Nishimwe Aurore, Conco Daphney Nozizwe, Nyssen Marc, Ibisomi Latifat
School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, 1 Smuts Avenue, 2000, Braamfontein, South Africa.
School of Public Health, College of Medicine and Health Sciences, University of Rwanda, P.O. Box 3286, Kigali, Rwanda.
BMC Nurs. 2022 Jul 4;21(1):176. doi: 10.1186/s12912-022-00951-w.
Innovative use of mobile health (mHealth) technology in timely management of childbirth complications is a promising strategy, but its evidence base is limited. The Safe Delivery mHealth Application (SDA) is one of the recent mhealth applications (loaded in smartphones) which is a clinical decision support and training tool for basic emergency obstetric and newborn care (BEmONC). This paper describes, the health providers' experiences, perceptions, and acceptability of using the SDA, as well as the perceptions of key stakeholders.
A mixed-methods approach was utilized. Quantitative methods consisted of a self-reported acceptability survey, administered to 54 nurses and midwives, including questions on their usage and perceptions of the SDA. Descriptive statistics were employed to analyze the survey data. Qualitative methods included two focus group discussions with 24 nurses and midwives, and six key informant interviews with stakeholders (maternity matrons, responsible for maternal and child health, and district hospital managers). Thematic analysis was performed and selected quotations used to illustrate themes. The study took place in two district hospitals in Rwanda.
Quantitative results found that 31 (57.4%) participants used the SDA four to six times per week. Many participants felt more confident (53.7%) and better at their job (40.7%) since having the SDA. Likert scale survey responses (1-5, 1 = Strongly Disagree, 5 = Strongly Agree) indicated general agreement that SDA is easy to use (Mean = 4.46), is an effective decision support tool (4.63), and training tool (4.65). Qualitative results included themes on perceived usefulness; professional growth acquired through the use of the SDA; SDA, an empowering, intuitive, and user-friendly technology; desired SDA features and functions; benefits of SDA as perceived by key informants, and future use of the SDA.
The nurses and midwives perceive the SDA as having improved their ability to manage childbirth complications. Key stakeholders also perceive the SDA as a useful tool with a reasonable cost and recommend its implementation in routine practices. This study deepens the understanding of the potential benefits of mHealth such as the SDA in low-income settings, like Rwanda. It also provides more evidence on the impact of mHealth in assuring quality BEmONC.
创新性地利用移动健康（mHealth）技术及时处理分娩并发症是一项很有前景的策略，但其证据基础有限。安全分娩移动健康应用程序（SDA）是近期的移动健康应用程序之一（安装在智能手机中），是用于基本急诊产科和新生儿护理（BEmONC）的临床决策支持和培训工具。本文描述了卫生服务提供者使用SDA的经历、看法和可接受性，以及关键利益相关者的看法。
采用混合方法。定量方法包括对54名护士和助产士进行的自我报告可接受性调查，包括关于他们对SDA的使用情况和看法的问题。采用描述性统计分析调查数据。定性方法包括与24名护士和助产士进行的两次焦点小组讨论，以及与利益相关者（负责妇幼健康的产科护士长和地区医院管理人员）进行的六次关键 informant访谈。进行了主题分析，并选取了一些引语来说明主题。该研究在卢旺达的两家地区医院进行。
定量结果发现，31名（57.4%）参与者每周使用SDA四至六次。许多参与者自从有了SDA后，感觉更有信心（53.7%），工作表现也更好（40.7%）。李克特量表调查回答（1 - 5分，1 = 强烈不同意，5 = 强烈同意）表明，总体上认为SDA易于使用（平均 = 4.46）、是有效的决策支持工具（4.63）和培训工具（4.65）。定性结果包括关于感知有用性的主题；通过使用SDA获得的专业成长；SDA是一种赋能、直观且用户友好的技术；期望的SDA功能和特性；关键 informant认为的SDA的好处，以及SDA的未来使用。
护士和助产士认为SDA提高了他们处理分娩并发症的能力。关键利益相关者也认为SDA是一种成本合理的有用工具，并建议在常规实践中实施。这项研究加深了对mHealth（如SDA）在卢旺达等低收入环境中的潜在益处的理解。它还为mHealth在确保高质量BEmONC方面的影响提供了更多证据。
