M health technology for surveillance of infectious diseases: Challenges and learning for scale up and replication
Filza Ali · International Journal of Infectious Diseases · 2016
Background: Smart Phone based infectious disease surveillance has the potential to provide real-time, high quality, validated data for early response and investigation. However, little evidence is available on practical use of m health technology and challenges in infectious disease surveillance in lower and middle income countries. The objective of this paper is to examine the practical challenges in using m health technology in surveillance of infectious diseases and share the learning for replication and scale up of m health in surveillance of infectious diseases. Methods & Materials: An electronic search was conducted for research articles on mobile phone based infectious diseases surveillance and the articles published only in peer reviewed journals after year 2008 were considered for including in this paper. A total of 11 research papers were selected based on this criteria and thematic analysis was done to understand challenges and learning. Results: There were challenges in diseases surveillance using m health technologies. These were mainly technology related, financial, political and social, ethical and cultural. Technological issues were mainly - touch screen interface, application errors, and change in settings of the device. A training program in local language and handholding support in the field was found effective. Financial issues were related to procurement of smart phones, annual maintenance, repair, lost and damaged phones, software cost including application development and maintenance. Locally available hardware and open source software options should be explored. Political issues were including continued resource support and interests. Ensuring their participation from the design phase of the project has been useful for aligning the project with their priorities. Ethical, societal and cultural issues were related to data security, use of data, resistance to change and operating on mobile devices and scepticism in the community about the new technology. Building data security system, setting forth purpose of data collection and involving community in the process was useful. Conclusion: The disease surveillance using m health technology possesses several challenges including technology related, financial, political and social. For scale up and replication, training and handholding, local technology providers, open source software and involvement of multiple stakeholders from the design phase of the project should be considered.