Operability, Acceptability, and Usefulness of a Mobile App to Track Routine Immunization Performance in Rural Pakistan: Interview Study Among Vaccinators and Key Informants
| Autor: | Saleem Sayani, Saqib Ali Shaikh, Shehla Zaidi, Abdul Momin Kazi, Syed Shahzad Hussain, Rabia Najmi, Adeel Khoja |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Operability 020205 medical informatics media_common.quotation_subject Health Informatics Information technology 02 engineering and technology 03 medical and health sciences 0302 clinical medicine experience 0202 electrical engineering electronic engineering information engineering medicine Humans Pakistan 030212 general & internal medicine Android (operating system) Empowerment Child mHealth media_common Medical education Original Paper End user Public health Vaccination Reproducibility of Results T58.5-58.64 Mobile Applications Outreach health workers Data access Immunization Business Public aspects of medicine RA1-1270 digital technology |
| Zdroj: | JMIR mHealth and uHealth JMIR mHealth and uHealth, Vol 8, Iss 2, p e16081 (2020) |
| ISSN: | 2291-5222 |
| Popis: | Background There has been a recent spate of mobile health (mHealth) app use for immunizations and other public health concerns in low- and middle-income countries. However, recent evidence has largely focused on app development or before-and-after effects on awareness or service coverage. There is little evidence on the factors that facilitate adoption of mHealth programs, which is critical to effectively embed digital technology into mainstream health systems. Objective This study aimed to provide the qualitative experiences of frontline health staff and district managers while engaging with real-time digital technology to improve the coverage of routine childhood immunization in an underserved rural district in Pakistan. Methods An Android-based app was iteratively developed and used for a 2-year period in 11 union councils of the Tando Muhammad Khan district, an underserved rural district with poor immunization coverage in Pakistan. We used iterative methods to examine the (1) acceptability and operability of the app, (2) validity of the collected data, and (3) use of the collected data. In addition, we collected the barriers and enablers for uptake of the mHealth app. Each of these topics was further explored related to changes in work as well as the enabling factors for and barriers to app use. In-depth interviews were conducted with the 26 vaccinators posted in the 11 union councils and 7 purposively selected key informants (government district managers) involved with the Expanded Program for Immunization. Findings were triangulated in line with the three broad research areas. Results Digital immunization tracking was considered acceptable by vaccinators and district managers. Real-time immunization data were used to monitor vaccination volume, track children with incomplete vaccinations, develop outreach visit plans, correct existing microplans, and disburse a fuel allowance for outreach sessions. The validity of the app data was perceived to be superior to that of data from manual records. Ease of operability, satisfaction with data, personal recognition, links to field support, and a sense of empowerment served as powerful enablers. Taking twice the time to complete both manual and digital entries and outdated phones over time were considered constraints. An unintended knock-on effect was improved coordination and strengthening of Expanded Program for Immunization review platforms across district stakeholders through digitalized data. Conclusions Embedding digital technology into mainstream health systems relies on use by both end users and district stakeholders. Ease of operability, satisfaction with data reliability, personal recognition, links to field support, and empowerment are powerful enablers, whereas improved coordination as a result of easy, transparent data access can be an important by-product of digitalization. Findings are relevant not only for wide-scale implementation of immunization tracking apps in Pakistan but also for informing the use of digital technology for results-based delivery by frontline health workers. |
| Databáze: | OpenAIRE |
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