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Please use this identifier to cite or link to this item: http://hdl.handle.net/123456789/15210

Title: Symptom monitoring of childhood illnesses and referrals: A pilot study on the feasibility of a mobile phone-based system as a disease surveillance tool in a rural health district of Ghana
Authors: Mohammed, Aliyu
Acheampong, Princess Ruhama
Otupiri, Easmon
Owusu-Dabo, Ellis
Keywords: child health
clinical algorithm
clinical decision-making
interactive voice response mHealth
Issue Date: Oct-2019
Publisher: Health Informatics Journal
Citation: Health Informatics Journal
Abstract: Although Ghana made modest improvements with Millennium Development Goal 4, child survival interventions and efforts at reducing mortality are still lagging behind desirable levels.1 Weak health systems exacerbated by persistent challenges in developing and retaining the requisite human resource for health, inadequate access to basic proven interventions and the huge burden of endemic diseases coupled with nutrition challenges in the country conspire to reverse some of the fragile gains made.2 Improving child survival requires investment in innovative approaches such as mobile health (mHealth) – the use of mobile devices to support public health and clinical care – which could empower the rural poor, giving them the tools to recognize the signs and symptoms of childhood illnesses and, to take prompt and appropriate action. Pilot mHealth projects have proven, particularly in developing countries, that mobile phones improve communication and information-delivery as well as information retrieval processes over vast distances between healthcare service providers and clients.3 Mobile phones provide remote access to healthcare facilities, facilitate trainings and consultations among health workers, and allow for remote monitoring and surveillance to improve public health programmes.4 Ultimately, mobile phone technology has the potential to improve the efficiency and effectiveness of under-resourced health system infrastructure, which could translate into benefits for communities. In Ghana alone, mobile phone users exceed 27 million in both urban and rural regions.5 That notwithstanding, the foreseen potential of mHealth interventions in improving health systems has not been adequately explored. Few studies have examined the disease surveillance potential of mHealth in developing countries,6,7 and limited evidence exists on the use of an automated mHealth system for monitoring disease symptoms of children based on reports directly obtained from caregivers in rural communities.8–10 Hence, in order to provide empirical evidence and inform policy about the relevance of mHealth to the health sector, we examined the capacity of an mHealth system to assess the health condition of sick children and provide useful health advice to their caregivers. The system was automated and based on a clinical algorithm, so that after the caregiver answers a set of questions, data on current disease symptoms are captured by the system, and based on the severity of the disease symptoms reported by the caregiver, the system recommends a referral or home-based care. The system, therefore, provides an automated real-time syndrome-specific surveillance and early alert data. An earlier study, conducted by Franke et al.,11 examined the feasibility of using this same system to identify symptoms of common childhood illnesses at the outpatient department (OPD) of a district health facility in Ghana. The findings of this study suggest that the system was reliable and effective for detecting symptoms and providing treatment recommendations. Similarly, a qualitative assessment also found this mHealth system to be generally acceptable by the caregivers.12 This prompted the need for a community-based evaluation of the mHealth system’s capacity as a disease surveillance tool. Ultimately, this study reports on the capacity of the system to aid in assessing disease symptoms of common childhood illnesses, and provides useful referral advice to caregivers living in communities of a rural district in Ghana
Description: This article is published by Health Informatics Journal and is also available at DOI: 10.1177/1460458219879329
URI: DOI: 10.1177/1460458219879329
http://hdl.handle.net/123456789/15210
Appears in Collections:College of Health Sciences

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