Center for Bioengineering Innovation and Design, Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States.
School of Public Health, Makerere University, Kampala, Uganda.
JMIR Mhealth Uhealth. 2020 Feb 18;8(2):e16426. doi: 10.2196/16426.
A shortage of community health workers to triage sick neonates and poor recognition of neonatal illness by mothers contribute significantly toward neonatal deaths in low- and middle-income countries. Providing low-resource communities with the tools and knowledge to recognize signs of neonatal distress can lead to early care-seeking behavior. To empower and educate mothers to recognize signs of neonatal illness, we developed a neonatal health assessment device consisting of a smartphone app and a wearable sensor (the NeMo system).
The aim of this study was to determine if mothers in rural Uganda were willing and able to use the NeMo system during the first week of their infant's life. We also assessed mothers' responses to the device's recommendation to seek care.
A total of 20 mothers were enrolled in the study after giving birth in the Iganga District Hospital. Each mother was trained to use the NeMo system to assess her infant for signs of illness before leaving the hospital and was given the NeMo system to use at home for 1 week. Throughout the week, the smartphone tracked the mothers' usage of NeMo, and the study team visited twice to observe mothers' ability to use NeMo. Each mother was interviewed at the end of 1 week to gather qualitative feedback on her experience with the NeMo system.
In total, 18 mothers completed the study; 2 mothers were withdrawn during the week because of extenuating health circumstances. Moreover, 1 day after enrollment and training, 75% (15/20) of mothers used NeMo properly with no mistakes. Three days after enrollment and training, only 1 mother placed the wearable sensor improperly on her infant. On the final study day, only 1 mother connected the device improperly. Mothers used NeMo an average of 11.67 (SD 5.70) times on their own at home during the 5 full study days. Although the frequency of use per day decreased from day 1 to day 5 of the study (P=.04), 72% (13/18) of mothers used NeMo at least once per day. In total, 64% (9/14) of mothers who received an alert from the NeMo system to seek care for their infants either called the health care professional working with the study team or reused the system immediately and found no danger signs. All 18 mothers agreed or strongly agreed that the NeMo system was easy to use and helped them know when to seek care for their babies.
NeMo is a feasible and acceptable tool to aid mothers in rural Uganda to assess their infant's health.
在中低收入国家，缺少能够对患病新生儿进行分诊的社区卫生工作者，以及母亲对新生儿疾病识别能力差，这是导致新生儿死亡的重要原因。为资源匮乏的社区提供识别新生儿窘迫迹象的工具和知识，可以促使他们及早寻求医疗护理。为了使母亲能够识别新生儿疾病的迹象，我们开发了一种由智能手机应用程序和可穿戴传感器（NeMo 系统）组成的新生儿健康评估设备。
本研究旨在确定乌干达农村的母亲是否愿意并能够在婴儿出生后的第一周内使用 NeMo 系统。我们还评估了母亲对设备建议寻求护理的反应。
在伊甘加区医院分娩后，共有 20 名母亲参加了这项研究。每位母亲都接受了使用 NeMo 系统评估婴儿患病迹象的培训，并在出院后使用 NeMo 系统一周。在整个一周内，智能手机跟踪了母亲对 NeMo 的使用情况，研究团队两次访问以观察母亲使用 NeMo 的能力。在一周结束时，每位母亲都接受了采访，以收集她对 NeMo 系统使用体验的定性反馈。
共有 18 名母亲完成了研究；2 名母亲因特殊健康状况在一周内退出。此外，在入组和培训后的第 1 天，75%（15/20）的母亲正确无误地使用了 NeMo。入组和培训后的第 3 天，只有 1 位母亲没有正确地将可穿戴传感器戴在婴儿身上。在最后一天研究中，只有 1 位母亲没有正确地连接设备。母亲们在 5 个完整的研究日中，平均在家中自行使用 NeMo 11.67（SD 5.70）次。尽管每天的使用频率从研究的第 1 天到第 5 天有所下降（P=.04），但 72%（13/18）的母亲每天至少使用一次 NeMo。共有 64%（9/14）收到 NeMo 系统发出的带婴儿去看医生的警报的母亲，或者联系了与研究团队合作的医疗保健专业人员，或者立即重新使用系统并发现没有危险迹象。所有 18 名母亲均表示同意或强烈同意 NeMo 系统易于使用，并帮助她们了解何时需要为婴儿寻求医疗护理。
NeMo 是一种可行且可接受的工具，可帮助乌干达农村地区的母亲评估婴儿的健康状况。
