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Cited by 384Mobile Health and mHealth ApplicationsICT in Developing CommunitiesMobile Learning in Education

Assessing the impact of mHealth interventions in low- and middle-income countries – what has been shown to work?

Open access
Hall, Charles S., Fottrell, Edward, Wilkinson, Sophia, Byass, Peter·2014·Global Health Action
DOI 10.3402/gha.v7.25606PMC PMC4216389
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Abstract

BACKGROUND: Low-cost mobile devices, such as mobile phones, tablets, and personal digital assistants, which can access voice and data services, have revolutionised access to information and communication technology worldwide. These devices have a major impact on many aspects of people's lives, from business and education to health. This paper reviews the current evidence on the specific impacts of mobile technologies on tangible health outcomes (mHealth) in low- and middle-income countries (LMICs), from the perspectives of various stakeholders. DESIGN: Comprehensive literature searches were undertaken using key medical subject heading search terms on PubMed, Google Scholar, and grey literature sources. Analysis of 676 publications retrieved from the search was undertaken based on key inclusion criteria, resulting in a set of 76 papers for detailed review. The impacts of mHealth interventions reported in these papers were categorised into common mHealth applications. RESULTS: There is a growing evidence base for the efficacy of mHealth interventions in LMICs, particularly in improving treatment adherence, appointment compliance, data gathering, and developing support networks for health workers. However, the quantity and quality of the evidence is still limited in many respects. CONCLUSIONS: Over all application areas, there remains a need to take small pilot studies to full scale, enabling more rigorous experimental and quasi-experimental studies to be undertaken in order to strengthen the evidence base.

AI snapshot

Written from the paper’s full text.

TL;DR

This review assessed evidence on mHealth interventions in low- and middle-income countries by screening 676 publications and reviewing 76 papers across 12 application domains. It found growing but limited evidence, with positive signals for treatment adherence, appointment compliance, data collection, and health-worker support, but most evidence came from small pilots and few rigorous scaled evaluations.

Key findings

  • Of 676 publications screened, 76 papers were reviewed; evidence concentrated in client education/behaviour change (20 papers) and data collection/reporting (17 papers), with no results uniquely associated with human resource management or financial transactions/incentives.
  • Positive outcomes included a Zanzibar cluster-randomised trial of 2,550 women where 60% of the intervention arm used a skilled birth attendant versus 47% in the control group, and 44% versus 31% received the recommended four antenatal visits; a Kenyan malaria SMS trial improved treatment adherence by 31.7% short term (95% CI 15.6–47.8) and 28.6% long term (95% CI 12.7–44.6); and a Pakistani TB campaign showed a 2.2-fold increase in case detection (95% CI 1.9–2.5).
  • Data-related results included a Malawi SMS malnutrition decision-support system with an average error rate of 2.8% versus 14.2% for previous paper tools; mTRAC in Uganda reduced stock-outs of key malarial drugs from 25% to 14%; Nigerian cancer patients with phone access maintained appointments at 97.6% versus 19.2% without; and automated reminders in Brazil reduced mean non-attendance from 25.6% to 19.4%.
  • Mixed or negative findings included a Thailand TB risk-benefit analysis showing increased mortality and DALYs for mHealth reminders compared with family-member-based directly observed treatment; a South African diabetes peer-support study (n=22) found no significant health change over 6 months; a Ugandan HIV SMS quiz had only 2.3% of recipients redeem a free HIV test; and a Ugandan cluster-randomised mHealth CHW intervention showed no statistical difference in virological failure (19.4% intervention vs 16.4% control).

Methods

  • Systematic electronic literature search from 2009 to early 2014 in PubMed and Google Scholar, plus grey literature sources (mHealth Evidence, GSMA, Global mHealth Initiative), using combinations of mHealth/mobile phone terms with developing/low-income/impact/evidence terms. Searches yielded 676 papers from PubMed and Google Scholar plus six non-duplicated grey literature papers; after abstract screening and exclusion, 76 papers were included and cross-checked by another author.
  • Inclusion criteria were human health, technology per WHO definition, LMICs, publication from 2009 onward, and evidence of a measured change in health outcomes (mortality, morbidity, DALYs, behavioural change). Findings were categorised by Labrique et al.’s 12 common mHealth applications; health impacts were defined a priori, and the review took an inclusive view of evidence levels.

Limitations

  • Stated by the authors: the quantity and quality of evidence remain limited; many studies are small pilots rarely taken to scale or rigorously evaluated; much evidence is anecdotal; there is no clear consensus on paper-based versus device-based data capture; equity risks arise if mHealth assumes mobile phone availability; and more rigorous experimental and quasi-experimental studies are needed.
  • Stated by the authors: the review deliberately took an inclusive view rather than insisting on particular levels of evidence, and it included grey literature; no results were uniquely associated with two of the 12 domains (human resource management, and financial transactions and incentives).
  • Evident from the text: the review reports no formal quality appraisal or meta-analysis, and it includes studies with small samples, no controls, retrospective designs, and acknowledged recall bias.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.3402/gha.v7.25606

Cites

Statistics

Nothing to recompute.

Claims the paper makes

0 of 115 cited sources checked · 0 supported · 0 flagged

  • Findingcitation

    Retrospective analysis of an intervention in South Africa using SMS reminders sent to 18 tuberculosis patients who delayed in opening their wireless pill bottles showed improved health compared to 72 control patients who received no SMS reminder.

    “Retrospective analysis of an intervention in South Africa using SMS reminders sent to 18 tuberculosis patients who delayed in opening their wireless pill bottles showed improved health compared to 72 control patients who received no SMS reminder (31).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [31] Broomhead S Mars M Retrospective return on investment analysis of an electronic treatment adherence device piloted in the Northern Cape Province Telemed J E Health 2012 18 24 31 22150713 source

      Not checked in the free run.

  • Findingnone given

    The quantity and quality of the evidence on mHealth interventions in LMICs is still limited in many respects.

    “However, the quantity and quality of the evidence is still limited in many respects.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The 76 papers included in the review are representative of the available evidence on mHealth impacts in LMICs.
  • Findingown data

    There were no results uniquely associated with two of the application domains: human resource management, and financial transactions and incentives.

    “There were no results uniquely associated with two of those domains (human resource management, and financial transactions and incentives)”
    Quote in the paperNot a substantial claim
  • Findingcitation

    Studies showed the importance of the frequency and timing of messages to users to optimize their efficacy.

    “Studies showed the importance of the frequency and timing of messages to users to optimize their efficacy (20, 71).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [20] Lester RT Ritvo P Mills EJ Kariri A Karanja S Chung MH Effects of a mobile phone short message service on antiretroviral treatment adherence in Kenya (WelTel Kenya1): a randomised trial Lancet 2010 376 1838 45 21071074 source

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    • cites [71] Finitsis DJ Pellowski JA Johnson BT Text message intervention designs to promote adherence to antiretroviral therapy (ART): a meta-analysis of randomized controlled trials PLoS One 2014 9 e88166 PMC3914915 24505411 source

      Not checked in the free run.

  • Findingcitation

    A risk-benefit analysis study in Thailand exploring inexpensive mHealth reminders to improve TB medication adherence showed increased mortality and DALYs compared to equally inexpensive family-member-based directly observed treatments.

    “A risk-benefit analysis study in Thailand exploring inexpensive mHealth reminders to improve TB medication adherence showed increased mortality and DALYs compared to equally inexpensive family-member-based directly observed treatments (63).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [63] Hunchangsith P Barendregt JJ Vos T Bertram M Cost-effectiveness of various tuberculosis control strategies in Thailand Value Health 2012 15 S50 5 22265067 source

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  • Classified as probably not a substantial claim. 35
  • May combine two claims. 53
  • The quote only partly states this claim. 1

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    The searches resulted in 676 papers found on PubMed and Google Scholar, and another six relevant, non-duplicated papers discovered from grey literature sources.

    “The searches resulted in 676 papers found on PubMed and Google Scholar, and another six relevant, non-duplicated papers discovered from grey literature sources (Fig. 2).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Google searches for mHealth were first used in 2009, and plateaued at current levels in 2013.

    “Figure 1 shows that Google searches for mHealth were first used in 2009, and plateaued at current levels in 2013.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Findingown data

    In total, 76 papers were included in the review after the search and exclusion process.

    “In total, 76 papers were included in the review after this process and were cross-checked by another author (PB).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The 76 papers included in the review are representative of the available evidence on mHealth impacts in LMICs.

  • May combine two claims.

    Findingnone given

    There is a growing evidence base for the efficacy of mHealth interventions in LMICs, particularly in improving treatment adherence, appointment compliance, data gathering, and developing support networks for health workers.

    “There is a growing evidence base for the efficacy of mHealth interventions in LMICs, particularly in improving treatment adherence, appointment compliance, data gathering, and developing support networks for health workers.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The 76 papers included in the review are representative of the available evidence on mHealth impacts in LMICs.

  • May combine two claims.

    Findingcitation

    A Peruvian RCT using educational SMS to reduce risks of contracting dengue fever hinted at improved educational equity via SMS but showed no statistically significant improvement over alternative educational schemes.

    “A Peruvian RCT, using educational SMS to reduce risks of contracting dengue fever, hinted at improved educational equity via SMS but showed no statistically significant improvement over alternative educational schemes (54).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [54] Dammert AC Galdo JC Galdo V Preventing dengue through mobile phones: evidence from a field experiment in Peru J Health Econ 2014 35 147 61 24681813 source

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    The low data capacity associated with using SMS has been highlighted as a barrier to its use for long health surveys.

    “The low data capacity associated with using SMS has been highlighted as a barrier to its use for long health surveys (46).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [46] Blaschke S Bokenkamp K Cosmaciuc R Denby M Hailu B Short R Using mobile phones to improve child nutrition surveillance in Malawi 2009 Brooklyn, NY UNICEF Malawi, UNICEF Innovations, Mobile Development Solutions Available from: https://sipa.columbia.edu/sites/default/files/UNICEFFinalReport_2009_0.pdf [cited 27 July 2014].

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    Findingcitation

    Policy was subsequently altered to improve partograph uptake, with additional EpiSurveyor results demonstrating 28% use of partographs in the pilot regions, compared to 1% in regions outside the EpiSurveyor pilot.

    “Policy was subsequently altered to improve partograph uptake, with additional EpiSurveyor results demonstrating 28% use of partographs in the pilot regions, compared to 1% in regions outside the EpiSurveyor pilot.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [3] World Health Organization mHealth: new horizons for health through mobile technologies: second global survey on eHealth 2011 Geneva WHO

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    Findingreasoning

    mHealth education and behaviour change initiatives have also targeted non-communicable diseases in LMICs, although evidence of effectiveness is both mixed and scant.

    “mHealth education and behaviour change initiatives have also targeted non-communicable diseases in LMICs, although evidence of effectiveness is both mixed and scant.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    Mobile-based light microscopy offers a cheaper and more transportable tool for diagnosing infectious and haematological conditions.

    “Mobile-based light microscopy offers a cheaper and more transportable tool for diagnosing infectious and haematological conditions (70, 73).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [70] Breslauer DN Maamari RN Switz NA Lam WA Fletcher DA Mobile phone based clinical microscopy for global health applications PLoS One 2009 4 e6320 PMC2709430 19623251 source

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    • cites [73] Skandarajah A Reber CD Switz NA Fletcher DA Quantitative imaging with a mobile phone microscope PLoS One 2014 9 e96906 PMC4019540 24824072 source

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  • May combine two claims.

    Findingcitation

    mHealth data collection has been shown to be more cost effective than paper resources, and lower rates of data loss were reported, with fewer errors.

    “mHealth data collection has been shown to be more cost effective than paper resources (21), and lower rates of data loss were reported (33), with fewer errors (46, 52, 53).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [21] Rajput ZA Mbugua S Amadi D Chepngeno V Saleem JJ Anokwa Y Evaluation of an android-based mHealth system for population surveillance in developing countries J Am Med Inform Assoc 2012 19 655 9 22366295 PMC3384107 source

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    • cites [33] Tomlinson M Solomon W Singh Y Doherty T Chopra M Ijumba P The use of mobile phones as a data collection tool: a report from a household survey in South Africa BMC Med Inform Decis Mak 2009 9 51 20030813 PMC2811102 source

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    • cites [46] Blaschke S Bokenkamp K Cosmaciuc R Denby M Hailu B Short R Using mobile phones to improve child nutrition surveillance in Malawi 2009 Brooklyn, NY UNICEF Malawi, UNICEF Innovations, Mobile Development Solutions Available from: https://sipa.columbia.edu/sites/default/files/UNICEFFinalReport_2009_0.pdf [cited 27 July 2014].

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  • May combine two claims.

    Findingcitation

    SMS-based registration of birth dates and due dates in Bangladesh, Uganda, Nigeria, and Senegal has been used to improve data on birth rates, whilst improving the coverage of timely child immunisation.

    “SMS-based registration of birth dates and due dates in Bangladesh (65), Uganda, Nigeria, and Senegal (67) has been used to improve data on birth rates, whilst improving the coverage of timely child immunisation.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [65] Center for Health Market Innovations Aponjon 2012 Washington, DC Center for Health Market Innovations Available from: http://healthmarketinnovations.org/program/aponjon [cited 17 June 2014]

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    • cites [67] UNICEF Birth registration using SMS technology 2013 Available from: http://unicefinnovation.org/projects/birth-registration-using-sms-technology [cited 17 June 2014].

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    Findingcitation

    Results were directly transmitted to a central computer server both via satellite and SMS, with 33/40 and 38/40 being successfully received by each method respectively.

    “Results were directly transmitted to a central computer server both via satellite and SMS, with 33/40 and 38/40 being successfully received by each method respectively.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [27] Chin CD Cheung YK Laksanasopin T Modena MM Chin SY Sridhara AA Mobile device for disease diagnosis and data tracking in resource-limited settings Clin Chem 2013 59 629 40 23327782 source

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    Findingcitation

    Approximately 1,200 staff across Cambodia are involved in collecting and analysing data on 12 monitored diseases in the Cam e-Warn programme.

    “Approximately 1,200 staff across the country are involved in collecting and analysing data on 12 monitored diseases (3).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [3] World Health Organization mHealth: new horizons for health through mobile technologies: second global survey on eHealth 2011 Geneva WHO

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    Eight studies reported technical implementations related to imaging.

    “Eight studies reported technical implementations related to imaging.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    In a study in Swaziland, SMS delivery of LabPush results was at least 1 day faster for 49% of results, although for 28%, paper results arrived first.

    “SMS delivery of results was at least 1 day faster for 49% of results, although for 28%, paper results arrived first.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [34] Jian WS Hsu MH Sukati H Syed-Abdul S Scholl J Dube N LabPush: a pilot study of providing remote clinics with laboratory results via short message service (SMS) in Swaziland, Africa PLoS One 2012 7 e44462 PMC3446932 23028543 source

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  • May combine two claims.

    Findingcitation

    An SMS contraceptive education scheme in Kenya suggested improved contraceptive knowledge and use, but suffered from a sample size that was too small, with no control group, thus reducing the ability to draw firm conclusions.

    “An SMS contraceptive education scheme in Kenya suggested improved contraceptive knowledge and use, but suffered from a sample size that was too small, with no control group, thus reducing the ability to draw firm conclusions (22).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [22] Vahdat HL L'Engle KL Plourde KF Magaria L Olawo A There are some questions you may not ask in a clinic: providing contraception information to young people in Kenya using SMS Int J Gynaecol Obstet 2013 123 e2 6 24012514 source

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  • May combine two claims.

    Findingcitation

    A before-and-after evaluation of a mHealth-based peer-support group for women suffering from diabetes mellitus in South Africa showed no evidence of significant change in health over a 6-month period, although the sample size was very small (n=22).

    “Results showed no evidence of significant change in health over a 6-month period, although the sample size was very small (n=22) (32).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [32] Rotheram-Borus MJ Tomlinson M Gwegwe M Comulada WS Kaufman N Keim M Diabetes buddies: peer support through a mobile phone buddy system Diabetes Educ 2012 38 357 65 22546740 PMC4059372 source

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  • May combine two claims.

    Findingcitation

    A systematic review of the literature identified that although SMS campaigns have been useful in improving treatment compliance, they failed to address the risky health behaviour factors associated with contracting HIV, and did not improve uptake of HIV treatment.

    “A systematic review of the literature identified that although SMS campaigns have been useful in improving treatment compliance, they failed to address the risky health behaviour factors associated with contracting HIV, and did not improve uptake of HIV treatment (79).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [79] Pellowski JA Kalichman SC Recent advances (2011–2012) in technology-delivered interventions for people living with HIV Curr HIV AIDS Rep 2012 9 326 34 PMC3492505 22922945 source

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    Findingcitation

    In Senegal, findings of surveys showed that 45% of surveyed districts were not using partographs to monitor labour, despite being an important tool proven to help reduce intrapartum birth complications.

    “Findings of the surveys showed that 45% of surveyed districts were not using partographs to monitor labour, despite being an important tool proven to help reduce intrapartum birth complications.”
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    • cites [3] World Health Organization mHealth: new horizons for health through mobile technologies: second global survey on eHealth 2011 Geneva WHO

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    Findingcitation

    Since its implementation in 2008, Cam e-Warn has detected multiple outbreaks, including one of acute watery diarrhoea, a major cause of child mortality.

    “Since its implementation in 2008 it has detected multiple outbreaks, including one of acute watery diarrhoea, a major cause of child mortality.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [3] World Health Organization mHealth: new horizons for health through mobile technologies: second global survey on eHealth 2011 Geneva WHO

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    Findingcitation

    In this context, women were less likely to own a mobile phone, so were less likely to directly benefit from SMS education.

    “In this context, women were less likely to own a mobile phone, so were less likely to directly benefit from SMS education (40, 41, 77).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [40] Chib A Wilkin H Hoefman B Vulnerabilities in mHealth implementation: a Ugandan HIV/AIDS SMS campaign Glob Health Promot 2013 20 26 32 23549699 source

      Not checked in the free run.

    • cites [41] Chib A Wilkin H Ling LX Hoefman B Van Biejma H You have an important message! Evaluating the effectiveness of a text message HIV/AIDS campaign in Northwest Ugandam J Health Commun 2012 17 146 57 22548607 source

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    • cites [77] Jennings L Gagliardi L Influence of mHealth interventions on gender relations in developing countries: a systematic literature review Int J Equity in Health 2013 12 85 24131553 PMC4015705 source

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  • May combine two claims.

    Findingcitation

    Results from 167 samples, comparing the new technology to gold standards, were encouraging with HIV, viral hepatitis, and sexually transmitted infection test sensitivities and specificities of 100 and 99%, respectively.

    “Results from 167 samples, comparing the new technology to gold standards, were encouraging with HIV, viral hepatitis, and sexually transmitted infection test sensitivities and specificities of 100 and 99%, respectively.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [27] Chin CD Cheung YK Laksanasopin T Modena MM Chin SY Sridhara AA Mobile device for disease diagnosis and data tracking in resource-limited settings Clin Chem 2013 59 629 40 23327782 source

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  • May combine two claims.

    Findingcitation

    Vulnerable groups were less likely to know correct answers to the SMS HIV quiz, therefore less likely to benefit from the scheme.

    “Vulnerable groups were less likely to know correct answers to the quiz, therefore less likely to benefit from the scheme (40).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [40] Chib A Wilkin H Hoefman B Vulnerabilities in mHealth implementation: a Ugandan HIV/AIDS SMS campaign Glob Health Promot 2013 20 26 32 23549699 source

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    Findingcitation

    Additional testing demonstrated mHealth decision aids also reduced mental demand, frustration, and overall workload compared to paper aids.

    “Additional testing demonstrated mHealth decision aids also reduced mental demand, frustration, and overall workload compared to paper aids (69).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [69] Iyengar MS Florez-Arango JF Decreasing workload among community health workers using interactive, structured, rich-media guidelines on smartphones Technol Health Care 2013 21 113 23 23510972 source

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    Findingown data

    Although data on overall improvements in mortality for each scheme were unavailable, improved utilisation of specialist birth attendants was also observed.

    “Although data on overall improvements in mortality for each scheme were unavailable, improved utilisation of specialist birth attendants was also observed.”
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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingnone given

    The electronic decision support domain is largely intended to support and improve the functionality of health systems by embedding information in mHealth applications, and examples were reported in seven papers.

    “This domain is largely intended to support and improve the functionality of health systems, by embedding information in mHealth applications, and examples were reported in seven papers.”
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    Findingcitation

    Results from a pilot in South Africa demonstrated that the MIVA performed better than paper-based VAs, reducing interview times, eliminating paper processing and storage, and making cause of death data immediately available.

    “Results from a pilot in South Africa demonstrated that the MIVA performed better than paper-based VAs, reducing interview times, eliminating paper processing and storage, and making cause of death data immediately available.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [30] Bird J Byass P Kahn K Mee P Fottrell E A matter of life and death: practical and ethical constraints in the development of a mobile verbal autopsy tool Proceedings of the SIGCHI Conference on Human Factors in Computing Systems 27 April–2 May 2013 Paris, France 1489 98 source

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Some LMICs have piloted electronic health records.

    “Consequently some LMICs have piloted electronic health records (27).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [27] Chin CD Cheung YK Laksanasopin T Modena MM Chin SY Sridhara AA Mobile device for disease diagnosis and data tracking in resource-limited settings Clin Chem 2013 59 629 40 23327782 source

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  • May combine two claims.

    Findingcitation

    In the same study, 99% of SMS test results were received, compared to 92% of paper results, showing a reduction in lost results.

    “Furthermore, 99% of SMS test results were received, compared to 92% of paper results, showing a reduction in lost results.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [34] Jian WS Hsu MH Sukati H Syed-Abdul S Scholl J Dube N LabPush: a pilot study of providing remote clinics with laboratory results via short message service (SMS) in Swaziland, Africa PLoS One 2012 7 e44462 PMC3446932 23028543 source

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  • May combine two claims.

    Findingcitation

    In a Kenya scheme, improved data on birth weights were recorded, and the scheme noted an improved pregnancy case discovery before delivery, with only 25% of pregnancies discovered after delivery, a significant reduction from 30% 6 months earlier.

    “Whilst improved data on birth weights were recorded, importantly the scheme also noted an improved pregnancy case discovery before delivery, with only 25% of pregnancies discovered after delivery. This was a significant reduction from 30% 6 months earlier, with important implications for antenatal care (18).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [18] Gisore P Shipala E Otieno K Rono B Marete I Tenge C Community based weighing of newborns and use of mobile phones by village elders in rural settings in Kenya: a decentralised approach to health care provision BMC Pregnancy Childbirth 2012 12 15 22429731 PMC3344691 source

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  • May combine two claims.

    Findingcitation

    A randomised prospective crossover simulation study demonstrated that mHealth-based guidelines support reduced error rates by 33% (p=0.0001) and improved compliance to protocols by 30% (p=0.001).

    “A randomised prospective crossover simulation study demonstrated that mHealth-based guidelines support reduced error rates by 33% (p=0.0001) and improved compliance to protocols by 30% (p=0.001) (68).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [68] Florez-Arango JF Iyengar MS Dunn K Zhang J Performance factors of mobile rich media job aids for community health workers J Am Med Inform Assoc 2011 18 131 7 21292702 PMC3116248 source

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  • May combine two claims.

    Findingnone given

    Health records are generally problematic in LMICs, and there were only four mHealth applications in this domain meeting the review criteria.

    “Health records are generally problematic in LMICs, and there were only four mHealth applications in this domain meeting our review criteria.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    In a randomised controlled trial in Kenya, short-term treatment adherence improved by 31.7% (95% CI 15.6-47.8) and long-term treatment adherence improved by 28.6% (95% CI 12.7-44.6).

    “Results suggested that, in the short term, treatment adherence improved by 31.7% (95% CI 15.6–47.8) and, in the long term, treatment adherence improved by 28.6% (95% CI 12.7–44.6).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [24] Zurovac D Sudoi RK Akhwale WS Ndiritu M Hamer DH Rowe AK The effect of mobile phone text-message reminders on Kenyan health workers’ adherence to malaria treatment guidelines: a cluster randomised trial Lancet 2011 378 795 803 21820166 PMC3163847 source

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    Eight papers exemplified the provider-provider communication domain.

    “Eight papers exemplified this.”
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    Findingcitation

    Focus group discussions and in-depth interviews (n=86) showed benefits of giving mobile technology to midwives in rural Aceh Besar, Indonesia, including the facilitation of communication, greater time efficiency, and better access to medical information.

    “Focus group discussions and in-depth interviews (n=86) showed benefits, including the facilitation of communication, greater time efficiency, and better access to medical information.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [58] Chib A The Aceh Besar midwives with mobile phones project: design and evaluation perspectives using the information and communication technologies for healthcare development model J Comput Mediat Commun 2010 15 500 25 source

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    • cites [59] Lee S Chib A Kim JN Midwives’ cell phone use and health knowledge in rural communities J Health Commun 2011 16 1006 23 21728781 source

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    Findingcitation

    The review covers the scope of mHealth as postulated by Labrique et al. as comprehensively as possible.

    “Our review covers the scope of mHealth as postulated by Labrique et al. (8) as comprehensively as possible.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [8] Labrique AB Vasudevan L Kochi E Fabricant R Mehl G mHealth innovations as health system strengthening tools: 12 common applications and a visual framework Glob Health Sci Pract 2013 1 160 71 25276529 PMC4168567 source

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    Findingcitation

    The review categorised 76 publications under application domains, with considerable variety in the quantity and quality of content across those domains.

    “There was considerable variety in the quantity and quality of content across the application domains (8) under which we categorised the 76 publications in the review.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [8] Labrique AB Vasudevan L Kochi E Fabricant R Mehl G mHealth innovations as health system strengthening tools: 12 common applications and a visual framework Glob Health Sci Pract 2013 1 160 71 25276529 PMC4168567 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Mobile network coverage and availability of mobile handsets are necessary but not sufficient conditions to capitalise on possible mHealth benefits.

    “Mobile network coverage and availability of mobile handsets are necessary but not sufficient conditions to capitalise on possible mHealth benefits (6).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [6] Byass P D'Ambruoso L Cellular telephone networks in developing countries Lancet 2008 371 650 18295022 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    An extensive review and meta-analysis of mHealth interventions aimed at improving healthcare delivery identified 42 controlled trials, but concluded that none delivered high-quality evidence and almost all were in high-income countries.

    “An extensive review and meta-analysis of mHealth interventions aimed at improving healthcare delivery identified 42 controlled trials, but concluded that none delivered high-quality evidence and almost all were in high-income countries (7).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [7] Free C Phillips G Watson L Galli L Felix L Edwards P The effectiveness of mobile-health technologies to improve health care service delivery processes: a systematic review and meta-analysis PLoS Med 2013 10 e1001363 PMC3566926 23458994 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    In many places people are more likely to have access to a mobile phone than to have clean water, a bank account, or even a source of electricity.

    “In many places people are more likely to have access to a mobile phone than to have clean water, a bank account, or even a source of electricity (4).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [4] World Bank Information and communications for development: maximizing mobile 2012 Washington, DC World Bank

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The 76 included papers were cross-checked by another author (PB).

    “In total, 76 papers were included in the review after this process and were cross-checked by another author (PB).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based). May combine two claims.

    Interpretationreasoning

    Mobile technologies make people more contactable and as such offer a useful tool to deliver education and improve health-seeking behaviour or health-related lifestyle decisions.

    “Mobile technologies make people more contactable and as such offer a useful tool to deliver education and improve health-seeking behaviour or health-related lifestyle decisions.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based). May combine two claims.

    Interpretationreasoning

    As a consequence of high uptake of mobile phones in LMICs, mobile-based educational schemes have an opportunity to enhance health behaviour, and therefore health outcomes, at the population level.

    “As a consequence of high uptake of mobile phones in LMICs, mobile-based educational schemes have an opportunity to enhance health behaviour, and therefore health outcomes, at the population level.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The market penetration of mobile phones has been estimated to reach 78% worldwide.

    “The market penetration of mobile phones has been estimated to reach 78% worldwide (5).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [5] Groupe Speciale Mobile Association The mobile economy 2014 2014 London GSMA

      Not checked in the free run.

  • May combine two claims.

    Premisenone given

    Logistic issues are a major barrier to fast test reporting, with laboratories frequently being far away from the clinics they serve.

    “Logistic issues are a major barrier to fast test reporting; with laboratories frequently being far away from the clinics they serve.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductreasoning

    The data on which statements about positive effects of SMS-based registration were made were not accessible, nor was there discussion of the study design.

    “This suggests positive effects of mHealth interventions, but the data on which these statements were made were not accessible, nor was there discussion of the study design.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationreasoning

    Fast reporting of test results can enable faster treatment of medical issues and, in the case of communicable diseases, might prevent further infection.

    “Fast reporting of test results can enable faster treatment of medical issues and, in the case of communicable diseases, might prevent further infection.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    Cheaper and faster diagnostic tools combined with centralised health records offer a novel modality to improve health.

    “Cheaper and faster diagnostic tools combined with centralised health records offer a novel modality to improve health.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    Larger scale studies are still needed for mobile tele-dermatology because of the small sample size in both studies (n=30 in Egypt and n=72 in Uganda).

    “Larger scale studies are still needed, because of the small sample size in both studies (n=30 in Egypt and n=72 in Uganda).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Premisecitation

    Antenatal care uptake is an important consideration in maternal and child health.

    “Antenatal care uptake is an important consideration in maternal and child health (74).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [74] Darmstadt GL Lee AC Cousens S Sibley L Bhutta ZA Donnay F 60 Million non-facility births: who can deliver in community settings to reduce intrapartum-related deaths? Int J Gynaecol Obstet 2009 107 S89 112 19815200 PMC3428830 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    Using digital communications to transmit images for remote expert interpretation could ameliorate shortages of specialist physicians in LMICs, especially in rural areas.

    “Using digital communications to transmit images for remote expert interpretation could ameliorate shortages of specialist physicians in LMICs, especially in rural areas.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductcitation

    The Malawi pilot evaluation was based on a retrospective observational study, not a randomised controlled trial, with recall bias noted as a major problem.

    “It is important to note, however, that this evaluation was based on a retrospective observational study so was not placed under the rigors of a randomised controlled trial, with recall bias noted as a major problem.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [25] Mahmud N Rodriguez J Nesbit J A text message-based intervention to bridge the healthcare communication gap in the rural developing world Technol Health Care 2010 18 137 44 20495253 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    The authors of the Better Border Healthcare Programme concluded that mobile technology improved the speed of data collection compared to paper processes, and improved follow-up rates and malaria control actions.

    “The authors concluded that mobile technology improved the speed of data collection compared to paper processes, and improved follow-up rates and malaria control actions.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [64] Meankaew P Kaewkungwal J Khamsiriwatchara A Khunthong P Singhasivanon P Satimai W Application of mobile-technology for disease and treatment monitoring of malaria in the “Better Border Healthcare Programme.” Malar J 2010 9 237 20723223 PMC2936405 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In the Better Border Healthcare Programme, follow-up rates for patients in the immigrant community post-intervention were more than 80%, compared to a baseline of less than 10%.

    “Results improved to a follow-up rate of more than 80% amongst patients in the immigrant community too, compared to a baseline of less than 10% before the intervention.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [64] Meankaew P Kaewkungwal J Khamsiriwatchara A Khunthong P Singhasivanon P Satimai W Application of mobile-technology for disease and treatment monitoring of malaria in the “Better Border Healthcare Programme.” Malar J 2010 9 237 20723223 PMC2936405 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Premisereasoning

    Electronic health records contain key patient conditions, results, and treatment plans, and access to this information facilitates more effective treatment.

    “Electronic health records contain key patient conditions, results, and treatment plans. Access to this information facilitates more effective treatment.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Birth registration can enhance health systems, increase accountability, and reduce mortality.

    “Birth registration can ‘enhance health systems, increase accountability, and reduce mortality’ (72)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [72] Labrique AB Pereira S Christian P Murthy N Bartlett L Mehl G Pregnancy registration systems can enhance health systems, increase accountability and reduce mortality Reprod Health Matters 2012 20 113 17 22789088 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Approximately a third of births worldwide are not registered.

    “yet approximately a third of births worldwide are not registered (83).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [83] UNICEF Every child's birth right: inequities and trends in birth registration 2013 New York UNICEF

      Not checked in the free run.

  • The quote only partly states this claim.

    Premisecitation

    The 104 mobile service in Andhra Pradesh established 10 million unique electronic health records.

    “and 10 million unique electronic health records being established.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [66] Center for Health Market Innovations (2012) Health Management and Research Institute (HMRI) 2012 Washington, DC Center for Health Market Innovations Available from: http://healthmarketinnovations.org/program/health-management-and-research-institute-hmri [cited 27 July 2014].

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    This demonstrated the use of both financial incentives, and the benefits of employing lay people equipped with mobile phones to improve case detection of TB.

    “This demonstrated the use of both financial incentives, and the benefits of employing lay people equipped with mobile phones to improve case detection of TB.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    CHWs are frequently the main providers of primary care in LMICs, but care quality can be poor.

    “CHWs are frequently the main providers of primary care in LMICs, but care quality can be poor (12).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [12] Rowe AK Onikpo F Lama M Osterholt DM Rowe SY Deming MS A multifaceted intervention to improve health worker adherence to integrated management of childhood illness guidelines in Benin Am J Public Health 2009 99 837 46 19299681 PMC2667861 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Only a third of deaths worldwide have a medically certified cause of death.

    “Only a third of deaths worldwide have a medically certified cause of death (75).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [75] Fottrell E Byass P Verbal autopsy: methods in transition Epidemiol Rev 2010 32 38 55 20203105 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationnone given

    The available evidence on mHealth largely concerns pilot studies and small-scale implementations, and is not completely positive in terms of potential mHealth benefits.

    “Such evidence as there is largely concerns pilot studies and small-scale implementations, and is not completely positive in terms of potential mHealth benefits.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    Client-based interventions for education and behaviour change are a rapidly increasing area of interest.

    “First, client-based interventions for education and behaviour change are a rapidly increasing area of interest, now that substantial proportions of people in many LMIC populations have access to mobile communications technology.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Substantial proportions of people in many low- and middle-income country populations have access to mobile communications technology.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationnone given

    Applications involving imaging, data collection, registration procedures, and patient records may benefit from mHealth components, but also need wider functionality in health systems to be beneficial.

    “The second major grouping is largely technical; applications involving imaging, data collection, registration procedures, and patient records may well benefit from mHealth components, but also need wider functionality in health systems to be beneficial.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    In Botswana, short-term learning outcome analysis has shown benefits of access to medical apps with condensed medical information, but does not analyse long-term benefits to knowledge retention.

    “Short-term learning outcome analysis has shown the benefits of access to medical apps with condensed medical information in Botswana, but does not analyse the long-term benefits to knowledge retention (15).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [15] Goldbach H Chang AY Kyer A Ketshogileng D Taylor L Chandra A Evaluation of generic medical information accessed via mobile phones at the point of care in resource-limited settings J Am Med Inform Assoc 2014 21 37 42 23535665 PMC3912712 source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Interpretationreasoning

    In low- and middle-income countries, there remains a strong focus on mHealth pilot studies, which have rarely been followed-up with more rigorous evaluation studies and have generally not been taken to scale.

    “Perhaps this partly explains, despite notable exceptions, why at least in LMICs there remains a strong focus on mHealth pilot studies, which have rarely been followed-up with more rigorous evaluation studies and have generally not been taken to scale.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The history of mHealth, framed as a potentially important solution to pre-existing problems, so far only covers 5 years.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    There is still no clear consensus on the relative merits of paper-based and device-based primary data capture.

    “Despite debates that started 25 years ago on the relative merits of paper-based and device-based primary data capture (84), there is still no clear consensus.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [84] Forster D Behrens RH Campbell H Byass P Evaluation of a computerised field data collection system for health surveys Bull World Health Organ 1991 69 107 11 2054915 PMC2393220

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    Health service providers in low- and middle-income countries are in a difficult position in terms of choosing effective and cost-effective mHealth strategies for widespread use.

    “Much of the available evidence is somewhat anecdotal and health service providers in LMICs are, as yet, in a difficult position in terms of choosing effective and cost-effective mHealth strategies for widespread use.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Interpretationnone given

    mHealth is becoming an important concept in low- and middle-income countries.

    “mHealth is clearly becoming an important concept in LMICs, but as yet there is very limited hard evidence on its effects within health systems.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Interpretationcitation

    There are many examples which show considerable potential for mHealth.

    “Nevertheless, there are many examples which show considerable potential.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    A study of 223 midwives in Indonesia showed that mobile technology improves access to medical information resources, which is positively associated with improved health knowledge.

    “A study of 223 midwives in Indonesia showed mobile technology improves access to medical information resources, which is positively associated with improved health knowledge (59).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [59] Lee S Chib A Kim JN Midwives’ cell phone use and health knowledge in rural communities J Health Commun 2011 16 1006 23 21728781 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Interpretationnone given

    mHealth tools that directly support health workers may be beneficial in terms of technical and managerial issues, enable more effective communication with clients, and directly enhance logistic issues such as supply chains.

    “The third major area is in mHealth tools that directly support health workers. These range across domains that provide information and decision support to professionals, which may be beneficial in terms of technical and managerial issues, enable more effective communication with clients, and directly enhance logistic issues such as supply chains.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    A handheld device developed in the United States detects differences in counterfeit packaging and is currently undergoing field tests in Ghana.

    “A handheld device developed in the United States detects differences in counterfeit packaging and is currently undergoing field tests in Ghana (80).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [80] McCarthy M Handheld device for counterfeit drug detection to be tested in Africa BMJ 2013 346 f2732 23624668 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    According to the New York Times, the Sproxil system has led to 9 million verifications being undertaken since the project was launched in 2010.

    “According to the New York Times, this has led to 9 million verifications being undertaken since the project was launched in 2010 (82).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [82] Rosenberg T The fight against fake drugs 2014 Opinionator, The New York Times Available from: http://opinionator.blogs.nytimes.com/2014/06/04/the-fight-against-fake-drugs [cited 27 July 2014].

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    The strong focus on mHealth pilot studies is a major weakness that threatens the future credibility of mHealth as a concept.

    “This seems to be a major weakness, which threatens the future credibility of mHealth as a concept.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    mHealth strategies that assume the availability of mobile phones risk further marginalising already vulnerable groups.

    “Nevertheless, as noted in some of the reviewed papers, attention has to be given to equity issues if mHealth strategies assume the availability of mobile phones, with the attendant risks of further marginalising already vulnerable groups (41, 77).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [41] Chib A Wilkin H Ling LX Hoefman B Van Biejma H You have an important message! Evaluating the effectiveness of a text message HIV/AIDS campaign in Northwest Ugandam J Health Commun 2012 17 146 57 22548607 source

      Not checked in the free run.

    • cites [77] Jennings L Gagliardi L Influence of mHealth interventions on gender relations in developing countries: a systematic literature review Int J Equity in Health 2013 12 85 24131553 PMC4015705 source

      Not checked in the free run.

76 of 76

  • The paper relies on this without support.

    The 76 papers included in the review are representative of the available evidence on mHealth impacts in LMICs.

    “In total, 76 papers were included in the review after this process and were cross-checked by another author (PB).”

  • The paper relies on this without support.

    Substantial proportions of people in many low- and middle-income country populations have access to mobile communications technology.

    “now that substantial proportions of people in many LMIC populations have access to mobile communications technology.”

  • The paper relies on this without support.

    The history of mHealth, framed as a potentially important solution to pre-existing problems, so far only covers 5 years.

    “The history of mHealth, framed as a potentially important solution to pre-existing problems, so far only covers 5 years.”

  • The paper relies on this without support.

    Health services in low- and middle-income countries generally struggle with inadequate data on the populations they seek to serve, which is a major constraint on standardising procedures.

    “Because health services in LMICs generally struggle with inadequate data on the populations they seek to serve, this continues to be a major constraint on standardising procedures.”
4 of 4

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Each is checked against this paper’s own text: does it say what the citing paper says it does?

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References 71 · Cited by 384

Authors
Hall, C. S., Fottrell, E., Wilkinson, S., & Byass, P.
Affiliations
  • University College London (GB)
  • British Broadcasting Corporation (United Kingdom) (GB)
  • University of the Witwatersrand (ZA)
Corresponding author
Fottrell, Edward
ORCID
Venue
Global Health Action
Publisher
Informa UK Limited
Published
2014-10-27
Volume
7
Issue
1
Pages
25606-25606
ISSN
  • 1654-9716 (ISSN-L)
  • 1654-9880
DOI
10.3402/gha.v7.25606
PMC
PMC4216389
OpenAlex
W2127293276
Semantic Scholar
bd6e0703f253aa53edfb652505dcd5b9295370aa
Cited by
384
References
71
Citations by year
2026: 15 · 2025: 24 · 2024: 39 · 2023: 23 · 2022: 27 · 2021: 44 · 2020: 53 · 2019: 35 · 2018: 34 · 2017: 48 · 2016: 32 · 2015: 10
FWCI
5.08
Type
journal article
Language
en
Open access
Licence
Locations
  • Global Health Action (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion)
  • DiVA at Umeå University (Umeå University) (submittedVersion, other-oa)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Physical Sciences › Computer Science › Information Systems › ICT in Developing Communities
  • Physical Sciences › Computer Science › Information Systems › Mobile Learning in Education
Keywords
mobile health, mobile health intervention, low- and middle-income countries, medication adherence, appointment compliance, health data collection, evidence base, health outcomes, mobile devices, tablets, personal digital assistants
MeSH terms
Community Health Services, Developing Countries, Humans, Outcome Assessment, Health Care, Telemedicine, Computers, Handheld, Cell Phone

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-07.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-07.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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