Acceptability and Potential Effectiveness of eHealth Tools for Training Primary Health Workers From Nigeria at Scale: Mixed Methods, Uncontrolled Before-and-After Study
| Autor: | Babasola O. Okusanya, Okey Okuzu, Matthew J Allsop, Kehinde S Okunade, Joseph P. Hicks, Adegbenga Ajepe, Ramsey M. Yalma, David Akeju, Jamilu Tukur, Osasuyi Dirisu, Tolib Mirzoev, Bassey Ebenso, Godwin O Akaba |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
digital health technology
Health Personnel Child Health Services Nigeria Health Informatics video-based training primary health worker training Nursing eHealth Humans Child Reproductive health Original Paper mobile phone business.industry Infant Newborn Workload Usability maternal and child health Digital health Telemedicine Scale (social sciences) Technology acceptance model Rural area business Psychology Delivery of Health Care |
| Zdroj: | JMIR mHealth and uHealth |
| ISSN: | 2291-5222 |
| Popis: | BackgroundThe in-service training of frontline health workers (FHWs) in primary health care facilities plays an important role in improving the standard of health care delivery. However, it is often expensive and requires FHWs to leave their posts in rural areas to attend courses in urban centers. This study reports the implementation of a digital health tool for providing video training (VTR) on maternal, newborn, and child health (MNCH) care to provide in-service training at scale without interrupting health services. The VTR intervention was supported by satellite communications technology and existing 3G mobile networks.ObjectiveThis study aims to determine the feasibility and acceptability of these digital health tools and their potential effectiveness in improving clinical knowledge, attitudes, and practices related to MNCH care.MethodsA mixed methods design, including an uncontrolled pre- and postquantitative evaluation, was adopted. From October 2017 to May 2018, a VTR mobile intervention was delivered to FHWs in 3 states of Nigeria. We examined changes in workers’ knowledge and confidence in delivering MNCH services through a pre- and posttest survey. Stakeholders’ experiences with the intervention were explored through semistructured interviews that drew on the technology acceptance model to frame contextual factors that shaped the intervention’s acceptability and usability in the work environment.ResultsIn total, 328 FHWs completed both pre- and posttests. FHWs achieved a mean pretest score of 51% (95% CI 48%-54%) and mean posttest score of 69% (95% CI 66%-72%), reflecting, after adjusting for key covariates, a mean increase between the pre- and posttest of 17 percentage points (95% CI 15-19; PConclusionsThis study found that VTR supported through a digital technology approach is a feasible and acceptable approach for supporting improvements in clinical knowledge, attitudes, and reported practices in MNCH. The determinants of technology acceptance included ease of use, perceived usefulness, access to technology and training contents, and the cost-effectiveness of VTR, whereas barriers to the adoption of VTR were poor electricity supply, poor internet connection, and FHWs’ workload. The evaluation also identified the mechanisms of the impact of delivering VTR Mobile at scale on the micro (individual), meso (organizational), and macro (policy) levels of the health system. Future research is required to explore the translation of this digital health approach for the VTR of FHWs and its impact across low-resource settings to ameliorate the financial and time costs of training and support high-quality MNCH care delivery.Trial RegistrationISRCTN Registry 32105372; https://www.isrctn.com/ISRCTN32105372 |
| Databáze: | OpenAIRE |
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