Abstract
BackgroundMobile phone-based technology has been used in improving the delivery of healthcare services in many countries. However, data on the effects of this technology on improving primary healthcare services in resource-poor settings are limited. The aim of this study is to develop and test a mobile phone-based system to improve health, population and nutrition services in rural Bangladesh and evaluate its impact on service delivery.MethodsThe study will use a quasi-experimental pre-post design, with intervention and comparison areas. Outcome indicators will include: antenatal care (ANC), delivery care, postnatal care (PNC), neonatal care, expanded programme on immunization (EPI) coverage, and contraceptive prevalence rate (CPR). The study will be conducted over a period of 30 months, using the existing health systems of Bangladesh. The intervention will be implemented through the existing service-delivery personnel at various primary-care levels, such as community clinic, union health and family welfare centre, and upazila health complex. These healthcare providers will be given mobile phones equipped with Apps for sending text and voice messages, along with the use of Internet and device for data-capturing. Training on handling of the Smartphones, data-capturing and monitoring will be given to selected service providers. They will also be trained on inputs, editing, verifying, and monitoring the outcome variables.DiscussionMobile phone-based technology has the potential to improve primary healthcare services in low-income countries, like Bangladesh. It is expected that our study will contribute to testing and developing a mobile phone-based intervention to improve the coverage and quality of services. The learning can be used in other similar settings in the low-and middle-income countries.
Highlights
Mobile phone-based technology has been used in improving the delivery of healthcare services in many countries
This study aims to: (i) improve the coverage of Antenatal care (ANC), delivery care and postnatal care (PNC) among pregnant woman; (ii) Improve the use of family planning services among newly-married couples; (iii) improve utilization of MNCH services, including expanded programme on immunization (EPI), to reduce neonatal and child mortality rate; and (iv) establish technologybased referral linkage of CCs with the higher facilities, such as union health and family welfare centre (UH&FWC) and upazila health complex (UHC)
We aim that the proposed mobile phone-based technology in healthcare (mHealth) project will change the measurable indicators: contraceptive prevalence rates, antenatal care visits from skilled community midwives, delivery attended by skilled birth attendants; postnatal care from skilled birth attendants by 10% points or more from the baseline level in the study area
Summary
Mobile phone-based technology has been used in improving the delivery of healthcare services in many countries. In Bangladesh, only 26% women receive the recommended four or more ANC visits, and 68% receive at least one ANC visit during their pregnancies; only 27% receive PNC, and only 29% deliveries are taken place at facilities. These are some of the important challenges facing Bangladesh for ensuring. It is necessary to increase the age at first birth as data indicate complications for both child and the mother for early marriage of women. Despite tremendous success of EPI in Bangladesh, a substantial number of children are not fully vaccinated under expanded programme on immunization (EPI) as data show 82% were fully vaccinated by the age of 12 months [3].
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