scholarly journals eRegTime, Efficiency of Health Information Management Using an Electronic Registry for Maternal and Child Health: Protocol for a Time-Motion Study in a Cluster Randomized Trial

10.2196/13653 ◽  
2019 ◽  
Vol 8 (8) ◽  
pp. e13653 ◽  
Author(s):  
Marie Hella Lindberg ◽  
Mahima Venkateswaran ◽  
Khadija Abu Khader ◽  
Tamara Awwad ◽  
Buthaina Ghanem ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Child Health ◽  
Health Information ◽  
Information Management ◽  
Maternal And Child Health ◽  
Health Information Management ◽  
Care Providers ◽  
Primary Health ◽  
And Child Health

Background Paper-based routine health information systems often require repetitive data entry. In the West Bank, the primary health care system for maternal and child health was entirely paper-based, with care providers spending considerable amounts of time maintaining multiple files and client registers. As part of the phased national implementation of an electronic health information system, some of the primary health care clinics are now using an electronic registry (eRegistry) for maternal and child health. The eRegistry consists of client-level data entered by care providers at the point-of-care and supports several digital health interventions that are triggered by the documented clinical data, including guideline-based clinical decision support and automated public health reports. Objective The aim of the eRegTime study is to investigate whether the use of the eRegistry leads to changes in time-efficiency in health information management by the care providers, compared with the paper-based systems. Methods This is a substudy in a cluster randomized controlled trial (the eRegQual study) and uses the time-motion observational study design. The primary outcome is the time spent on health information management for antenatal care, informed and defined by workflow mapping in the clinics. We performed sample size estimations to enable the detection of a 25% change in time-efficiency with a 90% power using an intracluster correlation coefficient of 0.1 and an alpha of .05. We observed care providers for full workdays in 24 randomly selected primary health care clinics—12 using the eRegistry and 12 still using paper. Linear mixed effects models will be used to compare the time spent on health information management per client per care provider. Results Although the objective of the eRegQual study is to assess the effectiveness of the eRegistry in improving quality of antenatal care, the results of the eRegTime study will contribute to process evaluation, supplementing the findings of the larger trial. Conclusions Electronic health tools are expected to reduce workload for the care providers and thus improve efficiency of clinical work. To achieve these benefits, the implementation of such systems requires both integration with existing workflows and the creation of new workflows. Studies assessing the time-efficiency of electronic health information systems can inform policy decisions for implementations in resource-limited low- and middle-income settings. International Registered Report Identifier (IRRID) DERR1-10.2196/13653

scholarly journals A qualitative appraisal of stakeholders’ perspectives of a community-based primary health care program in rural Ghana

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Mawuli K. Kushitor ◽  
Adriana A. Biney ◽  
Kalifa Wright ◽  
James F Phillips ◽  
John Koku Awoonor-Williams ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Child Health ◽  
Maternal And Child Health ◽  
Scale Up ◽  
Care Providers ◽  
Community Members ◽  
Community Based ◽  
Primary Health ◽  
And Child Health

Abstract Background The Ghana Community-based Health Planning and Services (CHPS) initiative is a national strategy for improving access to primary health care services for underserved communities. Following a successful trial in the North Eastern part of the country, CHPS was adopted as Ghana’s flagship programme for achieving the Universal Health Coverage. Recent empirical evidence suggests, however, that scale-up of CHPS has not necessarily replicated the successes of the pilot study. This study examines the community’s perspective of the performance of CHPS and how the scale up could potentially align with the original experimental study. Method Applying a qualitative research methodology, this study analysed transcripts from 20 focus group discussions (FGDs) in four functional CHPS zones in separate districts of the Northern and Volta Regions of Ghana to understand the community’s assessment of CHPS. The study employed the thematic analysis to explore the content of the CHPS service provision, delivery and how community members feel about the service. In addition, ordinary least regression model was applied in interpreting 126 scores consigned to CHPS by the study respondents. Results Two broad areas of consensus were observed: general favourable and general unfavourable thematic areas. Favourable themes were informed by approval, appreciation, hard work and recognition of excellent services. The unfavourable thematic area was informed by rudeness, extortion, inappropriate and unprofessional behaviour, lack of basic equipment and disappointments. The findings show that mothers of children under the age of five, adolescent girls without children, and community leaders generally expressed favourable perceptions of CHPS while fathers of children under the age of five and adolescent boys without children had unfavourable expressions about the CHPS program. A narrow focus on maternal and child health explains the demographic divide on the perception of CHPS. The study revealed wide disparities in actual CHPS deliverables and community expectations. Conclusions A communication gap between health care providers and community members explains the high and unrealistic expectations of CHPS. Efforts to improve program acceptability and impact should address the need for more general outreach to social networks and men rather than a sole focus on facility-based maternal and child health care.

scholarly journals Improving maternal and child health: a situational analysis of primary health care centres of Sokoto state, Nigeria

2018 ◽  
Vol 5 (12) ◽  
pp. 5052
Author(s):  
Aminu U. Kaoje ◽  
Sani Labaran ◽  
Aminu G. Magashi ◽  
Jessica T. Ango
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Child Health ◽  
Maternal And Child Health ◽  
The State ◽  
Current Form ◽  
Primary Health ◽  
Nurse Midwife ◽  
Care Facilities ◽  
And Child Health

Background: Primary health care facilities constitute the first point of contacts of public with healthcare and form integral part of the country’s health system.Methods: A descriptive cross sectional study was conducted among 88 primary care facilities in the State. A simple random sampling technique was used to select the facilities. Federal Ministry of Health integrated supportive supervision tool was adapted for data collection and analysis done using SPSS Version 20.0. The variables were summarised with frequency and percentage and results presented in tables.Results: Almost two-thirds (65%) of the facilities provide 24 hours service coverage for both maternal and child care services. Only 16% of the facilities had medical officers, 12.5% had required number of nurse/midwife while 27% had no single nurse/midwife. With respect to trainings, one third of the facilities had personnel trained on medium and extended lifesaving skills, 20% had a trained staff on emergency obstetrics and newborn care while 61% had no single trained personnel on integrated management of childhood illnesses. A large proportion of the facilities provide maternal services such as focused ANC and delivery but none use partograph to monitor labour. A good number of facilities were lacking basic equipment and medicine supply with about two third of facilities lacking misoprostol and magnesium sulphate, and only 15% had functional DRF.Conclusions: Health resources and the level of service provision in its current form may not lead to a significant improvement in maternal and child health in the state to guarantee universal coverage.

scholarly journals Effects of The Leadership, Management And Governance Intervention On Maternal And Child Health Service Performances In Ethiopia: A Propensity Score Matched Analysis

2021 ◽  
Author(s):  
Mesele Damte Argaw ◽  
Binyam Fekadu Desta ◽  
Sualiha Abdlkader Muktar ◽  
Wondwosen Shiferaw Abera ◽  
Ismael Ali Beshir ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Child Health ◽  
Maternal And Child Health ◽  
Work Climate ◽  
Exposed Group ◽  
Health System Strengthening ◽  
Primary Health ◽  
New Challenges ◽  
And Child Health

Abstract Background: The maternal, neonatal and child mortality rates in Ethiopia are among the reported highest in Africa. Despite the reported alarming mortality rates, there are proven public health interventions in place to avoid preventable maternal and child deaths. Leadership, management, and governance (LMG) interventions play a significant role in improving management systems, enhancing the work climate, and creating responsive health systems. Hence, the Ethiopian Ministry of Health with the support of the USAID Transform: Primary Health Care Activity has been implementing LMG interventions to improve performance of primary health care entities. The LMG interventions include a six-day classroom training with an additional six to nine months of leadership project implementation, supplemented with three to four onsite coaching sessions. The purpose of this evaluation was to measure the effects of LMG interventions on maternal and child health service performances and on the overall health system strengthening measurement results of primary health care entities. Methods: The study used a cross-sectional study design with propensity matched score analysis and was conducted from August 28, 2017, to September 30, 2018, in Amhara, Oromia, Tigray, and Southern Nations, Nationalities, and Peoples’ (SNNP) regions. Data collection took place through interviewer and self-administered questionnaires among 227 LMG intervention exposed and 227 non-exposed health workers. Propensity score matched analysis was used to estimate the average treatment effects of LMG interventions on contraceptive acceptance rates, antenatal care, skilled birth attendance, postnatal care, full immunization services, growth monitoring services, management system, work climate and capacity to respond to new challenges. Results: The mean overall maternal and child health key performance indicator score with standard deviation (SD) for the LMG intervention exposed group was 63.86 ± 13.16 (SD) and 57.02 ± 13.71 (SD) for the non-exposed group. The overall health system strengthening score for the LMG intervention exposed group (mean rank =269.31) and non-exposed group (mean rank = 158.69) had statistically significant differences (U=10.145, z= -11.175, p=0.001). The average treatment effects of 3.54, 3.51, 2.64, 3.00, 1.073.34 percentage-points were observed for contraceptive acceptance rate, antenatal care, skilled birth attendance, postnatal care, full immunization, and growth monitoring services, respectively. In addition, with regards to health system strengthening measurements, we found an average treatment effect (ATE) of 12.46, 4.79 and 4.88 percentage points for strengthening management system, enhancing work climate and capacity to respond to new challenges, respectively. Conclusion: We found positive evidence of effects of the LMG intervention on increased maternal and child health services performances at primary healthcare entities. Moreover, health facilities with LMG intervention exposed health workers had a higher and statistically significant difference in management systems, work climate and readiness to face new challenges. Therefore, this study generates evidence for integrating LMG interventions to improve the performance of primary healthcare entities and maternal and child service uptake of community members, which contributes to the reduction maternal and child deaths.

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