mHealth interventions for health system strengthening in China: a Systematic Review
Date Submitted: Oct 26, 2016
Open Peer Review Period: Oct 26, 2016 - Dec 21, 2016
Background: With rapidly expanding infrastructure in China, mobile technology has been deemed to have the potential to revolutionise healthcare delivery. There is particular promise for mHealth to positively influence health system reform, and confront the new challenges of chronic diseases. Objective: To systematically review existing mHealth initiatives in China, to characterise them and examine the extent to which mHealth contributes towards the health system strengthening in China. Also to identify gaps in mHealth development and evaluation. Methods: Systematically review of the literature from English and Chinese electronic database and trial registries, including PubMed, EMBASE, Cochrane, China National Knowledge of Infrastructure, and WHO International Clinical Trials Registry Platform. We used the English keywords of mHealth, eHealth, telemedicine, telehealth, mobile phone, cell phone, text messaging, and China, as well as their corresponding Chinese keywords. All articles using mobile technology for healthcare management were included in the study. Results: 1,704 articles were found using the search terms. and eventually 72 were included. Overall, few high quality interventions were identified. Most interventions were found to be insufficient in scope, and their evaluation was of inadequate rigour to generate scalable solutions and provide reliable evidence of effectiveness. Most interventions focused on text messaging for consumer education and behaviour change. There were a limited number of interventions that addressed health information management, health workforce issues, use of medicines and technologies, or leadership and governance from a health system perspective. Conclusions: We provide four recommendations for future mHealth interventions in China that include the need for the development, evaluation and trials examining integrated mHealth interventions in effort to guide the development of future mHealth interventions, target disadvantaged populations with mHealth interventions, and generate appropriate evidence for scalable and sustainable models of care.