mPneumonia, an Innovation for Diagnosing and Treating Childhood Pneumonia in Low-Resource Settings: A Feasibility, Usability and Acceptability Study in Ghana

Abstract

Pneumonia is the leading cause of infectious disease mortality in children. Currently, health care providers (HCPs) are trained to use World Health Organization Integrated Management of Childhood Illness (IMCI) paper-based protocols and manually assess respiratory rate to diagnose pneumonia in low-resource settings (LRS). However, this approach of relying on clinical signs alone has proven problematic. Hypoxemia, a diagnostic indicator of pneumonia severity associated with an increased risk of death, is not assessed because pulse oximetry is often not available in LRS. To improve HCPs’ ability to diagnose, classify, and manage pneumonia and other childhood illnesses, “mPneumonia” was developed. mPneumonia is a mobile health application that integrates a digital version of the IMCI algorithm with a software-based breath counter and a pulse oximeter. A design-stage qualitative pilot study was conducted to assess feasibility, usability, and acceptability of mPneumonia in six health centers and five community-based health planning and services centers in Ghana. Nine health administrators, 30 HCPs, and 30 caregivers were interviewed. Transcribed interview audio recordings were coded and analyzed for common themes. Health administrators reported mPneumonia would be feasible to implement with approval and buy-in from national and regional decision makers. HCPs felt using the mPneumonia application would be feasible to integrate into their work with the potential to improve accurate patient care. They reported it was “easy to use” and provided confidence in diagnosis and treatment recommendations. HCPs and caregivers viewed the pulse oximeter and breath counter favorably. Challenges included electricity requirements for charging and the time needed to complete the application. Some caregivers saw mPneumonia as a sign of modernity, increasing their trust in the care received. Other caregivers were hesitant or confused about the new technology. Overall, this technology was valued by users and is a promising innovation for improving quality of care in frontline health facilities.

Open Data Kit 2.0

“…PATH found that mPneumonia was feasible to integrate into rural healthcare workers workflow and had the potential to improve patient care. Interviewees reported mPneumonia was "easy to use" and lent confidence to their diagnosis and treatments [18].…”

Extended Abstract

“…The project illustrated how ODK 2.0 simplified building a mobile clinical applications with complex medical workflow integrated with a sensor. PATH conducted user studies in Ghana where interviewees reported mPneumonia was "easy to use" [9].…”

Evaluation of a digital triage platform in Uganda: A quality improvement initiative to reduce the time to antibiotic administration

“…Although the World Health Organization's Integrated Management of Childhood Illness manual (IMCI) and Emergency Triage Assessment and Treatment protocol (ETAT) aid in diagnosis and triage [11,12], successful implementation is stymied by significant hospital resource limitations including the dedicated time required for healthcare workers to undergo training [13,14]. Electronic technology using mobile devices may circumvent some barriers and may improve the adherence to IMCI protocols [15,16]. However, an electronic system designed for patient triage has not previously been implemented in LMICs.…”