Digital Health
- Unintended Consequences of mHealth Interactive Voice Messages Promoting Contraceptive Use After Menstrual Regulation in Bangladesh: Intimate Partner Violence Results From a Randomized Controlled Trial
Automated interactive voice messages about post-menstrual regulation contraception delivered to women in Bangladesh via mobile phone were associated with increased reports of intimate partner violence. This finding highlights the importance of taking steps to minimize risk when delivering phone messages on sensitive topics and the need for assessing violence in such situations.
- Getting to the First 90: Incentivized Peer Mobilizers Promote HIV Testing Services to Men Who Have Sex With Men Using Social Media in Mumbai, India
This peer mobilization pilot for HIV and syphilis testing used messaging on gay dating sites, clinic referrals, and peer recruitment to reach men who have sex with men in Mumbai. In 6 months, the pilot reached a relatively modest 247 individuals, 244 of whom had never tested for HIV. Challenges included low recruitment and loss to follow-up for posttest counseling and treatment initiation for individuals with HIV.
- Cell Phone Counseling Improves Retention of Mothers With HIV Infection in Care and Infant HIV Testing in Kisumu, Kenya: A Randomized Controlled Study
Tailored, one-on-one counseling delivered via cell phone was very effective in retaining mothers with HIV in care and in promoting infant HIV testing and antenatal and postnatal care attendance. The highest risk of loss to follow-up among women with HIV accessing PMTCT services was prior to delivery and then after infant HIV testing at 6 weeks. Challenges include continued limited access to cell phones, difficulty with reaching participants on the phone, and poor adherence to antiretroviral therapy for a substantial percentage of the population.
- Efficacy of a Digital Health Tool on Contraceptive Ideation and Use in Nigeria: Results of a Cluster-Randomized Control Trial
A mobile digital health tool piloted in Kaduna City, Nigeria, was efficacious in promoting positive contraceptive attitudes and encouraging women to adopt a modern contraceptive method, thus showing potential for reducing unmet need in Nigeria.
- Unpacking the “Black Box”: How an SMS-Based Continuing Medical Education Intervention Improved Medical Knowledge Among HIV Clinicians in Vietnam
Daily SMS quizzes sent to medical practitioners seem to act as a stimulus for further self-study when paired with access to additional readings and online courses, improving medical knowledge as a result.
- mLearning in the Democratic Republic of the Congo: A Mixed-Methods Feasibility and Pilot Cluster Randomized Trial Using the Safe Delivery App
Health worker knowledge and self-confidence in basic emergency obstetric and newborn care (BEmONC) increased significantly 3 months after introduction of the Safe Delivery App in intervention facilities compared with controls.
- Digital Health and Health Systems of the Future
Digital strategies have been formally recognized as a critical health systems strengthening strategy to help meet the Sustainable Development Goals and universal health coverage targets. This landscaping collection reviews multiple possible approaches across health system pillars, from digital referrals to decision support systems, identifying key knowledge gaps across these domains and recognizing the growth needed in the field to realize its full potential.
- What Does It Take to Be an Effective National Steward of Digital Health Integration for Health Systems Strengthening in Low- and Middle-Income Countries?
A purposeful literature review of peer-reviewed and gray literature identified 4 broad thematic areas of digital health stewardship—strategic direction, policies and procedures, roles and responsibilities, and health service delivery—that need further research and development in order for digital health to be better positioned to positively impact low- and middle-income country health systems.
- The Role of Digital Strategies in Financing Health Care for Universal Health Coverage in Low- and Middle-Income Countries
The development and adoption of effective digital health financing solutions that fit well in both coherent digital health information architectures and the universal health coverage agenda will require strong partnerships between entrepreneurs, developers, implementers, policy makers, and funders.
- Digital Technologies for Health Workforce Development in Low- and Middle-Income Countries: A Scoping Review
Digital health interventions have the potential to improve the health workforce by supporting training, supervision, and communication. More evidence is needed on the effectiveness of interventions implemented at scale, including the return on investment, the effect of government and donor policies on scale up, and the role of the private sector.