2023-09-28 14:46:10 +00:00
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abstract: 'Background: The in-service training of frontline health workers (FHWs)
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in primary health care facilities plays an important role in improving
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the standard of health care delivery. However, it is often expensive and
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requires FHWs to leave their posts in rural areas to attend courses in
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urban centers. This study reports the implementation of a digital health
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tool for providing video training (VTR) on maternal, newborn, and child
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health (MNCH) care to provide in-service training at scale without
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interrupting health services. The VTR intervention was supported by
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satellite communications technology and existing 3G mobile networks.
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Objective: This study aims to determine the feasibility and
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acceptability of these digital health tools and their potential
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effectiveness in improving clinical knowledge, attitudes, and practices
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related to MNCH care.
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Methods: A mixed methods design, including an uncontrolled pre- and
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postquantitative evaluation, was adopted. From October 2017 to May 2018,
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a VTR mobile intervention was delivered to FHWs in 3 states of Nigeria.
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We examined changes in workers'' knowledge and confidence in delivering
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MNCH services through a pre- and posttest survey. Stakeholders''
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experiences with the intervention were explored through semistructured
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interviews that drew on the technology acceptance model to frame
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contextual factors that shaped the intervention''s acceptability and
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usability in the work environment.
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Results: In total, 328 FHWs completed both pre- and posttests. FHWs
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achieved a mean pretest score of 51\% (95\% CI 48\%-54\%) and mean
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posttest score of 69\% (95\% CI 66\%-72\%), reflecting, after adjusting
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for key covariates, a mean increase between the pre- and posttest of 17
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percentage points (95\% CI 15-19; P<.001). Variation was identified in
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pre- and posttest scores by the sex and location of participants
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alongside topic-specific areas where scores were lowest. Stakeholder
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interviews suggested a wide acceptance of VTR Mobile (delivered via
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digital technology) as an important tool for enhancing the quality of
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training, reinforcing knowledge, and improving health outcomes.
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Conclusions: This study found that VTR supported through a digital
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technology approach is a feasible and acceptable approach for supporting
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improvements in clinical knowledge, attitudes, and reported practices in
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MNCH. The determinants of technology acceptance included ease of use,
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perceived usefulness, access to technology and training contents, and
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the cost-effectiveness of VTR, whereas barriers to the adoption of VTR
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were poor electricity supply, poor internet connection, and
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FHWs''workload. The evaluation also identified the mechanisms of the
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impact of delivering VTR Mobile at scale on the micro (individual), meso
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(organizational), and macro (policy) levels of the health system. Future
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research is required to explore the translation of this digital health
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approach for the VTR of FHWs and its impact across low-resource settings
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to ameliorate the financial and time costs of training and support
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high-quality MNCH care delivery.'
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affiliation: 'Allsop, MJ (Corresponding Author), Univ Leeds, Acad Unit Palliat Care,
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Leeds Inst Hlth Sci, Worsley Bldg,Clarendon Way, Leeds LS2 9LU, W Yorkshire, England.
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Hicks, Joseph Paul; Ebenso, Bassey, Univ Leeds, Nuffield Ctr Int Hlth \& Dev, Leeds,
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W Yorkshire, England.
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Allsop, Matthew John, Univ Leeds, Acad Unit Palliat Care, Leeds Inst Hlth Sci, Worsley
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Bldg,Clarendon Way, Leeds LS2 9LU, W Yorkshire, England.
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Akaba, Godwin O., Univ Abuja, Dept Obstet \& Gynaecol, Abuja, Nigeria.
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Yalma, Ramsey M., Univ Abuja, Dept Community Med, Abuja, Nigeria.
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Dirisu, Osasuyi, Populat Council, Abuja, Nigeria.
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Okusanya, Babasola; Okunade, Kehinde; Ajepe, Adegbenga, Univ Lagos, Coll Med, Dept
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Obstet \& Gynaecol, Lagos, Nigeria.
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Tukur, Jamilu, Aminu Kano Teaching Hosp, Kano, Nigeria.
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Akeju, David, Univ Lagos, Coll Med, Dept Sociol, Lagos, Nigeria.
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Okuzu, Okey, Instrat Global Hlth Solut, Abuja, Nigeria.
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Mirzoev, Tolib, London Sch Hyg \& Trop Med, Dept Global Hlth \& Dev, London, England.'
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article-number: e24182
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author: Hicks, Joseph Paul and Allsop, Matthew John and Akaba, Godwin O. and Yalma,
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Ramsey M. and Dirisu, Osasuyi and Okusanya, Babasola and Tukur, Jamilu and Okunade,
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Kehinde and Akeju, David and Ajepe, Adegbenga and Okuzu, Okey and Mirzoev, Tolib
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and Ebenso, Bassey
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author-email: m.j.allsop@leeds.ac.uk
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author_list:
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- family: Hicks
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given: Joseph Paul
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- family: Allsop
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given: Matthew John
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- family: Akaba
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given: Godwin O.
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- family: Yalma
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given: Ramsey M.
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- family: Dirisu
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given: Osasuyi
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- family: Okusanya
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given: Babasola
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- family: Tukur
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given: Jamilu
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- family: Okunade
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given: Kehinde
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- family: Akeju
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given: David
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- family: Ajepe
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given: Adegbenga
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- family: Okuzu
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given: Okey
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- family: Mirzoev
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given: Tolib
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- family: Ebenso
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given: Bassey
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da: '2023-09-28'
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doi: 10.2196/24182
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files: []
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issn: 2291-5222
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journal: JMIR MHEALTH AND UHEALTH
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keywords: 'primary health worker training; digital health technology; eHealth;
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video-based training; maternal and child health; Nigeria; mobile phone'
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keywords-plus: MIDDLE-INCOME COUNTRIES; MOBILE HEALTH
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language: English
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month: SEP
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number: '9'
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number-of-cited-references: '39'
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orcid-numbers: 'AKABA, GODWIN/0000-0002-8149-5492
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AKABA, GODWIN/0000-0002-8149-5492
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Ebenso, Dr. Bassey E./0000-0003-4147-0968
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Mirzoev, Tolib/0000-0003-2959-9187
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Allsop, Matthew/0000-0002-7399-0194
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Hicks, Joseph/0000-0002-0303-6207
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Tukur, Jamilu/0000-0002-1529-0448
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OKUNADE, KEHINDE/0000-0002-0957-7389
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Ajepe, Adegbenga/0000-0002-4967-4597'
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papis_id: 6528c951ff20d54abfc80fd8dec9881e
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ref: Hicks2021acceptabilitypotenti
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researcherid-numbers: 'Yalma, Ramsey Msheliza/AGZ-4237-2022
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AKABA, GODWIN/GLV-1941-2022
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AKABA, GODWIN/S-7756-2019
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Ebenso, Dr. Bassey E./H-5536-2017
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OKUNADE, KEHINDE/A-8201-2017
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'
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times-cited: '4'
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title: 'Acceptability and Potential Effectiveness of eHealth Tools for Training Primary
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Health Workers From Nigeria at Scale: Mixed Methods, Uncontrolled Before-and-After
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Study'
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000709011500002
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usage-count-last-180-days: '1'
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usage-count-since-2013: '2'
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volume: '9'
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web-of-science-categories: Health Care Sciences \& Services; Medical Informatics
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year: '2021'
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