Assessing implementation modalities of mhealth intervention on pregnant women in Dschang health district, West region of Cameroon

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Study Justification:
– Maternal mortality is a significant global issue, with over 340,000 maternal deaths occurring each year.
– Antenatal care (ANC) and postnatal care (PNC) are crucial for safe motherhood and improving maternal and infant health.
– mHealth interventions, which utilize mobile telecommunication and multimedia technologies, have the potential to enhance ANC and PNC services.
– This study aimed to assess the acceptable implementation modalities of mHealth intervention on pregnant women in the Dschang health district of Cameroon.
Highlights:
– The majority of pregnant women interviewed preferred receiving mHealth interventions through SMS texts in the afternoon or evening.
– Cell phones were found to be the most accessible and accepted means of communication for pregnancy and postpartum support.
– The study provides valuable insights into the preferences and needs of pregnant women in the Dschang health district regarding mHealth interventions.
Recommendations:
– Implement mHealth interventions using SMS texts in the afternoon or evening to reach pregnant women effectively.
– Develop and promote mobile applications or platforms that provide pregnancy and postpartum support to women.
– Collaborate with mobile network operators and healthcare providers to ensure the availability and affordability of mobile services for pregnant women.
– Conduct further research to evaluate the impact and effectiveness of mHealth interventions on maternal and infant health outcomes.
Key Role Players:
– Ministry of Health: Responsible for policy development and coordination of mHealth interventions.
– Healthcare providers: Involved in the implementation and delivery of mHealth interventions.
– Mobile network operators: Collaborate to ensure the availability and affordability of mobile services.
– Community health workers: Assist in the dissemination of mHealth interventions and provide support to pregnant women.
Cost Items for Planning Recommendations:
– Development and maintenance of mobile applications or platforms.
– Training and capacity building for healthcare providers and community health workers.
– Promotion and awareness campaigns to educate pregnant women about the benefits of mHealth interventions.
– Monitoring and evaluation of the effectiveness and impact of mHealth interventions.
– Collaboration and coordination efforts between stakeholders.

The strength of evidence for this abstract is 7 out of 10.
The evidence in the abstract is moderately strong. The study design is described as a cross-sectional descriptive study, which provides a snapshot of the population at a specific point in time. The sample size was determined using a formula, and the data collection methods were described. However, there is no mention of randomization or control group, which limits the ability to establish causation. To improve the strength of the evidence, the study could consider using a randomized controlled trial design, with a control group receiving standard care and an intervention group receiving the mHealth intervention. This would allow for a comparison of outcomes between the two groups and provide stronger evidence of the effectiveness of the intervention.

Introduction: every 90 seconds, a woman dies of complications related to pregnancy and childbirth, resulting in more than 340,000 maternal deaths a year. Antenatal care (ANC) and postnatal care (PNC) are significant determinants of maternal health and, particularly, safe motherhood. Antenatal care is an important predictor of safe delivery and provides health information and services that can improve the health of women and infants. mHealth broadly encompasses the use of mobile telecommunication and multimedia technologies as they are integrated within increasingly mobile and wireless health care delivery systems. This study aimed at assessing the acceptable implementation modalities of mHealth intervention on pregnant Women in Dschang health district, West Region of Cameroon.ng ba. Methods: this was a cross sectional descriptive study in the Dschang health district, West region of Cameroon. Key informants were all pregnant women from 18 years and above and a total of 372 pregnant women were included. This study was carried out from March to July 2017. Results: majority of the women, that is, 252(67.74%) were married, 117(31.45%) declaredtheir status as being single, while 3(0.81%) were devorced. Out of the 335 women that declared wanting an mHealth intervention, 41.79% of this number preferred SMS texts in the afternoon, 111(33.13%) in the evening, 46(13.73%) anytime and 38(11.34%) in the morning hours. A total of 83.33% women confirmed using telephone services. Conclusion: this study reveals that cell phones would be the acceptable medium of providing pregnancy and postpartum support to women in the Dschang health district. This is justified by the fact that a vast majority of women interviewed had access to a cell phone and referred to it as their desired and accepted means of communication.

Study design: this was a cross sectional descriptive study. Study area: the Dschang health district, West region of Cameroon. Inclusion criterion: pregnant women, with the minimum 18 years old who gave their consent to participate in the study. Exclusion criteria: pregnant women with less than 18 years and pregnant women who did not give consent to participate in the study; pregnant women who refuse to continue participating in the study after consent (inconvenient questions). Sample size: sample size was determined using the Fisher’s formula; N = minimum sample size, Z = Z–value corresponding to 95% confidence interval (1.96), P = The acceptable implementation modalities of mHealth intervention on Pregnant Women in Dschang Health district, West Region of Cameroon is not known; hence 50% will be used, e = error margin (0.05). Therefore, N= 1.96²*0.05 (1-0.05)/0.05² N=372. From the calculation, the minimum sample size is 372 pregnant women to be included. Sampling methods: the recruitment centre was the Dschang health district Hospital. This choice was made out of convenience because they account for the greatest number of prenatal consultations in the Dschang health district. Investigators interviewed all eligible women who had consented to participate in the study until the minimum sample size number was reached. Data collection and analyses: the data were collected with the use of questionnaires, pretested by some 15 female students in the department of Public Health of the university of Dschang, and made available in English (original language which the questionnaire was designed) and translated into French by a final year master’s student in Bilingual Letters of the University of Dschang. This questionnaire was adapted from a previous study by Cormick and colleagues in Argentina and the main question was on modalities of mHealth intervention on pregnant Women [9]. They wereorally administered by the investigator after prenatal consultations had been done with the selected women who had consented to participate in the study. The period of data collection was one month, one week (from the 30th of May to the 7th of July 2017), and was done in the Dschang district hospital. There are pre organised sessions of prenatal consultations on every Mondays, so, special emphasis and mobilisation was done every Monday to administer questionnaires to pregnant women. Sampling was performed by convenience. Investigators recruited all eligible women who consented to participate until the minimum sample size number was reached. The questionnaires were then coded and entered in EPI Info 7.1.3.3 and thus analysed. Descriptive and inferential statistical analyses were used. Data quality assessment: questionnaires were checked by the principal investigator for completeness on a daily basis by immediate supervisors. After checking for consistency and completeness, the supervisor submitted the filled questionnaire to the principal investigator. Incorrectly filled or missed ones were sent back to respective data collectors for correction. The principal investigator again rechecked the completed questionnaires to maintain the quality of data. Ethical considerations: given the fact that this research involved humans (participants, investigator, data collectors), ethical consideration was mandatory. In this light, ethical clearance was obtained from the National Ethical Committee in Yaoundé (Ref: 446/17). Potential risk minimization: the participants of this research (community individuals of all ages) have some potential risk link to this study which includes: violation of autonomy, rupture of confidentiality on the private data with regards to participants, exploitation of participants and inequality in risk/benefit ratio and also rupture of social equilibrium in the community. Such potential risks were minimized by all the information mentioned in the information notice. These risks were minimized in the following ways: administering Informed Consent to participants before administering questionnaire; Respecting the autonomy of participants; The data collection tool (questionnaire) were anonymous, and access to data was restricted only to those concerned, physical and electronic barriers; Electronic data were stored in an apple cloud account accessible only to the principal investigator and the physical questionnaires burned after verification of data; Permission was obtained both from the District administration and the hospital administration.

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Based on the information provided, here are some potential innovations that can be used to improve access to maternal health:

1. mHealth Intervention: The study mentioned the use of mobile telecommunication and multimedia technologies as part of mHealth intervention. This can be further developed and implemented to provide pregnant women with important health information and services through mobile phones.

2. SMS Texts: The study found that a significant number of pregnant women preferred receiving SMS texts for mHealth intervention. This can be utilized as a means to deliver timely and relevant information about antenatal care, postnatal care, and safe motherhood practices.

3. Mobile Applications: Developing mobile applications specifically designed for maternal health can provide pregnant women with easy access to information, appointment reminders, and personalized care plans. These applications can also include features such as tracking baby’s growth, monitoring maternal health indicators, and connecting with healthcare providers.

4. Telemedicine: Implementing telemedicine services can enable pregnant women in remote or underserved areas to access healthcare professionals through video consultations. This can help address the lack of healthcare facilities and specialists in certain regions, improving access to prenatal and postnatal care.

5. Community Health Workers: Training and equipping community health workers with mobile devices can enhance their ability to provide maternal health services and education in rural areas. These workers can use mobile devices to collect and transmit data, conduct health assessments, and communicate with healthcare professionals for guidance and support.

6. Mobile Clinics: Mobile clinics equipped with necessary medical equipment and staffed by healthcare professionals can reach remote areas and provide essential maternal health services. These clinics can travel to different locations on a regular schedule, ensuring that pregnant women have access to prenatal care and necessary interventions.

7. Health Information Hotlines: Establishing toll-free hotlines dedicated to maternal health can provide pregnant women with a direct line to healthcare professionals who can answer their questions, provide guidance, and offer support. This can be particularly beneficial for women who may not have access to mobile phones or internet services.

It is important to note that the implementation of these innovations should consider the specific context and needs of the target population, as well as ensure privacy and data security measures are in place.
AI Innovations Description
The recommendation to improve access to maternal health based on the study is the implementation of a mobile health (mHealth) intervention using SMS texts. The study found that a majority of pregnant women in the Dschang health district of Cameroon have access to cell phones and consider it their desired and accepted means of communication. Therefore, utilizing SMS texts as a medium of providing pregnancy and postpartum support can be an effective way to improve access to maternal health services.

The mHealth intervention can be designed to send SMS texts with important health information and reminders to pregnant women. These messages can include information about antenatal care visits, nutrition, breastfeeding, and postpartum care. By delivering these messages directly to the women’s cell phones, it ensures that they receive the necessary information and support even if they are unable to attend in-person consultations.

The implementation of the mHealth intervention should consider the preferences of the pregnant women in terms of timing for receiving the SMS texts. The study found that a significant number of women preferred to receive the messages in the afternoon and evening. Therefore, the intervention should be designed to accommodate these preferences to maximize engagement and effectiveness.

To ensure the success of the mHealth intervention, it is important to establish partnerships with local healthcare providers and organizations. This collaboration can help in developing the content of the SMS texts, ensuring accuracy and relevance to the local context. Additionally, healthcare providers can play a role in promoting the mHealth intervention to pregnant women during their antenatal care visits.

Regular monitoring and evaluation of the mHealth intervention should be conducted to assess its impact on improving access to maternal health services. This can include tracking the number of women who receive and engage with the SMS texts, as well as measuring changes in knowledge and behavior related to maternal health.

Overall, implementing an mHealth intervention using SMS texts can be an innovative approach to improve access to maternal health services in the Dschang health district of Cameroon. By utilizing the widespread availability of cell phones, this intervention can provide pregnant women with important health information and support, ultimately contributing to safer pregnancies and childbirths.
AI Innovations Methodology
Based on the provided information, here are some potential recommendations for improving access to maternal health:

1. Implement a mobile health (mHealth) intervention: Given the widespread use of cell phones in the Dschang health district, an mHealth intervention can be developed to provide pregnancy and postpartum support to women. This can include sending SMS texts with health information, appointment reminders, and personalized advice.

2. Provide antenatal care (ANC) and postnatal care (PNC) services through mobile platforms: Utilize mobile platforms to deliver ANC and PNC services, such as virtual consultations with healthcare providers, remote monitoring of vital signs, and access to educational resources.

3. Establish a maternal health hotline: Set up a dedicated hotline where pregnant women can call or text to receive immediate assistance, ask questions, and seek guidance on maternal health issues.

4. Develop a mobile application for maternal health: Create a user-friendly mobile application that provides comprehensive information on pregnancy, childbirth, and postpartum care. The app can include features like appointment scheduling, medication reminders, and access to emergency services.

To simulate the impact of these recommendations on improving access to maternal health, a methodology can be developed as follows:

1. Define the indicators: Identify key indicators to measure the impact of the recommendations, such as the number of pregnant women accessing ANC and PNC services, the rate of maternal mortality, the level of satisfaction among pregnant women, and the utilization of the mHealth intervention.

2. Collect baseline data: Gather data on the current state of maternal health in the Dschang health district, including the number of pregnant women receiving ANC and PNC services, the maternal mortality rate, and the availability of healthcare facilities.

3. Implement the recommendations: Roll out the proposed recommendations, including the mHealth intervention, hotline, and mobile application. Ensure that pregnant women are aware of and have access to these services.

4. Monitor and evaluate: Continuously monitor the implementation of the recommendations and collect data on the selected indicators. This can be done through surveys, interviews, and data analysis.

5. Analyze the data: Analyze the collected data to assess the impact of the recommendations on improving access to maternal health. Compare the baseline data with the post-implementation data to identify any changes or improvements.

6. Draw conclusions and make recommendations: Based on the analysis of the data, draw conclusions about the effectiveness of the recommendations in improving access to maternal health. Identify any challenges or areas for improvement and make recommendations for further enhancements.

By following this methodology, it will be possible to simulate the impact of the recommendations on improving access to maternal health in the Dschang health district.

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