamabad, Pakistan., Nautiyal A; Indian Institute of Technology Bombay, Mumbai, India., Nurmansyah M; Departmentof Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia., Panwar S; Centre for Technology Alternatives for Rural Areas (CTARA), Indian Institute of Technology Bombay, Mumbai, India., Patil R; NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, University of Edinburgh, UK.; Vadu Rural Health Program, King Edward Memorial Hospital Research Centre Pune, India., Rinawan FR; Departmentof Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia., Salim H; Department of Family Medicine, Faculty of Medicine and Health Sciences, University Putra Malaysia, Kuala Lumpur, Malaysia., Satav A; MAHAN Trust, Mahatma Gandhi Tribal Hospital, Maharashtra, India., Shah JN; MAHAN Trust, Mahatma Gandhi Tribal Hospital, Maharashtra, India.; Indian Institute of Technology Bombay, Mumbai, India., Shukla A; Centre for Technology Alternatives for Rural Areas (CTARA), Indian Institute of Technology Bombay, Mumbai, India., Tanim CZH; Department of Physical Medicine and Rehabilitation, Sylhet MAG Osmani Medical College Hospital, Sylhet, Bangladesh., Balharry D; NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, University of Edinburgh, UK., Pinnock H; NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, University of Edinburgh, UK. |
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Jazyk: | angličtina |
Zdroj: | Journal of global health [J Glob Health] 2022 Dec 29; Vol. 12, pp. 04094. Date of Electronic Publication: 2022 Dec 29. |
DOI: | 10.7189/jogh.12.04094 |
Abstrakt: | Background: Digital health can support health care in low- and middle-income countries (LMICs) by overcoming problems of distance, poor infrastructure and the need to provide community practitioners with specialist support. We used five RESPIRE countries as exemplars (Bangladesh, India, Indonesia, Malaysia, Pakistan) to identify the digital health solutions that are valuable in their local setting, worked together with local clinicians and researchers to explore digital health policy, electricity/ICT infrastructure, and socio-cultural factors influencing users' ability to access, adopt and utilise digital health. Methods: We adopted the Joanna Briggs Institute's scoping review protocol and followed the Cochrane Rapid Review method to accelerate the review process, using the Implementation and Operation of Mobile Health projects framework and The Extended Technology Acceptance Model of Mobile Telephony to categorise the results. We conducted the review in four stages: (1) establishing value, (2) identifying digital health policy, (3) searching for evidence of infrastructure, design, and end-user adoption, (4) local input to interpret relevance and adoption factors. We used open-source national/international statistics such as the World Health Organization, International Telecommunication Union, Groupe Speciale Mobile, and local news/articles/government statistics to scope the current status, and systematically searched five databases for locally relevant exemplars. Results: We found 118 studies (2015-2021) and 114 supplementary online news articles and national statistics. Digital health policy was available in all countries, but scarce skilled labour, lack of legislation/interoperability support, and interrupted electricity and internet services were limitations. Older patients, women and those living in rural areas were least likely to have access to ICT infrastructure. Renewable energy has potential in enabling digital health care. Low usage mobile data and voice service packages are relatively affordable options for mHealth in the five countries. Conclusions: Effective implementation of digital health technologies requires a supportive policy, stable electricity infrastructures, affordable mobile internet service, and good understanding of the socio-economic context in order to tailor the intervention such that it functional, accessible, feasible, user-friendly and trusted by the target users. We suggest a checklist of contextual factors that developers of digital health initiatives in LMICs should consider at an early stage in the development process. Competing Interests: Disclosure of interest: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and declare that the views expressed in this publication are those of the author(s) and not necessarily those of the NIHR or the UK Government. (Copyright © 2022 by the Journal of Global Health. All rights reserved.) |
Databáze: | MEDLINE |
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