Mobile Medical Units—Can They Improve the Quality of Health Services in Developing Countries?

Abstract

Purpose:

Mobile Medical Units, developed under health strategies of many developing countries, are now emerging as a newer approach on mass scale for improving access to health care services in underserved rural areas. Therefore, it is important to study the role of Mobile Medical Units in improving the quality of health services in developing countries.

Methodology:

An extensive literature search was performed with databases such as MEDLINE, PsycINFO, Biomed Central, Web of Science, Cochrane Library and Worldcat library, using a filter for last 25 years. Google was used to further refine the search. Studies of developed world, emergency role of Mobile Medical Units and unpublished items were excluded from this review.

Findings:

The literature revealed that Mobile Medical Units is still a nascent strategy to deliver health care. The available data regarding effect of Mobile Medical Units on quality of health care are very inconsistent and scanty. Better strategies, not only during the implementation period but also both pre- and post-launch are required for improving effectiveness and sustainability of Mobile Medical Units.

Practical implications:

This review summarizes the body of evidence which can assist the scientists and policymakers while evaluating the effectiveness of mobile medical units in health care delivery.

Research implications:

The present study gives a direction for future research mainly in three areas: assessing the stakeholder satisfaction, studying the constraints and critical success factors while implementing the services of Mobile Medical Units.

Value:

Since it is the first review of its kind, it will not only fill the gap in published literature but also provide a direction to the researchers for taking up in-depth studies in future which could improve the quality of health services in developing countries.

Keywords

Developing countries health services Mobile Medical Units underserved review

References

Abolfotouh

M. A.

Al-Assiri

M. H.

Al-Omani

Al Johar

Al Hakbani

Alaskar

A. S.

(2014). Public awareness of blood donation in Central Saudi Arabia, International Journal of General Medicine, 12(7), 401–410. eCollection 2014.

ACCESS Health International . (2012). Comparative case study: Mobile Medical Units in Bihar and Madhya Pradesh, Retrieved August 2014, from http://www.accessh.org/CaseStudies_Pdf/mmu%20Comparative%20Case%20Study.pdf/

Aliou

(1992). What health system for nomadic populations? World Health Forum, 13(4), 311–314.

Alliance for Health Policy and Systems Research, Geneva-An initiative of Global Forum for Health Research and World Health Organization (Alliance-HPSR). (2004). Strengthening health systems: The role and promise of policy and systems research, ISBN 2-940286-25-6. Retrieved April 2015, from http://www.who.int/alliance-hpsr/resources/Strengthening_complet.pdf

APHA Policy statement. (2008). Strengthening health systems in developing countries (Policy Number 20089). Retrieved August 2014, from http://www.apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/2014/07/23/09/09/strengthening-health-systems-in-developing-countries

Bedholm

Hansen

Sondergaard

(2007). OUTREACH: Mobile health clinics to combat HIV/AIDS in sub-Saharan Africa. Open Architecture Network (online), Retrieved August 2014, from http://openarchitecturenetwork.org/projects/387

Chan

Y. Y.

Kim

J. J.

(2010). Remote mobile health service utilization post 2005 Kashmir-Pakistan earthquake. European Journal of Emergency Medicine, 17(3), 158–163.

Chillimuntha

A. K.

Thakor

K. R.

Mulpuri

J. S.

(2013). Disadvantaged rural health—Issues and challenges: A review. National Journal of Medical Research, 3(1), 80–82.

Clark

(2013). Mumbai Mobile Van Project bringing healthcare to more of India. Retrieved August 2014, from http://www.healthcareglobal.com/tech/1376/Mumbai-Mobile-Van-Project-Bringing-Healthcare-to-More-of-India

10.

Crouse

H. L.

Macias

C. G.

Cruz

A. T.

Wilson

K. A.

Torrey

S. B.

(2010). Utilization of a mobile medical van for delivering pediatric care in the bateys of the Dominican Republic. International Journal of Emergency Medicine, 3(4), 227–232.

11.

Department of Health and Human Services (DoHHS), U.S. (n.d.). What is public health system? Retrieved August 2014, from http://www.hhs.gov/ash/initiatives/quality/system/

12.

Diouf

Goedertz

Diop

F. T.

(2006). A mobile clinic: An innovative approach to improve access to care and treatment for illegal sex workers in Senegal. In 16th International Conference on AIDS, Toronto, Canada, 13–18 August 2006, AIDS, p. 16 (Published abstract no. WEPE0646).

13.

Forster

(n.d.). Zambia’s mobile hospitals, Retrieved August 2014, from http://www.thinkafricapress.com/zambia/zambias-mobile-hospitals

14.

Fox-Rushby

J. A.

(1995). The Gambia: Cost and effectiveness of a mobile maternal health care service, West Kiang. World Health Statistics Quarterly, 48(1), 23–27.

15.

Ganavadiya

Chandrashekar

Goel

Hongal

Jain

(2014). Mobile and portable dental services catering to the basic oral health needs of the underserved population in developing countries: A proposed model. Annals of Medical and Health Sciences Research, 4(3), 293–304.

16.

Goel

Torwane

N. A.

(2014). Cost-efficiency of indigenously fabricated mobile portable dental unit in delivery of primary healthcare in rural India. Journal of Clinical and Diagnostic Research, 8(7), ZC06–ZC09.

17.

Government of India. (2012). Guidelines for the operationalization of Mobile Medical Unit (in North-eastern States, Himachal Pradesh and Jammu & Kashmir). Retrieved August 2014, from http://nrhmmanipur.org/wp-content/uploads/2012/08/Mobile_Medical_Unit1.pdf

18.

Green

Collins

(2003). Health systems in developing countries: Public sector managers and the management of contradictions and change. International Journal of Health Planning and Management, 18(Suppl 1: S), October–December, 67–78.

19.

Gwatkin

D. R.

Devishwar-Bahl

(2001). Immunization coverage inequalities: An overview of socioeconomic and gender differentials in developing countries. Retrieved August 2014, from http://siteresources.worldbank.org/INTPAH/Resources/Publications/Recent-Papers/8970_Imm._Paper_-_Text_(Final)_gwatkin.pdf

20.

Hill

Kirkwood

Edmond

(2003). Family and community practices that promote child survival, growth and development. Retrieved December 2015, from http://apps.who.int/iris/bitstream/10665/42924/1/9241591501.pdf

21.

Hashemi

Rezvan

Yekta

A. A.

Hashemi

Norouzirad

Khabazkhoob

(2014). The prevalence of astigmatism and its determinants in a rural population of Iran: The ‘NooravaranSalamat’ mobile eye clinic experience. Middle East African Journal of Ophthalmology, 21(2), 175–181.

22.

International Committee of the Red Cross (ICRC). (2006). Mobile health units: Methodological approach. Retrieved August 2014, from http://www.icrc.org/eng/assets/files/other/icrc_002_0886.pdf

23.

Jamir

Nongkynrih

Gupta

S. K.

(2013). Mobile health clinics: Meeting health needs of the urban underserved. Indian Journal of Community Medicine, 38(3), 132–134.

24.

Kar

G. C.

Sarangi

S. L.

Nanda

(2007). Mobile health unit and primary health delivery system under RLTAP in KBK districts (An Evaluation Study). Retrieved August 2014, from http://www.odisha.gov.in/pc/Download/MHU_Final_Report.pdf

25.

Knowledge@Wharton. (2013). Mobile Medical Vans: Overcoming India’s last-mile health care challenges. Retrieved August 2014, from http://knowledge.wharton.upenn.edu/article/mobile-medical-vans-overcoming-indias-last-mile-health-care-challenges/

26.

Kumar

Khattar

Tiwari

V. K.

Shivdasani

J. P.

Dhar

Nandan

(2009). An assessment of functioning of Mobile Medical Units in Jharkhand. Indian Journal of Public Health, 53(3), 157–160.

27.

Lindgren

T. G.

Deutsch

Schell

Bvumbwe

Hart

K. B.

Laviwa

Rankin

S. H.

(2011). Using mobile clinics to deliver HIV testing and other basic health services in rural Malawi, Rural Remote Health11: 1682. Retrieved January 2015, from http://www.rrh.org.au

28.

Mabuto

Latka

M. H.

Kuwane

Churchyard

G. J.

Charalambous

Christopher

J. H.

(2014). Four models of HIV counseling and testing: Utilization and test results in South Africa. PLOS ONE, 9(7), (e102267).

29.

Mauad

E. C.

Nicolau

S. M.

Moreira

L. F.

Haikel

R. L.

Jr Longatto-Filho

Baracat

E. C.

(2009). Adherence to cervical and breast cancer programs is crucial to improving screening performance. Rural and Remote Health, 9: 1241. Retrieved August 2014, from http://www.rrh.org.au

30.

Mauad

E. C.

Silva

T. B.

Latorre

Maria-R. D. O.

Vieira

Rene-A. C.

Haikel

R. L.

Jr Vazquez

V. L.

Longatto-Filho

(2011). Opportunistic screening for skin cancer using a mobile unit in Brazil. BMC Dermatology, 11(12), 1–6. Retrieved August 2014, from http://www.biomedcentral.com/content/pdf/1471-5945-11-12.pdf

31.

Moon

T. D.

Jequicene

Blevins

Jose

Lankford

J. R.

Wester

W. C.

Fuchs

M. C.

Vermund

S. H.

(2014). Mobile clinics for antiretroviral therapy in rural Mozambique. Bulletin of WHO, 92(9), 680–684.

32.

Morrison

(1996). India’s mobile health teams set pace for progress in urban communities. Population Concern News, 11(3).

33.

Moulton

A. D.

Halverson

P. K.

Honore

P. A.

Berkowitz

(2004). Public health finance: A conceptual framework. Journal of Public Health Management and Practice, 10(5), 377–382.

34.

Narathius

(2004). Feasibility study of the mobile van for voluntary counseling and testing (VCT) for HIV/AIDS. Report submitted to The Uganda Program for Human and Holistic Development (UPHOLD). Retrieved February 2015, from http://uphold.jsi.com/Docs/Resources/Research/HIVAIDS/mobile_van_for_voluntary_counseling_and_testing.pdf

35.

Patro

B. K.

Kumar

Goswami

Nongkynrih

Pandav

C. S.

UG Study Group (2008). Community perception and client satisfaction about the primary health care services in an urban resettlement colony of New Delhi. Indian Journal of Community Medicine: Official Publication of Indian Association of Preventive and Social Medicine, 33(4), 250–254.

36.

Peterson

Manchester

LeMay

(1996). Using mobile video units to educate and motivate hard-to-reach populations. International Conference on AIDS, 7–12 July, Vol. 11, p. 361 (Abstract no. Th.C.4700), Vancouver.

37.

Prabhakaran

Krishnan

Nongkynrih

Goswami

Pandav

C. S.

(2014). Cost of ambulatory care by mobile health clinic run by a Medical College in India for the year 2008–09. Indian Journal of Public Health, 58(2), 100–105.

38.

Rao

S. P.

Dubewar

R. V.

Deotale

P. G.

(1999). Yavatmal district blindness control society: A case study. Indian Journal of Ophthalmology, 47(3), 199–203.

39.

Roy

Kakkar

Kandpal

S. D.

(2012). Trend in utilization of mobile health services, morbidity pattern & health seeking in Uttarakhand. Indian Journal of Community Health, 24(4), 347–351.

40.

Ruggiero

C. P.

Gloyd

(1995). Evaluation of vision services delivered by a mobile eye Clinic in Costa Rica. Optometry and Vision Science, 72(4), 241–248.

41.

Save the Children. (n.d.). How our mobile healthcare units are bringing healthcare to the doorstep of urban poor. Retrieved August 2015, from https://www.savethechildren.in/85-latest-news/323-how-our-mobile-healthcare-units-are-bringing-healthcare-to-the-doorstep-of-urban-poor.html

42.

Sheehan

D. A.

(n.d.). A prototype in Afghanistan: The story of the development and construction of a prototype healthcare facility to help transform culture. Retrieved August 2014, from http://hospitalbuild.lifesciencemagazines.com/a-prototype-in-afghanistan-the-story-of-the-development-and-construction-of-a-prototype-healthcare-facility-to-help-transform-culture/

43.

Siemens. (2011a). Access to primary healthcare and health education. Retrieved January 2015, from http://www.siemens.co.in/about-us/sustainability/corporate-citizenship/social/sanjeevan-mobile-clinic.htm

44.

Siemens. (2011b). Access to primary healthcare and health education. Retrieved January 2015, from http://www.siemens.co.in/pool/press/news_archive/sep2011/siemenslimited_sanjeevan_delhi_23092011.pdf

45.

Sinclair

C. A.

(2002). Mobile AIDS clinic for Africa, Poster Exhibition: The XIV International AIDS Conference (Abstract no. TuPeG5701), Barcelona Spain.

46.

Strasser

(2003). Rural health around the world: Challenges and solutions. Family Practice, 20(4), 457–463.

47.

Sushma

Nagabushana

(2012). Oral health and wellness on wheels. Indian Journal Multiplicity Dentistry, 2(3), 497–499.

48.

Swaddiwudhipong

Chaovakiratipong

Nguntra

Mahasakpan

Tatip

Boonmak

(1999). A mobile unit: An effective service for cervical cancer screening among rural Thai women. International Journal of Epidemiology, 28(1), 35–39.

49.

The World Bank. (2004). The Millennium Development Goals for health: Rising to the challenges. Washington DC: The World Bank.

50.

US Doctors for Africa. (2012). Project Mobile Africa, [Internet@2012]. Retrieved August 2014, from http://www.usdfa.org/index.cfm?views=Proj_MobileClinicAfrica