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. 2022 Apr 11:8:20552076221092213.
doi: 10.1177/20552076221092213. eCollection 2022 Jan-Dec.

A digital mobile health platform increasing efficiency and transparency towards universal health coverage in low- and middle-income countries

Liesbeth Huisman  1 , Shannen Mc van Duijn  1 , Nuno Silva  1 , Rianne van Doeveren  1 , Jacinta Michuki  2 , Moses Kuria  2 , David Otieno Okeyo  3 , Isaiah Okoth  4 , Nathalie Houben  4 , Tobias F Rinke de Wit  1 , Khama Rogo  5
Affiliations

A digital mobile health platform increasing efficiency and transparency towards universal health coverage in low- and middle-income countries

Liesbeth Huisman et al. Digit Health. .

Abstract

In low-and middle-income countries, achieving universal health coverage remains challenging due to insufficient, temporary and fragmented funding as well as limited accessibility to quality healthcare. Leveraging a mobile health platform can be a powerful tool to address these problems. This paper demonstrates how analysing data collected from a mobile health platform helps optimize healthcare provider networks, monitor patient flows and assess the quality and equitability of access to care. The COVID-19 pandemic reinforces the importance of real-time data on health-seeking behaviour. Between 2018 and 2019, as a Kenyan universal health coverage pilot was being planned, Kisumu County, with support from PharmAccess Foundation, implemented household-level digital registration for healthcare and collected socio-economic and healthcare claims data using the M-TIBA platform. In total, 273,350 Kisumu households enrolled. The claims data showed many patients visit higher-level facilities for ailments, that can be treated at primary care levels, unnecessarily. High-level estimate of the disease burden at participating facilities revealed rampant overprescription of pertinent medicines for highly prevalent malaria and respiratory tract infections, exemplifying clinical management deficiencies. M-TIBA data allowed tracking of individual patient trajectories. Analyses of data are shown at the aggregate level. The paper shows how mobile health platforms can be used to generate valuable insights into access to and quality of care. Funding for healthcare can be united through mobile health platforms, limiting the fragmentation in funding. They can be useful for funders, health managers and policymakers to improve the implementation of universal health coverage programs in low-and middle-income countries.

Keywords: Kenya; malaria; mobile digital health; respiratory tract infections; universal health coverage.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
(a). The locations of Kisumu (public) health facilities are colour-coded by type. Preferential use by households is depicted by the bubble size, representing the number of households selecting the pertinent facility for primary care. (b) County hospital claims. Number of services that could have been treated at a primary care facility in blue.
Figure 2.
Figure 2.
Frequency of diagnosis of conditions and corresponding costs in Kisumu. The colour of the circles presents one of the conditions displayed in the legend on the right. The surface of the circles indicates the percentage of the total health costs in the county. A large circle represents a higher percentage of the total costs.
Figure 3.
Figure 3.
Antibiotic prescriptions (%) for upper respiratory diseases in public health facilities in Kisumu. Overprescription in orange, under-prescription in green, correct prescription in blue.
Figure 4.
Figure 4.
Sankey plot showing the flows of malaria tests versus medicine (width of lines is proportional to numbers of cases following pertinent trajectory).
See this image and copyright information in PMC

References

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