Target women: Equity in access to mHealth technology in a non-communicable disease care intervention in Kenya

English version

Autoři: Christine Ngaruiya ^aff001; Samuel Oti ^aff002; Steven van de Vijver ^aff003; Catherine Kyobutungi ^aff004; Caroline Free ^aff005
Působiště autorů: Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, United States of America ^aff001; International Development Research Centre, Nairobi, Kenya ^aff002; Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands ^aff003; African Population Health Research Center, Nairobi, Kenya ^aff004; Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom ^aff005
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0220834

Souhrn

Background

Non-Communicable Diseases (NCDs) constitute 40 million deaths annually. Eighty-percent of these deaths occur in Low- and Middle-Income Countries. MHealth provides a potentially highly effective modality for global public health, however access is poorly understood. The objective of our study was to assess equity in access to mHealth in an NCD intervention in Kenya.

Methods

This is a secondary analysis of a complex NCD intervention targeting slum residents in Kenya. The primary outcomes were: willingness to receive SMS, whether SMS was received, and access to SMS compared to alternative health information modalities. Age, sex, level of education, level of income, type of work, number of hours worked, and home environment were explanatory variables considered. Multivariable regression analyses were used to test for association using likelihood ratio testing.

Results

7,618 individual participants were included in the analysis. The median age was 44 years old. Majority (75%, n = 3,691/ 4,927) had only attended up to primary (elementary) school. Majority reported earning “KShs 7,500 or greater” (27%, n = 1,276/ 4,736). Age and level of income had evidence of association with willingness to receive SMS, and age, sex and number of hours work with whether SMS was received. SMS was the health information modality with highest odds of being accessed in older age groups (OR 4.70, 8.72 and 28.89, for age brackets 60–69, 70–79 and 80 years or older, respectively), among women (OR = 1.86, 95% CI 1.19–2.89), and second only to Baraazas (community gatherings) among those with lowest income.

Conclusion

Women had the greatest likelihood of receiving SMS. SMS performed equitably well amongst marginalized populations (elderly, women, and low-income) as compared to alternative health information modalities, though sensitization prior to implementation of mHealth interventions may be needed. These findings provide guidance for developing mHealth interventions targeting marginalized populations in these settings.

Klíčová slova:

Research and analysis methods – Social sciences – Sociology – People and places – Population groupings – Medicine and health sciences – Health care – Research design – Public and occupational health – Socioeconomic aspects of health – Education – Schools – Survey research – Surveys – Age groups – Geriatrics – Elderly – Health education and awareness

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