Implementation of a Pilot Test mHealth Application to Improve Home Based Newborn Care (IMNCI) in Remote Tribal Gujarat
Journal Title: Journal of Clinical and Diagnostic Research - Year 2018, Vol 12, Issue 6
Abstract
ABSTRACT India has adopted a neonatal component to Integrated Management of Childhood Illness (IMCI), creating IMNCI. In the era of Digital India initiatives, we reviewed the appropriateness of an electronic IMNCI/IMCI, the barriers to adherence and potential of Information and Communication Technologies (ICT) for evaluation and management of young infants (0-2 months). An Audit of local and national challenges related to IMCI/IMNCI practices was performed accompanied with a review of local and global mHealth initiatives that have demonstrated success in exploring and collaborating ICT with IMCI/IMNCI practices. IMNCI algorithm for evaluation and management of neonate and young infant has a good sensitivity and specificity for referring cases with severe illness. However, gross deficiencies have been identified in the areas of long-term knowledge and skill retention among trained workers, lagging refresher training, referrals of young infants, non-availability of a trained paediatrician at rural or block level health facilities coupled with poor healthcare seeking in the postnatal period. Diagnostic discordance between IMNCI algorithm and IMNCI trained medical officers’ or health workers’ decision is also of concern. IMCI Computerised Adaptation and Training Tool and similar approaches leveraging ICT have demonstrated reduced training time, improved adherence, potential cost-effectiveness and quality data collection to strengthen program implementation and policy decisions. Smartphones have developed advanced computing capabilities, which is why development of a mobile application (app) to digitise the algorithm, to reduce the cognitive load on the peripheral worker, and to enhance utilisation of IMNCI is in process. India should pilot test m-IMNCI prototype targeting present implementation challenges as decision support technologies have considerable potential to improve coverage and quality of health care for the poor.
Authors and Affiliations
Kandarp Talati, Amee A Amin, Somashekhar M Nimbalkar
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