ABSTRACT
Approximately 3 million children younger than 5 years living in low- and middle-income countries (LMICs) die each year from treatable clinical conditions such as pneumonia, dehydration secondary to diarrhea, and malaria. A majority of these deaths could be prevented with early clinical assessments and appropriate therapeutic intervention. In this study, we describe the development and initial validation testing of a mobile health (mHealth) platform, MEDSINC®, designed for frontline health workers (FLWs) to perform clinical risk assessments of children aged 2-60 months. MEDSINC is a web browser-based clinical severity assessment, triage, treatment, and follow-up recommendation platform developed with physician-based Bayesian pattern recognition logic. Initial validation, usability, and acceptability testing were performed on 861 children aged between 2 and 60 months by 49 FLWs in Burkina Faso, Ecuador, and Bangladesh. MEDSINC-based clinical assessments by FLWs were independently and blindly correlated with clinical assessments by 22 local health-care professionals (LHPs). Results demonstrate that clinical assessments by FLWs using MEDSINC had a specificity correlation between 84% and 99% to LHPs, except for two outlier assessments (63% and 75%) at one study site, in which local survey prevalence data indicated that MEDSINC outperformed LHPs. In addition, MEDSINC triage recommendation distributions were highly correlated with those of LHPs, whereas usability and feasibility responses from LHP/FLW were collectively positive for ease of use, learning, and job performance. These results indicate that the MEDSINC platform could significantly increase pediatric health-care capacity in LMICs by improving FLWs' ability to accurately assess health status and triage of children, facilitating early life-saving therapeutic interventions.
Subject(s)
Child Health Services , Community Health Workers , Delivery of Health Care , Health Information Systems , Rural Health Services , Algorithms , Bangladesh , Burkina Faso , Child, Preschool , Ecuador , Humans , Infant , Reproducibility of Results , TelemedicineSubject(s)
Environmental Health/standards , Environmental Pollution/adverse effects , Global Health/standards , Adolescent , Adult , Age Distribution , Aged , Air Pollutants/adverse effects , Child , Child, Preschool , Chronic Disease/epidemiology , Chronic Disease/prevention & control , Conservation of Natural Resources , Cost of Illness , Environmental Health/economics , Environmental Health/legislation & jurisprudence , Environmental Pollution/prevention & control , Female , Global Health/statistics & numerical data , Health Policy , Health Status Disparities , Humans , Infant , Infant, Newborn , International Cooperation , Male , Middle Aged , Mortality, Premature , Noncommunicable Diseases/epidemiology , Occupational Health/standards , Poverty , Residence Characteristics , Soil Pollutants/adverse effects , Water Pollutants/adverse effects , World Health Organization , Young AdultSubject(s)
Biomedical Research , Health Personnel/education , Health Services Accessibility , Health Workforce , Healthcare Financing , Leadership , Africa South of the Sahara , Conservation of Natural Resources , Delivery of Health Care , Humans , Inventions , Organizational Innovation , Public HealthSubject(s)
Communicable Disease Control , Community Health Services , Delivery of Health Care, Integrated , Adult , Burkina Faso , Child Health Services/organization & administration , Child, Preschool , Developing Countries , Disease Management , Ethiopia , Female , Humans , Infant , Malawi , National Health Programs/organization & administration , Public Health PracticeABSTRACT
The Ebola virus disease, as a first epidemic in West Africa, stands as the most deadly one throughout history. Guinea, the source of the epidemic, Sierra Leone and Liberia remain the most strongly affected. That epidemic thoroughly destabilized the health system of those countries. Following Nigeria, Senegal received its first imported case from the neighboring Republic of Guinea. In that sub regional psychotic context, such a situation has been handled and managed starting from the potential of a health system that is already suitably structured. The organization of the response, the management of the communication system and the rigorous monitoring of contacts have been decisive in the control of the epidemic. Our countries have to be prepared in order to face health threats, and that is the reason why the need to empower our health systems is important.