Barriers and facilitators for the sustainability of digital health interventions in low and middle-income countries: A systematic review.

Background: Digital health interventions (DHIs) have increased exponentially all over the world. Furthermore, the interest in the sustainability of digital health interventions is growing significantly. However, a systematic synthesis of digital health intervention sustainability challenges is lacking. This systematic review aimed to identify the barriers and facilitators for the sustainability of digital health intervention in low and middle-income countries. Methods: Three electronic databases (PubMed, Embase and Web of Science) were searched. Two independent reviewers selected eligible publications based on inclusion and exclusion criteria. Data were extracted and quality assessed by four team members. Qualitative, quantitative or mixed studies conducted in low and middle-income countries and published from January 2000 to May 2022 were included. Results: The sustainability of digital health interventions is very complex and multidimensional. Successful sustainability of digital health interventions depends on interdependent complex factors that influence the implementation and scale-up level in the short, middle and long term. Barriers identified among others are associated with infrastructure, equipment, internet, electricity and the DHIs. As for the facilitators, they are more focused on the strong commitment and involvement of relevant stakeholders: Government, institutional, sectoral, stakeholders' support, collaborative networks with implementing partners, improved satisfaction, convenience, privacy, confidentiality and trust in clients, experience and confidence in using the system, motivation and competence of staff. All stakeholders play an essential role in the process of sustainability. Digital technology can have long term impacts on health workers, patients, and the health system, by improving data management for decision-making, the standard of healthcare service delivery and boosting attendance at health facilities and using services. Therefore, management changes with effective monitoring and evaluation before, during, and after DHIs are essential. Conclusion: The sustainability of digital health interventions is crucial to maintain good quality healthcare, especially in low and middle-income countries. Considering potential barriers and facilitators for the sustainability of digital health interventions should inform all stakeholders, from their planning until their scaling up. Besides, it would be appropriate at the health facilities level to consolidate facilitators and efficiently manage barriers with the participation of all stakeholders.

Public attitudes towards COVID-19 vaccines in Africa: A systematic review.

As COVID-19 vaccine acquisition and deployment accelerates, tensions also increase. This review aims to identify and understand the significance of population attitudes toward COVID-19 vaccines in Africa. A systematic review was conducted. Searches were conducted in MEDLINE, CINAHL, EMBASE, and Global Health databases. Database searches began on June 23, 2021, and the last search date was June 30, 2021. The methodological quality of the studies included in this review was assessed using the Mixed methods appraisal tool. A total of 609 articles were retrieved, and 23 met the eligibility criteria. All 23 included studies were cross-sectional. Three attitudes were identified: acceptance, reluctance, and refusal to be vaccinated. Acceptance of vaccination was motivated by confidence in the accuracy of the government's response to COVID-19 and the fact that relatives had been diagnosed with or died from COVID- 19. Reluctance was based on fear of vaccine quality and side effects, and insufficient clinical trials. Finally, refusal to be vaccinated was justified by reasons such as the unreliability of clinical trials and insufficient data regarding the vaccine's adverse effects. This review revealed common attitudes of African populations toward COVID-19 vaccines. The results indicate that research needs to focus more on identifying facilitators of COVID-19 vaccination. However, they also provide essential elements for health personnel in charge of vaccination to develop strategies to achieve satisfactory coverage rates.

Knowledge, beliefs and perceptions of religious leaders on modern contraceptive use in Burkina Faso: a qualitative study.

INTRODUCTION: in Burkina Faso, despite the strategies implemented to increase the use of contraceptives, the prevalence rate of modern contraceptives remains low. Religion is an important part of the socio-cultural fabric of many communities. Besides, religious leaders play an essential role in adopting and using contraceptive methods to support family health. The study objective was to explore the knowledge, beliefs and perceptions of religious leaders about modern contraceptives among women of childbearing age. METHODS: data were collected in September 2018 from twenty-one religious' leaders of the urban municipality of Dori. Study participants were selected based on reasoned sampling with maximum variation (sex, religion, age, residence and level of education). We conducted semi-structured individual interviews, non-participant observations and documentary review. RESULTS: religious leaders have a good knowledge of modern contraceptive methods, but they prefer traditional contraceptive methods and abstinence. They consider modern contraception as abortion and female sterilization and emphasize birth spacing. Furthermore, religious leaders lack training on contraception and have no real links and exchanges with sexual and reproductive health services. As a result, their assessment of the quality of these services is very mixed. CONCLUSION: religious leaders play a crucial role in improving modern contraceptive methods in Burkina Faso. Close collaboration with family planning services should, at all times, be maintained. The implementation of training and educational activities for religious leaders could help raise modern contraceptive use in Burkina Faso.

Religious Leaders' Knowledge of Family Planning and Modern Contraceptive Use and Their Involvement in Family Planning Programmes in Burkina Faso: A Qualitative Study in Dori in the Sahel Region.

INTRODUCTION: It is necessary to understand religious leaders' perceptions of modern contraceptive use and their role in influencing fertility behaviour for the successful adoption of family planning, especially in societies where the religious leaders' opinions can have a significant influence on individuals' reproductive decisions. This study, therefore, aimed to assess religious leaders' knowledge of family planning and their involvement in family planning programmes in the Sahel region of Burkina Faso. METHODS: This is a qualitative study comprising in-depth individual interviews with twenty-one religious' leaders in the town of Dori in the Sahel region of Burkina Faso. An interview guide was used for data collection. This interview guide was developed based on the central themes and sub-themes determined for the research, namely, the religious leaders' knowledge of modern contraception, the inclusion of information on modern contraception during religious activities and the relationship between religious leaders and reproductive health services. All interviews were recorded and transcribed in French using Microsoft Word. The verbatims were then coded for content analysis. The analysis method chosen was that of thematic analysis. RESULTS: The results of the study showed that religious leaders had good knowledge about family planning including modern contraceptive methods and fertility regulation through birth spacing. Regarding their involvement in family planning programme, religious leaders said they were not involved enough. However, the results of the study showed that leaders are reluctant to promote the use of FP methods. CONCLUSION: Although religious leaders are knowledgeable about family planning, they are still reluctant to promote the use of modern contraceptive methods in their communities. To do so, efforts are needed to sensitise and mobilise them in family planning programmes. The cooperation of local religious leaders will help promote family planning and improve Burkina Faso's performance on the Sustainable Development Goals through the achievement of the demographic dividend in the country.

An Imperative for the National Public Health School in Burkina Faso to Promote the Use of Information and Communication Technologies in Education During the COVID-19 Pandemic: Critical Analysis.

BACKGROUND: Several studies have reported the positive impact of information and communication technologies (ICTs) on academic performance and outcomes. Although some equipment is available, the ICTs for education at the National Public Health School (NPHS) of Burkina Faso have many shortcomings. These shortcomings were clearly revealed during the search for responses to the crisis caused by the COVID-19 pandemic. Indeed, to curb the spread of COVID-19, some measures were taken, such as closure of educational institutions. This resulted in a 2.5-month suspension of educational activities. Despite its willingness, the NPHS was unable to use ICTs to continue teaching during the closure period of educational institutions. OBJECTIVE: In this paper, we aim to propose practical solutions to promote ICT use in teaching at the NPHS by analyzing the weaknesses and challenges related to its use. METHODS: We conducted a critical analysis based on information from the gray literature of NPHS. This critical analysis was preceded by a review of systematic reviews on barriers and facilitating factors to using ICTs in higher education and a systematic review of ICT use during the COVID-19 pandemic in higher education. An ICT integration model and a clustering of ICT integration factors guided the analysis. RESULTS: The weaknesses and challenges identified relate to the infrastructure and equipment for the use of ICTs in pedagogical situations in face-to-face and distance learning; training of actors, namely the teachers and students; availability of qualified resource persons and adequate and specific financial resources; motivation of teachers; and stage of use of ICTs. CONCLUSIONS: To promote the use of ICTs in teaching at the NPHS, actions must be performed to strengthen the infrastructure and equipment, human resources, the skills of actors and the motivation of teachers in the pedagogical use of ICTs.