Health workers’ experiences with the Safe Delivery App in West Wollega Zone, Ethiopia: a qualitative study

Abstract

Background Health workers in many low-income countries are not adequately trained to deliver pregnant women safely. In response to this, the Safe Delivery App (SDA) has been developed, which provides animated clinical instruction videos in basic emergency obstetric and neonatal care. The SDA aims to improve knowledge and skills of health workers located in the periphery of the health system in order to improve quality of care and potentially save the lives of mothers and newborns. The objective of this qualitative study was to explore the users’ experiences with using the SDA and in which ways the SDA influences their work situation and their perceived ability to conduct safe deliveries. Methods Eleven focus group discussions and four individual interviews were conducted with a total of 56 midwives, nurses and health extension workers from five districts in West Wollega Zone, Oromiya region of Ethiopia. The data further include observations and informal conversations. All interviews were recorded, transcribed verbatim, checked for corrections and analysed using systematic text condensation. Results The findings indicate that health workers perceive the SDA as a useful tool, which helps them memorize and update knowledge and skills, and improves their confidence. User patterns follow the relevancy of the tool to the health workers’ work situation - those who conduct many deliveries have more often used the app in emergency situations, whereas those who conduct few deliveries more often use it to improve their knowledge and to provide health education to pregnant women. Thus, the SDA is used in varying ways depending on internal and external factors such as own competencies, availability of equipment and frequency of births attended. Health workers experienced that community members showed more recognition and trust in their abilities and ascribed this to their increased confidence in assisting in deliveries. The increased recognition from communities may also be associated to a medical technology. Conclusion The health workers perceive the SDA as having improved their ability to manage complications during childbirth and have gained increased recognition and trust from the communities.

Effectiveness of a mobile phone application to increase access to sexual and reproductive health information, goods, and services among university students in Uganda: a randomized controlled trial

“…MPAs are increasingly used in low- and middle-income countries for a wide range of applications, although applications in this setting are far exceeded by applications in high-income settings [ 12 ]. In sub-Saharan Africa and in the area of SRH, apps have been deployed to the public to support family planning [ 13 ] and to healthcare workers for improving provider quality of maternal and neonatal care [ 10 , 14 – 19 ]. To our knowledge, this is the first report of an app deployed to members of the public to increase access to SRH information, goods, and services in the low-income setting.…”

Effectiveness of a mobile phone application to increase access to sexual and reproductive health information, goods, and services among university students in Uganda: A randomized controlled trial

“…MPAs are increasingly used in low-and middle-income countries for a wide range of applications, although applications in this setting are far exceeded by applications in high-income settings [12]. In sub-Saharan Africa and in the area of SRH, apps have been deployed to the public to support family planning [13] and to healthcare workers for improving provider quality of maternal and neonatal care [14][15][16][17][18][19][20]. To our knowledge, this is the rst report of an app deployed to members of the public to increase access to SRH information, goods, and services in the low-income setting.…”

Informal mhealth at scale in Africa: Opportunities and challenges

“…Ethiopia has by far the fewest currently-active programmes (8); mostly small-scale initiatives targeting HEWs (e.g. Steege et al, 2018 , Thomsen et al, 2019 ). Overall, with one or two notable exceptions, mhealth in Ghana, Malawi and Ethiopia has faced the same challenges of sustainability and scalability those encountered in other locations, described above.…”