Assessment of the quality of antenatal care services provided by health workers using a mobile phone decision support application in northern Nigeria: a pre/post-intervention study.
Assessment of the quality of antenatal care services provided by health workers using a mobile phone decision support application in northern Nigeria: a pre/post-intervention study.
复制标题
DOI：
10.1371/journal.pone.0123940
复制
发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Jega F
中科院分区：
文献类型：
--
作者：
McNabb M;Chukwu E;Ojo O;Shekhar N;Gill CJ;Salami H;Jega F
鉴于尼日利亚缺乏熟练的医疗保健提供者，一线社区卫生推广工作者（CHEW）通常负责在初级卫生中心提供妇幼保健服务。2012年，我们在尼日利亚北方的20个初级卫生中心引入了一个移动的病例管理和决策支持应用程序，并进行了一项前测试/后测试研究，以评估应用程序的引入是否对该较低级别干部提供的产前保健服务质量产生了影响。使用CommCare移动的平台，该应用程序动态地指导CHEW通过产前护理协议，并收集真实的客户数据。13个健康教育音频剪辑也嵌入在应用程序中，以改善和标准化客户咨询。为了检测质量的变化，我们开发了一个基于证据的质量评分，包括25个指标，并进行了总共266个客户的离职面谈。我们分析了基线和终点数据，以评估整体质量评分的变化以及产前保健关键要素的提供变化。总体而言，质量评分从基线时的13.3分增加到终点时的17.2分（p<0.0001），总分为25分，其中最显著的改善与健康咨询、提供的技术服务和健康教育质量有关。这些研究结果表明，引入低成本的移动的病例管理和决策支持应用程序可以刺激行为改变，提高较低级别的医疗保健工作者提供的服务质量。未来的研究应该采用更严格的实验设计，以探索对客户健康结果的潜在长期影响。
Given the shortage of skilled healthcare providers in Nigeria, frontline community health extension workers (CHEWs) are commonly tasked with providing maternal and child health services at primary health centers. In 2012, we introduced a mobile case management and decision support application in twenty primary health centers in northern Nigeria, and conducted a pre-test/post-test study to assess whether the introduction of the app had an effect on the quality of antenatal care services provided by this lower-level cadre. Using the CommCare mobile platform, the app dynamically guides CHEWs through antenatal care protocols and collects client data in real time. Thirteen health education audio clips are also embedded in the app for improving and standardizing client counseling. To detect changes in quality, we developed an evidence-based quality score consisting of 25 indicators, and conducted a total of 266 client exit interviews. We analyzed baseline and endline data to assess changes in the overall quality score as well as changes in the provision of key elements of antenatal care. Overall, the quality score increased from 13.3 at baseline to 17.2 at endline (p<0.0001), out of a total possible score of 25, with the most significant improvements related to health counseling, technical services provided, and quality of health education. These study results suggest that the introduction of a low-cost mobile case management and decision support application can spur behavior change and improve the quality of services provided by a lower level cadre of healthcare workers. Future research should employ a more rigorous experimental design to explore potential longer-term effects on client health outcomes.
登录
查看更多内容
DOI：
10.1136/jamia.2010.010025
发表时间：
2011-03-01
影响因子：
6.4
作者：
Florez-Arango, Jose F.;Iyengar, M. Sriram;Zhang, Jiajie
通讯作者：
Zhang, Jiajie
影响因子：
--
作者：
DeRenzi, Brian;Borriello, Gaetano;Lesh, Neal
通讯作者：
Lesh, Neal
影响因子：
168.9
作者：
Zurovac, Dejan;Sudoi, Raymond K.;Akhwale, Willis S.;Ndiritu, Moses;Hamer, Davidson H.;Rowe, Alexander K.;Snow, Robert W.
通讯作者：
Snow, Robert W.
影响因子：
4.9
作者：
Mitchell M;Hedt BL;Eshun-Wilson I;Fraser H;John MA;Menezes C;Grobusch MP;Jackson J;Taljaard J;Lesh N
通讯作者：
Lesh N