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dc.contributor.authorOtu, Akaninyene Asuquo; orcid: 0000-0002-6009-2707
dc.contributor.authorEffa, Emmanuel E
dc.contributor.authorOnwusaka, Obiageli
dc.contributor.authorOmoyele, Chiamaka
dc.contributor.authorArakelyan, Stella; orcid: 0000-0003-0326-707X
dc.contributor.authorOkuzu, Okey
dc.contributor.authorWalley, John
dc.date.accessioned2022-09-22T11:06:51Z
dc.date.available2022-09-22T11:06:51Z
dc.date.issued2022-08-26
dc.date.submitted2021-12-19
dc.identifierpublisher-id: bmjopen-2021-060304
dc.identifierdoi: 10.1136/bmjopen-2021-060304
dc.identifier.citationBMJ Open, volume 12, issue 8, article-number e060304
dc.identifier.urihttps://eresearch.qmu.ac.uk/handle/20.500.12289/12590
dc.descriptionFrom BMJ via Jisc Publications Router
dc.descriptionHistory: received 2021-12-19, accepted 2022-07-12, ppub 2022-08, epub 2022-08-26
dc.descriptionPeer reviewed: True
dc.descriptionAcknowledgements: We appreciate the NCD division of the FMOH, Nigeria, Cross River State Ministry of Health and Primary Healthcare Development Agency as well as nurses and facility heads who participated in the pilot. We are grateful to all the patients who accepted to be managed using the NCD guides in the various health facilities in Cross River State Nigeria. We are thankful to Mr Tijesu Ojumu of the Nigeria Centre for Disease Control for designing the conceptual framework. Our sincere gratitude goes to the NIHR RUHF project of QMU Edinburgh for funding this initiative.
dc.descriptionPublication status: Published
dc.descriptionFunder: UK National Institute for Health Research (NIHR) [NIHR Global Health Research programme /NIHR Research Unit on Health in Situations of Fragility].; Grant(s): 16/136/100
dc.description.abstractObjective: To pilot the use of a scalable innovative mobile health (mHealth) non-communicable diseases (NCDs) training application for nurses at the primary care level. Design: Mixed methods pilot of mHealth training on NCD care for nurses at primary healthcare (PHC) facilities. We provide a descriptive analysis of mHealth training test scores, with trend analysis of blood pressure (BP) control using paired t-test for quantitative data and thematic analysis for qualitative data. Setting: PHC facilities in rural and urban communities in Cross River State, south eastern Nigeria. NCDs were not part of routine training previously. As in most low-and-middle-income settings, funding for scale-up using conventional classroom in-service training for NCDs is not available in Nigeria, and onsite supervision poses challenges. Participants: Twenty-four health workers in 19 PHC facilities. Intervention: A self-paced mHealth training module on an NCD desk guide was adapted to be applicable within the Nigerian context in collaboration with the Federal Ministry of Health. The training which focused on hypertension, diabetes and sickle cell disease was delivered via Android tablet devices, supplemented by quarterly onsite supervision and group support via WhatsApp. The training was evaluated with pre/post-course tests, structured observations and focus group discussions. This was an implementation pilot assessing the feasibility and potential effectiveness of mHealth training on NCD in primary care delivery. Results: Nurses who received mHealth training recorded a statistically significant difference (p<0.001) in average pretest and post-test training scores of 65.2 (±12.2) and 86.5 (±7.9), respectively. Recordings on treatment cards indicated appropriate diagnosis and follow-up of patients with hypertension with significant improvements in systolic BP (t=5.09, p<0.001) and diastolic BP (t=5.07, p<0.001). The mHealth nurse training and WhatsApp support groups were perceived as valuable experiences and obviated the need for face-to-face training. Increased workload, non-availability of medications, facility-level conflicts and poor task shifting were identified challenges. Conclusions: This initiative provides evidence of the feasibility of implementing an NCD care package supported by mHealth training for health workers in PHCs and the strong possibility of successful scale-up nationally.
dc.languageen
dc.publisherBMJ Publishing Group
dc.rightsLicence for this article starting on 2022-08-26: https://creativecommons.org/licenses/by/4.0/
dc.rightsEmbargo: ends 2022-08-26
dc.sourceeissn: 2044-6055
dc.subjectPublic health
dc.subject1506
dc.subject1724
dc.subjectpublic health
dc.subjecthealth informatics
dc.subjecteducation & training (see medical education & training)
dc.titlemHealth guideline training for non-communicable diseases in primary care facilities in Nigeria: a mixed methods pilot study
dc.typearticle
dcterms.dateAccepted2022-07-12
dc.date.updated2022-09-22T10:00:32Z


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