Feasibility, usability and acceptability of a novel digital hybrid-system for reporting of routine maternal health information in Southern Tanzania

A mixed-methods study

Bibliographic Data

ID19591451
AuthorsRegine Unkels (0000-0001-6348-1620, Ifakara Health Institute, corresponding author), Fatuma Manzi (0000-0001-9110-0776, Ifakara Health Institute, corresponding author), Ntuli Kapologwe (0000-0003-0900-2937, Ministry of Health and Social Welfare, corresponding author), Ulrika Baker (0000-0003-4011-8217, corresponding author), Aziz Ahmad (0000-0002-6028-3474, Ifakara Health Institute, corresponding author), Rustam Nabiev (corresponding author), Maria Berndtsson (corresponding author), J Baraka (0000-0003-4835-808X, Ifakara Health Institute, corresponding author), Claudia Hanson (0000-0001-8066-7873, Karolinska Institutet, corresponding author), Akihiko Hirose (0000-0002-3967-5529, Karolinska Institutet, corresponding author)
EditorsAbdur Razzaque Sarker (0000-0002-2022-7590)
Year2023
Volume3
Issue1
Pagese0000972
Publication date2023-01-12
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0000972
PMID36962837
OpenAlexW4315778948
LanguageEN
Citations received4
References cited46

Health information systems are important for health planning and progress monitoring. Still, data from health facilities are often of limited quality in Low-and-Middle-Income Countries. Quality deficits are partially rooted in the fact that paper-based documentation is still the norm at facility level, leading to mistakes in summarizing and manual copying. Digitization of data at facility level would allow automatization of these procedural steps. Here we aimed to evaluate the feasibility, usability and acceptability of a scanning innovation called Smart Paper Technology for digital data processing. We used a mixed-methods design to understand users’ engagement with Smart Paper Technology and identify potential positive and negative effects of this innovation in three health facilities in Southern Tanzania. Eight focus group discussions and 11 in-depth interviews with users were conducted. We quantified time used by health care providers for documentation and patient care using time-motion methods. Thematic analysis was used to analyze qualitative data. Descriptive statistics and multivariable linear models were generated to compare the difference before and after introduction and adjust for confounders. Health care providers and health care managers appreciated the forms’ simple design features and perceived Smart Paper Technology as time-saving and easy to use. The time-motion study with 273.3 and 224.0 hours of observations before and after introduction of Smart Paper Technology , respectively, confirmed that working time spent on documentation did not increase (27.0% at baseline and 26.4% post-introduction; adjusted p = 0.763). Time spent on patient care was not negatively impacted (26.9% at baseline and 37.1% at post-intervention; adjusted p = 0.001). Health care providers described positive effects on their accountability for data and service provision relating to the fact that individually signed forms were filled. Health care providers perceived Smart Paper Technology as feasible, easy to integrate and acceptable in their setting, particularly as it did not add time to documentation

Business · Copying · Descriptive statistics · Digital health · Documentation · Environmental health · Focus group · Geography · Health care · Health facility · Human–computer interaction · Knowledge management · Process management · Qualitative research · Statistics · Tanzania · Thematic analysis · Usability · Computer Science · Electronic Health Records Systems · Medicine · Mobile Health and mHealth Applications · Nursing · Telemedicine and Telehealth Implementation · Marketing