Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Jul 11, 2023
Date Accepted: Apr 25, 2024
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Feasibility, acceptability, satisfaction and challenges of a mHealth for community-based COVID-19 screening by community health workers in Rwanda: Insight from the e-ASCov project
ABSTRACT
Background:
The pyramid-shaped organization of the Rwanda health system makes Community Health Workers (CHWs) central to the community-based management of outbreaks.
Objective:
This mixed method study explored the feasibility, acceptability, satisfaction and challenges of a mobile health (mHealth) tool for community-based COVID-19 screening in Rwanda.
Methods:
Two urban (Gasabo and Nyarugenge) and two rural (Rusizi and Kirehe) districts participated to the project (smartphone application for COVID-19 screening). A mixed-method approach was used to inform the feasibility (awareness, expectation), acceptability, (use, perceived benefits), satisfaction and challenges of the mHealth intervention. At the end of the project, CHWs were asked to complete a quantitative questionnaire on use and satisfaction of the application. Then, in-depth interviews (IDIs) and Focus Group Discussions (FGDs) were organised with CHWs. Transcripts were content-analysed.
Results:
383 CHWs were recruited and trained 378 of whom participated in this study. More than 7,000 registered and 20% referred to a local COVID-19 testing facility. Despite the application was a novel tool, CHWs were well aware of the use of such tool with appropriate expectations. Use, perceived benefit, and satisfaction were very high, although there were differences between urban and rural districts. The application was perceived as a tool to generate information on COVID-19, inform on the status of the pandemic and help curbing the spread of the pandemic in Rwanda. CHWs were satisfied with the application at all stages of its implementation in their districts.
Conclusions:
In this proof-of-concept study, a smartphone application for screening COVID-19 proved useful as mHealth tool to be used by CHWs, with a potential to increase health system efficiency in an epidemic context. It appears important to analyse the context for its generalisation on a country-wide scale, both in the case of an epidemic and in order to take into account certain conditions at the community level. Clinical Trial: Not registred in clinicaltrials.gov Rwanda National Ethics Committee (n°752/RNEC/2020)
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