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
| Autor: | van Pelt, Sandra, Massar, Karlijn, Shields-Zeeman, Laura, de Wit, John B.F., van der Eem, Lisette, Lughata, Athanas S., Ruiter, Robert A.C., Social Policy and Public Health, Leerstoel de Wit |
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| Přispěvatelé: | Social Policy and Public Health, Leerstoel de Wit, Section Work & Organisational Psychology, RS: FPN WSP II, Section Applied Social Psychology |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Rural Population
STRATEGIES media_common.quotation_subject 030231 tropical medicine digital health Context (language use) HEALTH-WORKERS Tanzania maternal health 03 medical and health sciences Intervention mapping 0302 clinical medicine Nursing antenatal care Pregnancy Intervention (counseling) Health care PROGRAM Humans Quality (business) 030212 general & internal medicine intervention mapping implementation media_common Original Research biology Community engagement business.industry Environmental and Occupational Health Public Health Environmental and Occupational Health EDUCATION Prenatal Care biology.organism_classification Digital health electronic clinical decision and support system healthcare worker performance Female Pregnant Women Public Health Public aspects of medicine RA1-1270 Electronics Psychology business |
| Zdroj: | Frontiers in Public Health, 9, 1. Frontiers Media S.A. Frontiers in Public Health Frontiers in Public Health, Vol 9 (2021) Frontiers in Public Health, 9:645521. Frontiers Media S.A. |
| ISSN: | 2296-2565 |
| Popis: | 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 and colleagues (2007), which are based on the six steps of Intervention Mapping (IM; Bartholomew Eldredge et al., 2016). 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. |
| Databáze: | OpenAIRE |
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