scholarly journals An e-Health Decision Support System for Improving Compliance of Health Workers to the Maternity Care Protocols in South Africa

2013 ◽  
Vol 04 (01) ◽  
pp. 25-36 ◽  
Author(s):  
P. Rautenbach ◽  
N. Mbananga ◽  
T. Mashamba ◽  
H. Kwinda ◽  
V. Horner
Keyword(s):  
South Africa ◽  
Health Care ◽  
Primary Health Care ◽  
Decision Support ◽  
Decision Support System ◽  
Support System ◽  
Maternity Care ◽  
Health Workers ◽  
Primary Health ◽  
Health Decision

Summary Background: There are problems of quality in maternity services at primary health care level in South Africa. Many of these problems can be traced to non-adherence to the maternity care guidelines and lack of tools to support clinic staff and managers in their roles. Objective: The aim of this research was to investigate the utility of e-health (computerized) decision support systems at addressing the problem of compliance of health workers to the maternity care guidelines at primary health care in South Africa. At present there are no documented studies on e-health clinical decision support systems for primary health care in South Africa, though clinical decision support systems for primary health care are listed as part of the e-health strategy of the National Department of Health. Methods: An e-health decision support system named the Bacis (Basic Antenatal Care In-formation System) Program was developed, then implemented and evaluated at a primary health care clinic. The duration of the study was two years: this includes development, implementation and evaluation. Results and Conclusion: There was an overall improvement in compliance from 85.1 % to 89.3%. This result was not statistically significant. However when results were stratified into specific categories, the Bacis Program showed statistically significant improvement in compliance over the checklist system in three out of nine important categories. These are compliance at booking, patients younger than 18 years and patients booking after week 20. Further, insights and experience were also gained on development and implementation of clinical information systems at resource strained environments such as primary health care in South Africa. These results, insights and experience are invaluable for the implementation of the proposed e-health strategy in South Africa. Citation: Horner V, Rautenbach P, Mbanang N, Mashamba T, Kwinda H. An e-health decision support system for improving compliance of health workers to the maternity care protocols in South Africa. Appl Clin Inf 2013; 4: 25–36http://dx.doi.org/10.4338/ACI-2012-10-RA-0044

Strengthening Implementation of Guidelines at Primary Health Care

2016 ◽  
pp. 133-151 ◽  
Author(s):  
V. Horner ◽  
A. Coleman
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Decision Support ◽  
Decision Support Systems ◽  
Health Care Providers ◽  
Support Systems ◽  
Dissemination Strategy ◽  
Primary Health ◽  
Health Decision ◽  
Care Information

Implementation of guidelines in the health system is a complex and considerable undertaking. After the health administration has developed guidelines, a dissemination strategy needs to be put in place. Dissemination involves distribution of printed guidelines booklets, training of health care providers, provision of the equipment needed for implementing the guidelines, improvements to facilities, and supervision and monitoring by managers. This chapter reports on the Basic Antenatal Care Information System (Bacis) study in South Africa which pertains to an e-health decision support systems that is intended as an aid for nurses and managers at primary health care. The Bacis program study is important because there are few published studies from developing countries on implementation of e-health decision support systems at primary health care and their effectiveness in improving care.

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