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Lessening barriers to healthcare in rural Ghana: providers and users' perspectives on the role of mHealth technology. A qualitative exploration.

ABSTRACT: BACKGROUND:Key barriers to healthcare use in rural Ghana include those of economic, social, cultural and institutional. Amid this, though rarely recognised in Ghanaian healthcare settings, mHealth technology has emerged as a viable tool for lessening most healthcare barriers in rural areas due to the high mobile phone penetration and possession rate. This qualitative study provides an exploratory assessment of the role of mHealth in reducing healthcare barriers in rural areas from the perspective of healthcare users and providers. METHOD:Semi-structured interviews were conducted with 30 conveniently selected healthcare users and 15 purposively selected healthcare providers within the Birim South District in the Eastern Region of Ghana between June 2017 and April 2018. Data were thematically analysed and normative standpoints of participants were presented as quotations. RESULTS:The main findings were that all the healthcare users had functioning mobile phones, however, their knowledge and awareness about mHealth was low. Meanwhile, rural health care users and providers were willing to use mHealth services involving phone call in the future as they perceived the technology to play an important role in lessening healthcare barriers. Nevertheless, factors such as illiteracy, language barrier, trust, quality of care, and mobile network connectivity were perceived as barriers associated with using mHealth in rural Ghana. CONCLUSION:The support for mHealth service is an opportunity for the development of synergistic relationship between health policy planners and mobile network companies in Ghana to design efficient communication and connectivity networks, accessible, localised, user-friendly and cost-effective mobile phone-based health programmes to assist in reducing healthcare barriers in rural Ghana.

SUBMITTER: Peprah P

PROVIDER: S-EPMC7011292 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Lessening barriers to healthcare in rural Ghana: providers and users' perspectives on the role of mHealth technology. A qualitative exploration.

Peprah Prince P Abalo Emmanuel Mawuli EM Agyemang-Duah Williams W Budu Hayford Isaac HI Appiah-Brempong Emmanuel E Morgan Anthony Kwame AK Akwasi Adjei Gyimah AG

BMC medical informatics and decision making 20200210 1

<h4>Background</h4>Key barriers to healthcare use in rural Ghana include those of economic, social, cultural and institutional. Amid this, though rarely recognised in Ghanaian healthcare settings, mHealth technology has emerged as a viable tool for lessening most healthcare barriers in rural areas due to the high mobile phone penetration and possession rate. This qualitative study provides an exploratory assessment of the role of mHealth in reducing healthcare barriers in rural areas from the pe ...[more]

PMID: 32041608

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Project description:BackgroundFollowing the 2016 Peace Agreement with the Fuerzas Armadas Revolucionarias de Colombia (FARC), Colombia promised to reincorporate more than 13,000 guerrilla fighters into its healthcare system. Despite a subsidized healthcare insurance program and the establishment of 24 Espacios Territoriales de Capacitación y Reincorporación (ETCRs-Territorial Spaces for Training and Reintegration) to facilitate this transition, data has shown that FARC ex-combatants access care at disproportionately lower rates, and face barriers to healthcare services.MethodsSemi-structured interviews were conducted with FARC health promoters and healthcare providers working in ETCRs to determine healthcare access barriers for FARC ex-combatants. Analysis was completed with a qualitative team-based coding method and barriers were categorized according to Julio Frenk's Domains of Healthcare Access framework.ResultsAmong 32 participants, 25 were healthcare providers and 7 self-identified as FARC health promoters. The sample was majority female (71.9%) and worked with the FARC for an average of 12 months in hospital, health center, medical brigade, and ETCR settings. Our sample had experiences with FARC across 16 ETCRs in 13 Departments of Colombia. Participants identified a total of 141 healthcare access barriers affecting FARC ex-combatants, which affected healthcare needs, desires, seeking, initiation and continuation. Significant barriers were related to a lack of resources in rural areas, limited knowledge of the Colombian health system, the health insurance program, perceived stigma, and transition process from the FARC health system.ConclusionsFARC ex-combatants face significant healthcare access barriers, some of which are unique from other low-resource populations in Colombia. Potential solutions to these barriers included health insurance provider partnerships with health centers close to ETCRs, and training and contracting FARC health promoters to be primary healthcare providers in ETCRs. Future studies are needed to quantify the healthcare barriers affecting FARC ex-combatants, in order to implement targeted interventions to improve healthcare access.

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Project description:Healthcare-associated infections (HAIs) remain a serious threat to patient safety worldwide, particularly in low- and middle-income countries. Reducing the burden of HAIs through the observation and enforcement of infection prevention and control (IPC) practices remains a priority. Despite growing emphasis on HAI prevention in low- and middle-income countries, limited evidence is available to improve IPC practices to reduce HAIs. This study examined the perspectives of healthcare providers (HPs) and mothers in the neonatal intensive care unit on HAIs and determined the major barriers and facilitators to promoting standard IPC practices. This study draws on data from an ethnographic study using 38 in-depth interviews, four focus group discussions and participant observation conducted among HPs and mothers in neonatal intensive care units of a secondary- and tertiary-level hospital in Ghana. The qualitative data were analysed using a grounded theory approach, and NVivo 12 to facilitate coding. HPs and mothers demonstrated a modest level of understanding about HAIs. Personal, interpersonal, community, organizational and policy-level factors interacted in complex ways to influence IPC practices. HPs sometimes considered HAI concerns to be secondary in the face of a heavy clinical workload, a lack of structured systems and the quest to protect professional authority. The positive attitudes of some HPs, and peer interactions promoted standard IPC practices. Mothers expressed interest in participation in IPC activities. It however requires systematic efforts by HPs to partner with mothers in IPC. Training and capacity building of HPs, provision of adequate resources and improving communication between HPs and mothers were recommended to improve standard IPC practices. We conclude that there is a need for institutionalizing IPC policies and strengthening strategies that acknowledge and value mothers' roles as caregivers and partners in IPC. To ensure this, HPs should be better equipped to prioritize communication and collaboration with mothers to reduce the burden of HAIs.

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Project description:Background Women’s health remains a global public health concern, as enshrined in the Sustainable Development Goals. This study, therefore, sought to assess the individual and contextual factors associated with barriers to accessing healthcare among women in Ghana. Methods The study was conducted among 9370 women aged 15–49, using data from the 2014 Ghana Demographic and Health Survey. Barrier to healthcare, derived from four questions— whether a woman faced problems in getting money, distance, companionship, and permission to see a doctor—was the outcome variable. Descriptive and multilevel logistic regression analyses were carried out. The fixed effect results of the multilevel logistic regression analyses were reported using adjusted odds ratios at a 95% confidence interval. Results More than half (51%) of the women reported to have at least one form of barrier to accessing healthcare. Women aged 45–49 (AOR?=?0.65, CI: 0.49–0.86), married women (AOR?=?0.71, CI:0.58–0.87), those with a higher level of education (AOR?=?0.51, CI: 0.37–0.69), those engaged in clerical or sales occupation (AOR?=?0.855, CI: 0.74–0.99), and those who were covered by health insurance (AOR?=?0.59, CI: 0.53–0.66) had lower odds of facing barriers in accessing healthcare. Similarly, those who listened to radio at least once in a week (AOR =0.77, CI: 0.66–0.90), those who watched television at least once a week (AOR?=?0.75, CI: 0.64–0.87), and women in the richest wealth quintile (AOR?=?0.47, CI: 0.35–0.63) had lower odds of facing barriers in accessing healthcare. However, women who were widowed (AOR?=?1.47, CI: 1.03–2.10), those in the Volta Region (AOR 2.20, CI: I.38–3.53), and those in the Upper West Region (AOR =2.22, CI: 1.32–3.74) had the highest odds of facing barriers to healthcare accessibility. Conclusion This study shows that individual and contextual factors are significant in predicting barriers in healthcare access in Ghana. The factors identified include age, marital status, employment, health insurance coverage, frequency of listening to radio, frequency of watching television, wealth status, and region of residence. These findings highlight the need to pay critical attention to these factors in order to achieve the Sustainable Development Goals 3.1, 3.7, and 3.8. It is equally important to strengthen existing strategies to mitigate barriers to accessing healthcare among women in Ghana. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-020-10017-8.

Dataset Information

Lessening barriers to healthcare in rural Ghana: providers and users' perspectives on the role of mHealth technology. A qualitative exploration.

Publications

Lessening barriers to healthcare in rural Ghana: providers and users' perspectives on the role of mHealth technology. A qualitative exploration.

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