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

Pelt, Sandra van; Massar, Karlijn; Shields-Zeeman, Laura; Wit, John de; Eem, Lisette van der; Lughata, Athanas S.; Ruiter, Robert A. C.

doi:10.3389/fpubh.2021.645521

Cited by 5 publications

(5 citation statements)

References 43 publications

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“…There was no script available in the implementation plan to guide responses to unexpected changes making it difficult to solve problems and ensure sustained use of the programme. Based on the lessons learned during the process of developing and implementing the NAA we recommend future programme developers 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” [ 39 ].…”

Section: Explanation and Elaboration Of Icheck-dhmentioning

confidence: 99%

iCHECK-DH: Guidelines and Checklist for the Reporting on Digital Health Implementations

Perrin¹,

Babington-Ashaye²,

Dietrich³

et al. 2023

J Med Internet Res

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Background Implementation of digital health technologies has grown rapidly, but many remain limited to pilot studies due to challenges, such as a lack of evidence or barriers to implementation. Overcoming these challenges requires learning from previous implementations and systematically documenting implementation processes to better understand the real-world impact of a technology and identify effective strategies for future implementation. Objective A group of global experts, facilitated by the Geneva Digital Health Hub, developed the Guidelines and Checklist for the Reporting on Digital Health Implementations (iCHECK-DH, pronounced “I checked”) to improve the completeness of reporting on digital health implementations. Methods A guideline development group was convened to define key considerations and criteria for reporting on digital health implementations. To ensure the practicality and effectiveness of the checklist, it was pilot-tested by applying it to several real-world digital health implementations, and adjustments were made based on the feedback received. The guiding principle for the development of iCHECK-DH was to identify the minimum set of information needed to comprehensively define a digital health implementation, to support the identification of key factors for success and failure, and to enable others to replicate it in different settings. Results The result was a 20-item checklist with detailed explanations and examples in this paper. The authors anticipate that widespread adoption will standardize the quality of reporting and, indirectly, improve implementation standards and best practices. Conclusions Guidelines for reporting on digital health implementations are important to ensure the accuracy, completeness, and consistency of reported information. This allows for meaningful comparison and evaluation of results, transparency, and accountability and informs stakeholder decision-making. i-CHECK-DH facilitates standardization of the way information is collected and reported, improving systematic documentation and knowledge transfer that can lead to the development of more effective digital health interventions and better health outcomes.

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Section: Explanation and Elaboration Of Icheck-dhmentioning

confidence: 99%

iCHECK-DH: Guidelines and Checklist for the Reporting on Digital Health Implementations

Perrin¹,

Babington-Ashaye²,

Dietrich³

et al. 2023

J Med Internet Res

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“…Intervention mapping is a systematic approach that outlines a six-step process, using evidence and theory to introduce interventions and develop related implementation strategies for addressing health problems. Researchers and implementers have used intervention mapping in studies globally—and in sub-Saharan Africa specifically—to develop implementation strategies for introducing health interventions ranging from cancer management, [ 13 ] malaria elimination, [ 14 ] and improving antenatal care [ 15 ]. However, to our knowledge, studies have yet to employ an intervention mapping approach to develop an implementation strategy to improve the timely uptake of streamlined birth-dose vaccines.…”

Section: Methodsmentioning

confidence: 99%

Using intervention mapping to develop an implementation strategy to improve timely uptake of streamlined birth-dose vaccines in the Democratic Republic of the Congo

Boisson-Walsh,

Fried,

Shea

et al. 2024

PLOS Glob Public Health

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Despite the policy recommendation and effectiveness of administering the hepatitis B birth-dose vaccine (HepB-BD) to newborns to prevent mother-to-child hepatitis B transmission, timely uptake remains an issue. Countries adopting the HepB-BD to their national immunization schedule report programmatic challenges to administering the vaccine within the recommended 24-hour window after delivery. Further, while the World Health Organization recommends streamlining three birth-dose vaccines (HepB-BD, BCG, and OPV0), scarce Sub-Saharan(SSA)-based literature reports on a streamlined and timely approach to birth-dose vaccines. As more SSA countries adopt the new birth-dose vaccine to their immunization schedules, a systematically developed implementation strategy—Vaccination of Newborns–Innovative Strategies to Hasten Birth-Dose vaccines’ delivery (VANISH-BD)—will facilitate the adoption and implementation of timely birth-dose vaccine uptake. In this paper, we describe the development of the implementation strategy using intervention mapping, an evidence-based and theory-driven approach. We report on the development of our intervention, beginning with the needs assessment based in Kinshasa Province, Democratic Republic of the Congo (DRC), informing step 1 of intervention mapping. The intervention is contextually relevant, locally produced, sustainable, and designed to improve timely birth-dose vaccine uptake in the DRC. We intend to inform future implementers about improving timely and streamlined birth-dose vaccine uptake and for VANISH-BD to be adapted for similar contexts.

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“…The study setting has been described in detail elsewhere. 35 , 36 In brief, the Lake Zone has the highest maternal mortality rates in Tanzania (a total number of 176 maternal deaths in 2009) and is one of the regions with the highest percentages of women (46.6%) reporting problems in accessing healthcare. 14 , 48 This formed the decision to conduct research in this District.…”

Section: Methodsmentioning

confidence: 99%

“…In an effort to reduce this research gap and contribute to the evaluation of digital tool uptake in maternal healthcare in Tanzania, The Woman-Centered Care Project (WCCP) 35 , 36 developed a tablet-based digital health application to assist healthcare workers during ANC through step-by-step guidance through all necessary interventions and providing tailored advice and suggestions for follow-up actions when needed. This type of application is known as an electronic clinical decision and support system (eCDSS) of which a prototype was used for this study.…”

Section: Introductionmentioning

confidence: 99%

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Pregnant women’s perceptions of antenatal care and utilisation of digital health tools in Magu District, Tanzania: a qualitative study

van Pelt,

van der Pijl,

A.C. Ruiter

et al. 2023

Sexual and Reproductive Health Matters

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Antenatal care is essential to promote maternal health. Prior research has focused on barriers women face to attending antenatal care, and improving quality of care is seen as a precondition for better attendance. Digital health tools are seen as a promising instrument to increase the quality of healthcare. It is less clear to what extent the use of digital health tools in low- and middle-income counties would be perceived as beneficial by end-users. The aim of this research was to explore women’s experiences with antenatal care, and whether digital health tools would change their perceptions of quality of care. This qualitative research utilised an interpretative phenomenological approach on data from semi-structured in-depth interviews collected in 2016 with 19 randomly selected pregnant women from six different dispensaries in Magu District. Findings showed that pregnant women are motivated to attend antenatal care and are grateful for the services received. However, they also articulated a need for improvements in antenatal care services such as the availability of diagnostic tests and more interactions with healthcare workers. Participants indicated that a digital health tool could help in storing patient files and improving communication with health workers. Our results indicate that pregnant women are positive about the use of digital health tools during antenatal care but that the implementation of such a tool should be implemented in parallel to structural service delivery improvements, such as testing availability.

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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

Cited by 5 publications

References 43 publications

iCHECK-DH: Guidelines and Checklist for the Reporting on Digital Health Implementations

iCHECK-DH: Guidelines and Checklist for the Reporting on Digital Health Implementations

Using intervention mapping to develop an implementation strategy to improve timely uptake of streamlined birth-dose vaccines in the Democratic Republic of the Congo

Pregnant women’s perceptions of antenatal care and utilisation of digital health tools in Magu District, Tanzania: a qualitative study

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