(with thanks to Community Health Impact Coalition)
Read onlinne: https://mhealth.jmir.org/2024/1/e55819
Geographical region: Sub-Saharan Africa (multi-country)
Study aims: To assess whether mHealth tools used by CHWs improve uptake of antenatal care (ANC), facility-based births, and postnatal care (PNC), and to identify the social and technical factors shaping adoption.
Methods: Systematic review and narrative synthesis.
Key messages:
- mHealth most consistently shifts place of birth. Eighty-nine percent of studies reported increases in facility-based births when CHWs used digital tools.
- Effects on ANC and PNC are uneven. Digital tools alone are insufficient without supportive system design.
- Social systems matter as much as software. Trust, status, training, mentorship, supervision, and incentives repeatedly determined impact.
- mHealth works best inside strong systems. Programs pairing digital tools with supervision, equipment, and Ministry ownership performed best. CHIC has more to come on this in relation to AI in 2026—stay tuned and check out this recent announcement from the Gates Foundation and OpenAI.
Policy and Future Research Recommendations:
- Policy: Treat mHealth as an enabler of CHW systems—pairing devices with training, supervision, incentives, connectivity, and integration into routine workflows.
- Future research: Prioritize national or district-wide scale, measure early ANC and ≥8 contacts, and examine cultural and goal-setting factors.
COMMENT (NPW): The primary finding that mHealth was associated with facility-based births is at first sight positive, in the sense that facilities are the safest place for most mothers to give birth. However, it does not necessarily correlate with quality of care. An aspect of this study that I could not answer from the paper albeit only a few minutes of scanning) is whether mHealth actually led to better care: timely application of evidence according to clinical need.
HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org