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      Peer Review of “Development of a Digital Platform to Promote Mother and Child Health in Underserved Areas of a Lower-Middle-Income Country: Mixed Methods Formative Study”

      reviewer-report
      Anonymous
      JMIRx Med
      JMIR Publications
      primary health care, mother and child health, community health worker, slums, digital applications, health communication.

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          Abstract

          This is a peer review for “Development of a Digital Platform to Promote Mother and Child Health in Underserved Areas of a Lower-Middle-Income Country: Mixed Methods Formative Study.” Round 1 Review General Comments This paper [1] addresses a principal issue, especially for the developing world where the valuable lives of mothers and children can easily be prevented. However, of course, a big challenge in the proposed solution is the availability of Android devices that are also connected to the internet. This is a limitation, therefore, to be added. Another area that needs to be addressed is related to cultural acceptance and sensitivity to using technology, particularly during the prenatal stage. Also, I noted that the diagrams are not clearly developed and placed in the appropriate places. I am happy with the qualitative part but unfortunately not an authority on quantitative; thus, this part should be vetted by a quantitative expert. Specific Comments Major Comments 1. This is an excellent topic requiring continuous literature development. 2. The method used is mixed, whereas I would have preferred the total qualitative inquiry considering the set aims and objectives. 3. The authors need to pay attention to the sociocultural realities of the context; therefore, either address them or acknowledge them as limitations. Minor Comments 4. The diagrams need to be appropriately designed and placed in the paper.

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          Development of a Digital Platform to Promote Mother and Child Health in Underserved Areas of a Lower-Middle-Income Country: Mixed Methods Formative Study

          Abstract Background Primary health care (PHC) is the backbone of universal health coverage, with community health workers (CHWs) being one of its critical pillars in lower-middle-income countries. Most CHW functions require them to be an efficient communicator, but their program development has been deficient in this area. Can IT provide some solutions? Moreover, can some IT-based CHW-delivered innovations help mothers and children in areas not covered by PHC services? We explored these questions during the development and feasibility testing of a digital application designed to improve the communication capacity of CHWs in two underserved areas of Islamabad. Objective This study aims to explore the perceptions, practices, and related gaps about mother and child health, and child development in an underserved area; develop and deploy a behavior change communication program to address the gaps; and assess the feasibility of the program. Methods We carried out a mixed methods study with three steps. First, we conducted 13 in-depth interviews and two focus group discussions with stakeholders to explore the issues faced by mothers living in these underserved areas. To address these barriers, we developed Sehat Ghar, a video-based health education application to demonstrate practices mothers and families needed to adopt. Second, we trained 10 volunteer CHWs from the same community to deliver health education using the application and assessed their pre-post knowledge and skills. Third, these CHWs visited pregnant and lactating mothers in the community with random observation of their work by a supporting supervisor. Results Initial exploration revealed a need for health-related knowledge among mothers and suboptimal utilization of public health care. Sehat Ghar used behavior change techniques, including knowledge transfer, enhancing mothers’ self-efficacy, and improving family involvement in mother and child care. Volunteer CHWs were identified from the community, who after the training, showed a significant improvement in mean knowledge score (before: mean 8.00, SD 1.49; after: mean 11.40, SD 1.43; P<.001) about health. During supportive supervision, these CHWs were rated as excellent in their interaction with mothers and excellent or very good in using the application. The CHW and her community reported their satisfaction with the application and wanted its delivery regularly. Conclusions Sehat Ghar is a simple, easy-to-use digital application for CHWs and is acceptable to the community. Mothers appreciate the content and presentation and are ready to incorporate its messages into their daily practices. The real-world effectiveness of the innovation tested on 250 mother-infant pairs will be important for its proof of effectiveness. With its usefulness and adaptability, and the rapidly spreading use of mobile phones and internet technology, this cost-effective innovation can help in delivering health communications at a large scale in a minimum amount of time.

            Author and article information

            Journal
            JMIRx Med
            JMIRx Med
            JMIRxMed
            xmed
            34
            JMIRx Med
            JMIR Publications (Toronto, Canada )
            2563-6316
            2024
            31 July 2024
            : 5
            : e60429
            Author notes

            None declared.

            Article
            60429
            10.2196/60429
            11300378
            39087578
            809b8425-9eb6-440a-bf72-1c27b5784ce0
            Copyright © Anonymous. Originally published in JMIRx Med (https://med.jmirx.org)

            This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIRx Med, is properly cited. The complete bibliographic information, a link to the original publication on https://med.jmirx.org/, as well as this copyright and license information must be included.

            History
            : 10 May 2024
            : 10 May 2024
            Categories
            Peer Reviews
            Peer-Review Report

            primary health care,mother and child health,community health worker,slums,digital applications,health communication.

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