The Development of an Electronic Clinical Decision and Support System to Improve the Quality of Antenatal Care in Rural Tanzania

Lessons Learned Using Intervention Mapping

Datos Bibliográficos

ID22067129
AutoresSandra Van Pelt (0000-0003-3311-3848, Maastricht University, autor de correspondencia), Karlijn Massar (0000-0003-4388-3846, Maastricht University), Laura Shields‐zeeman (0000-0003-0923-8771, Institute of Mental Health), John De Wit (0000-0002-5895-7935, Utrecht University), John B F De Wit, Lisette van der Eem (Amref Health Africa), Athanas S Lughata (Amref Health Africa), Robert A C Ruiter (0000-0001-5017-3258, Maastricht University)
Año2021
Volumen9
Páginas645521-645521
Fecha de publicación2021-05-20
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaFrontiers in Public Health (JOURNAL)
Identificadores de la revistaISSN: 2296-2565 • E-ISSN: 2296-2565
EditorialFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2021.645521
PMID34095055
OpenAlexW3160491925
IdiomaEN
Citas recibidas1
Referencias citadas43

It is widely recognised that high quality antenatal care is a key element in maternal healthcare. Tanzania has a very high maternal mortality ratio of 524 maternal deaths per 100,000 live births. Most maternal deaths are due to preventable causes that can be detected during pregnancy, and antenatal care therefore plays an important role in reducing maternal morbidity and mortality. Unfortunately, quality of antenatal care in Tanzania is low: Research has shown that healthcare workers show poor adherence to antenatal care guidelines, and the majority of pregnant women miss essential services. Digital health tools might improve the performance of healthcare workers and contribute to improving the quality of antenatal care. To this end, an electronic clinical decision and support system (the Nurse Assistant App) was developed and implemented in Tanzania in 2016 to provide digital assistance during antenatal care consultations to healthcare workers. The current study systematically evaluated the development and implementation process of the Nurse Assistant App in Magu District, Tanzania, with the aim of informing future programme planners about relevant steps in the development of a digital health intervention. Desk research was combined with semi-structured interviews to appraise the development process of the digital health tool. We employed the criteria stipulated by Godin et al., which are based on the six steps of Intervention Mapping [IM; Bartholomew Eldredge et al.]. Findings indicated that five of the six steps of IM were completed during the development and implementation of the Nurse Assistant App. Tasks related to community engagement, adjustment to local context, implementation in the practical context in collaboration with local partners, and rigorous evaluation were accomplished. However, tasks related to identifying theory-based behaviour change methods were not accomplished. Based on the lessons learned during the process of developing and implementing the Nurse Assistant App, we conclude that programme developers are recommended to (1) engage the community and listen to their insights, (2), focus on clear programme goals and the desired change, (3), consult or involve a behaviour change specialist, and (4), anticipate potential problems in unexpected circumstances

Birth attendant · Clinical decision support system · Digital health · Environmental health · Family medicine · Health care · Health services · Maternal health · Population · Tanzania · Global Maternal and Child Health · ICT in Developing Communities · Medicine · Mobile Health and mHealth Applications · Nursing