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Using mobile technologies to support the training of community health workers in low-income and middle-income countries: mapping the evidence
  1. Niall Winters1,
  2. Laurenz Langer2,
  3. Promise Nduku2,
  4. James Robson1,
  5. James O'Donovan1,
  6. Pallab Maulik3,4,
  7. Chris Paton5,
  8. Anne Geniets1,
  9. David Peiris6,
  10. Shobhana Nagraj7,8
  1. 1Department of Education, University of Oxford, Oxford, UK
  2. 2Africa Centre for Evidence, University of Johannesburg, Johannesburg, South Africa
  3. 3George Institute for Global Health India, New Delhi, India
  4. 4Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
  5. 5Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
  6. 6The George Institute for Global Health, UNSW Sydney, Sydney, New South Wales, Australia
  7. 7Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, UK
  8. 8George Institute for Global Health, Oxford, UK
  1. Correspondence to Dr Niall Winters; niall.winters{at}education.ox.ac.uk

Abstract

Introduction This paper maps the evidence published between 2000 and 2018 on the use of mobile technologies to train community health workers (CHWs) in low- and middle-income countries (LMICs) across nine areas of global healthcare, including the neglected areas of disability and mental health.

Methods We used an evidence mapping methodology, based on systematic review guidelines, to systematically and transparently assess the available evidence-base. We searched eight scientific databases and 54 grey literature sources, developed explicit inclusion criteria, and coded all included studies at full text for key variables. The included evidence-base was visualised and made accessible through heat mapping and the development of an online interactive evidence interface.

Results The systematic search for evidence identified a total of 2530 citations of which 88 met the full inclusion criteria. Results illustrate overall gaps and clusters of evidence. While the evidence map shows a positive shift away from information dissemination towards approaches that use more interactive learner-centred pedagogies, including supervision and peer learning, this was not seen across all areas of global health. Areas of neglect remain; no studies of trauma, disability, nutrition or mental health that use information dissemination, peer learning or supervision for training CHWs in LMICs were found.

Conclusion The evidence map shows significant gaps in the use of mobile technologies for training, particularly in the currently neglected areas of global health. Significant work will be needed to improve the evidence-base, including assessing the quality of mobile-based training programmes.

  • systematic review
  • health education and promotion
  • public health

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Footnotes

  • NW and LL are joint first authors.

  • Handling editor Kerry Scott

  • Contributors Background framing and establishment of the research question: NW and LL. Mapping framework: All authors. Development of search strategy: LL, CP, AG, SN and NW. Database search: LL, PN and JR. Record screening: PN, JR and JOD; Coding and data extraction: PN, JR, LL and JOD. Evidence Mapping Visualisation: LL. Discussion: All authors. Conclusion: NW and LL. First draft: NW and LL. All authors provided comments on drafts of the article and approved the final version for publication.

  • Funding This research was funded by the University of Oxford under the HEFCE-GCRF support fund, project number: 0005267. The funder had no role in the study design, data collection, data analysis or writing of the manuscript. JO is a DPhil candidate at The University of Oxford and is supported by a grant from the Economic and Social Research Council (ES/P000649/1). SN is funded through a Medical Research Council Clinical Training Fellowship.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.

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