title: mHealth Interventions for Health System Strengthening in China: A Systematic Review.
abstract: BACKGROUND
  With rapidly expanding infrastructure in China, mobile technology has been deemed to have the potential to revolutionize health care delivery. There is particular promise for mobile health (mHealth) to positively influence health system reform and confront the new challenges of chronic diseases.
  
  
  OBJECTIVE
  The aim of this study was to systematically review existing mHealth initiatives in China, characterize them, and examine the extent to which mHealth contributes toward the health system strengthening in China. Furthermore, we also aimed to identify gaps in mHealth development and evaluation.
  
  
  METHODS
  We systematically reviewed the literature from English and Chinese electronic database and trial registries, including PubMed, EMBASE, Cochrane, China National Knowledge of Infrastructure (CNKI), and World Health Organization (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 health care management were included in the study.
  
  
  RESULTS
  A total of 1704 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 rigor to generate scalable solutions and provide reliable evidence of effectiveness. Most interventions focused on text messaging for consumer education and behavior 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 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.
authors.affiliation: The George Institute for Global Health at Peking University Health Science Center, Beijing, China.|Sydney Medical School, The George Institute for Global Health, Australia, University of Sydney, Sydney, Australia.
authors.forename: Maoyi
authors.identifier: http://orcid.org/0000-0002-5660-8571
authors.initials: M
authors.lastname: Tian
authors.affiliation: The George Institute for Global Health at Peking University Health Science Center, Beijing, China.
authors.forename: Jing
authors.identifier: http://orcid.org/0000-0003-4727-3754
authors.initials: J
authors.lastname: Zhang
authors.affiliation: The George Institute for Global Health at Peking University Health Science Center, Beijing, China.
authors.forename: Rong
authors.identifier: http://orcid.org/0000-0003-2725-9939
authors.initials: R
authors.lastname: Luo
authors.affiliation: School of Public Health, Peking University Health Science Center, Beijing, China.
authors.forename: Shi
authors.identifier: http://orcid.org/0000-0001-7588-7142
authors.initials: S
authors.lastname: Chen
authors.affiliation: Medical School, University of Michigan, Ann Arbor, MI, United States.
authors.forename: Djordje
authors.identifier: http://orcid.org/0000-0001-8964-0829
authors.initials: D
authors.lastname: Petrovic
authors.affiliation: Sydney Medical School, The George Institute for Global Health, Australia, University of Sydney, Sydney, Australia.
authors.forename: Julie
authors.identifier: http://orcid.org/0000-0001-8707-5563
authors.initials: J
authors.lastname: Redfern
authors.affiliation: Sun Yat-sen Global Health Institute, School of Public Health, Sun Yat-sen University, Guangzhou, China.
authors.forename: Dong Roman
authors.identifier: http://orcid.org/0000-0001-7438-632X
authors.initials: DR
authors.lastname: Xu
authors.affiliation: Sydney Medical School, The George Institute for Global Health, Australia, University of Sydney, Sydney, Australia.
authors.forename: Anushka
authors.identifier: http://orcid.org/0000-0003-3825-4092
authors.initials: A
authors.lastname: Patel
keywords: China; health care systems; mHealth