scholarly journals Development and Implementation of a Mobile Phone–Based Prevention of Mother-To-Child Transmission of HIV Cascade Analysis Tool: Usability and Feasibility Testing in Kenya and Mozambique (Preprint)

2019 ◽  
Author(s):  
Nami Kawakyu ◽  
Ruth Nduati ◽  
Khátia Munguambe ◽  
Joana Coutinho ◽  
Nancy Mburu ◽  
...  
Keyword(s):  
Decision Making ◽  
Health Workers ◽  
Data Entry ◽  
Ease Of Use ◽  
Analysis Tool ◽  
Care Cascade ◽  
Frontline Health Workers ◽  
Cascade Analysis ◽  
Context Specific ◽  
Mother To Child

BACKGROUND Prevention of mother-to-child HIV transmission (PMTCT) care cascade failures drive pediatric HIV infections in sub-Saharan Africa. As nurses’ clinical and management role in PMTCT expand, decision-support tools for nurses are needed to facilitate identification of cascade inefficiencies and solutions. The mobile phone–based PMTCT cascade analysis tool (mPCAT) provides health facility staff a quick summary of the number of patients and percentage drop-off at each step of the PMCTC care cascade, as well as how many women-infant pairs would be retained if a step was optimized. OBJECTIVE The objective of this study was to understand and improve the mPCAT’s core usability factors and assess the health workers’ experience with using the mPCAT. METHODS Overall, 2 rounds of usability testing were conducted with health workers from 4 clinics and leading experts in maternal and child health in Kenya and Mozambique using videotaped think aloud assessment techniques. Semistructured group interviews gauged the understanding of mPCAT’s core usability factors, based on the Nielsen Usability Framework, followed by development of cognitive demand tables describing the needed mPCAT updates. Post adaptation, feasibility was assessed in 3 high volume clinics over 12 weeks. Participants completed a 5-point Likert questionnaire designed to measure ease of use, convenience of integration into work, and future intention to use the mPCAT. Focus group discussions with nurse participants at each facility and in-depth interviews with nurse managers were also conducted to assess the acceptability, use, and recommendations for adaptations of the mPCAT. RESULTS Usability testing with software engineers enabled real-time feedback to build a tool following empathic design principles. The revised mPCAT had improved navigation and simplified data entry interface, with only 1 data entry field per page. Improvements to the results page included a data visualization feature and the ability to share results through WhatsApp. Coding was simplified to enable future revisions by nontechnical staff—critical for context-specific adaptations for scale-up. Health care workers and facility managers found the tool easy to use (mean=4.3), used the tool very often (mean=4.1), and definitely intended to continue to use the tool (mean=4.8). Ease of use was the most common theme identified, with emphasis on how the tool readily informed system improvement decision making. CONCLUSIONS The mPCAT was well accepted by frontline health workers and facility managers. The collaborative process between software developer and user led to the development of a more user-friendly, context-specific tool that could be easily integrated into routine clinical practice and workflow. The mPCAT gave frontline health workers and facility managers an immediate, direct, and tangible way to use their clinical documentation and routinely reported data for decision making for their own clinical practice and facility-level improvements.

scholarly journals Researching, Co-creating and Testing Innovations in Paper Health Information Systems (PHISICC) to Support Health Workers Decision-making: Protocol of a Multi-country, Transdisciplinary, Mixed-methods Research Programme in Three Sub-saharan Countries

2021 ◽  
Author(s):  
Xavier Bosch-Capblanch ◽  
David O’Donnell ◽  
L Kendall Krause ◽  
Christian Auer ◽  
Angela Oyo-Ita ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Information Systems ◽  
Health Information ◽  
Health Workers ◽  
Health Information Systems ◽  
Primary Health ◽  
Frontline Health Workers ◽  
Rural Settings ◽  
Sub Saharan

Abstract BackgroundHealth Information Systems are crucial to provide data for decision-making and data demands are constantly growing. However, the link between data and decisions is not always rational nor linear and the management of data ends up overloading frontline health workers, who may have to compromise the health care. Despite limited evidence, there is an increasing push for the digitalisation of Health Information Systems, which faces enormous challenges, particularly in remote, rural settings in low- and middle-income countries. Paper-based tools will continue to be used and this warrants efforts to make them more responsive to local needs. Paper Health Information Systems (PHISICC) is a transdisciplinary, multi-country research initiative to create and test innovative paper-based Health Information Systems in three Sub-Saharan African countries.MethodsThe PHISICC initiative is taking place in remote, rural settings, in Côte d’Ivoire, Mozambique and Nigeria, through partnership with Ministries of Health and research institutions. We began with research syntheses to acquire the most up to date knowledge on Health Information Systems. These were coupled with field work in the three countries to understand the current design, patterns and contexts of use, and health care worker perspectives. Frontline health workers, with designers and researchers, used co-creation methods to produce the new PHISICC tools. This suite of tools is being tested in the three countries. Throughout the project, we have engaged with a wide range of stakeholders and have kept the highest scientific standards to keep it relevant to health policy in each of the three countries.DiscussionWe have deployed a comprehensive research approach to ensure the robustness and future policy uptake of the finding. Beyond the resulting paper-based tool design innovations, our process itself was innovative. Rather than emphasizing the data management compliance aspects we focused instead on frontline health workers’ decision-making; by tackling the whole scope of health care areas in Primary Health Care rather than incremental improvement to existing tools, we developed an entirely new design approach and language for a suite of tools in Primary Health Care. The initiative is being tested in remote, rural areas where the most vulnerable live.

scholarly journals Researching, characterising, co-creating and testing innovations in Paper Health Information Systems (PHISICC) to support frontline health workers decision-making: protocol of a multi-country, transdisciplinary, mixed-methods research programme in three Sub-Saharan countries

2021 ◽  
Author(s):  
Xavier Bosch-Capblanch ◽  
David O'Donnell ◽  
L Kendall Krause ◽  
Christian Auer ◽  
Angela Oyo-Ita ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Information Systems ◽  
Health Information ◽  
Health Workers ◽  
Health Information Systems ◽  
Frontline Health Workers ◽  
Rural Settings ◽  
Wide Range ◽  
Sub Saharan

Abstract BackgroundHealth Information Systems (HIS) are crucial to provide data for decision-making and data demands are constantly growing. However, the link between data and decisions is not always rational nor linear and the management of data ends up overloading frontline health workers, who may have to compromise the health care. Despite limited evidence, there is an increasing push for HIS digitalisation, which faces enormous challenges, particularly in remote, rural settings in low- and middle-income countries. Paper-based tools will continue to be used and this warrants efforts to make them more responsive to local needs. Paper Health Information Systems (PHISICC) is a transdisciplinary, multi-country research initiative to create and test innovative paper-based HIS in three Sub-Saharan African countries.MethodsThe PHISICC initiative is taking place in remote, rural settings, in Côte d’Ivoire, Mozambique and Nigeria, through partnership with Ministries of Health and research institutions. We began with research syntheses to acquire the most up to date knowledge on HIS. These were coupled with field work in the three countries to understand the current design, patterns and contexts of use, and health care worker perspectives. Frontline health workers, with designers and researchers, used co-creation methods to produce the new PHISICC tools. This suite of tools is being tested in the three countries. Throughout the project we have engaged with a wide range of stakeholders and have kept the highest scientific standards to keep it relevant to health policy in each of the three countries.DiscussionWe have deployed a comprehensive research approach to ensure the robustness and future policy uptake of the finding. Beyond the resulting paper-based tool design innovations, our process itself was innovative. Rather than emphasizing the data management compliance aspects we focused instead on frontline health workers’ decision-making; by tackling the whole scope of health care areas in PHC rather than incremental improvement to existing tools, we developed an entirely new design approach and language for a suite of tools in Primary Health Care. The initiative is being tested in remote, rural areas where the most vulnerable live.

The Development of a Humanitarian Health Ethics Analysis Tool

2015 ◽  
Vol 30 (4) ◽  
pp. 412-420 ◽  
Author(s):  
Veronique Fraser ◽  
Matthew R. Hunt ◽  
Sonya de Laat ◽  
Lisa Schwartz
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Work Experience ◽  
Ethical Decision Making ◽  
Health Workers ◽  
Care Practice ◽  
Analysis Tool ◽  
Ethical Challenges ◽  
Publication Type ◽  
Health Ethics

AbstractIntroductionHealth care workers (HCWs) who participate in humanitarian aid work experience a range of ethical challenges in providing care and assistance to communities affected by war, disaster, or extreme poverty. Although there is increasing discussion of ethics in humanitarian health care practice and policy, there are very few resources available for humanitarian workers seeking ethical guidance in the field. To address this knowledge gap, a Humanitarian Health Ethics Analysis Tool (HHEAT) was developed and tested as an action-oriented resource to support humanitarian workers in ethical decision making.While ethical analysis tools increasingly have become prevalent in a variety of practice contexts over the past two decades, very few of these tools have undergone a process of empirical validation to assess their usefulness for practitioners.MethodsA qualitative study consisting of a series of six case-analysis sessions with 16 humanitarian HCWs was conducted to evaluate and refine the HHEAT.ResultsParticipant feedback inspired the creation of a simplified and shortened version of the tool and prompted the development of an accompanying handbook.ConclusionThe study generated preliminary insight into the ethical deliberation processes of humanitarian health workers and highlighted different types of ethics support that humanitarian workers might find helpful in supporting the decision-making process.FraserV,HuntMR,de LaatS,SchwartzL.The development of a humanitarian health ethics analysis tool.Prehosp Disaster Med.2015;30(4):19.

scholarly journals BARRIERS FACED BY THE FRONTLINE HEALTH WORKERS RELATED TO HEALTH COMMUNICATION STRATEGIES UNDER NATIONAL HEALTH MISSION (NHM) IN CHHOTAUDEPUR DISTRICT OF GUJARAT*

2021 ◽  
pp. 482-495
Author(s):  
Megha Sidhpura ◽  
Anjali Pahad
Keyword(s):  
Health Communication ◽  
National Health ◽  
Health Workers ◽  
Communication Strategies ◽  
Behavioural Change ◽  
Data Entry ◽  
Family Welfare ◽  
Frontline Health Workers ◽  
Grass Root Level ◽  
Communication Approach

Health Communication is an integral component of the National Health Mission used for promotion of health programmes and healthy behaviour amongst the communities. According to the Ministry of Health and Family Welfare, GoI (2019) a strategic framework for targeted IEC activities using 360-degree communication approach is designed. The Present research was undertaken in a tribal district of Gujarat state-Chhotaudepur to study the barriers related to Health Communication Strategies by the Frontline Health Workers and therefore, a combination of descriptive and analytical methods to explore and describe the existing situation of Health Communication Strategies was adopted. This paper describes about qualitative aspect of the research conducted through total twelve Focus Group Discussions i.e. two in each block (Chhotaudepur, Kawant, Naswadi, Bodeli, PaviJetpur and Sankheda) in which 74 ASHAs, 31 ASHA Facilitators and 34 Female Health Workers. Theme guides was used for FGDs. Results and discussion are illustrated on central themes of research. Data illustrated that majority of the ASHAs faced moderate barriers and significant differences level barriers were reported by those who belonged to Bodeli, having excellent occupational skills, with low knowledge about Health Communication Strategies and average media use expressed Towards Excellence: An Indexed, Refereed & Peer Reviewed Journal of Higher Education / Dr. Megha Sidhpura & Dr. Anjali Pahad / Page 482-495 March, 2021. VOL.13. ISSUE NO. 1 https://hrdc.gujaratuniversity.ac.in/Publication Page | 483 more barriers than their counterparts. Barriers related to availability, accessibility and characteristics of beneficiaries for Health Communication Strategies were faced to great extent by ASHAs and ASHA Facilitators, however, FHWs expressed barriers related to increase in workload due to duplication of data entry at multiple levels and teething problems in TeCHO, In a nutshell, results conclude that despite knowing the fact that Health Communication has a significant role to play, this component of NHM is neglected. Hence, the findings demand serious attention on the part of NHM officials and media experts who are the custodian of the community process component of NHM and also academicians and researchers who can also contribute immensely. It is suggested to pay utmost importance and adopt to evidence-based scientific approach for design, production and provision of tailormade, useful and effective Health Communication Strategies for grass-root level health workers and volunteers to foster communication efforts in improving on social determinants of health, achieving behavioural change.

scholarly journals Researching, co-creating and testing innovations in paper-based health information systems (PHISICC) to support health workers’ decision-making: protocol of a multi-country, transdisciplinary, mixed-methods research programme in three sub-Saharan countries

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Xavier Bosch-Capblanch ◽  
David O’Donnell ◽  
L. Kendall Krause ◽  
Christian Auer ◽  
Angela Oyo-Ita ◽  
...  
Keyword(s):  
Decision Making ◽  
Information Systems ◽  
Health Information ◽  
Health Workers ◽  
Health Information Systems ◽  
Research Approach ◽  
Frontline Health Workers ◽  
Rural Settings ◽  
Wide Range ◽  
Sub Saharan

Abstract Background Health information systems are crucial to provide data for decision-making and demand for data is constantly growing. However, the link between data and decisions is not always rational or linear and the management of data ends up overloading frontline health workers, which may compromise quality of healthcare delivery. Despite limited evidence, there is an increasing push for the digitalization of health information systems, which poses enormous challenges, particularly in remote, rural settings in low- and middle-income countries. Paper-based tools will continue to be used in combination with digital solutions and this calls for efforts to make them more responsive to local needs. Paper-based Health Information Systems in Comprehensive Care (PHISICC) is a transdisciplinary, multi-country research initiative to create and test innovative paper-based health information systems in three sub-Saharan African countries. Methods/Design The PHISICC initiative is being carried out in remote, rural settings in Côte d’Ivoire, Mozambique and Nigeria through partnership with ministries of health and research institutions. We began with research syntheses to acquire the most up-to-date knowledge on health information systems. These were coupled with fieldwork in the three countries to understand the current design, patterns and contexts of use, and healthcare worker perspectives. Frontline health workers, with designers and researchers, used co-creation methods to produce the new PHISICC tools. This suite of tools is being tested in the three countries in three cluster-randomized controlled trials. Throughout the project, we have engaged with a wide range of stakeholders and have maintained the highest scientific standards to ensure that results are relevant to the realities in the three countries. Discussion We have deployed a comprehensive research approach to ensure the robustness and future policy uptake of findings. Besides the innovative PHISICC paper-based tools, our process is in itself innovative. Rather than emphasizing the technical dimensions of data management, we focused instead on frontline health workers’ data use and decision-making. By tackling the whole scope of primary healthcare areas rather than a subset of them, we have developed an entirely new design and visual language for a suite of tools across healthcare areas. The initiative is being tested in remote, rural areas where the most vulnerable live.

scholarly journals DESIGNING A DATA VISUALISATION AND ANALYSIS TOOL FOR SUPPORTING DECISION-MAKING WITH PUBLIC TRANSPORTATION NETWORK

2021 ◽  
Vol 1 ◽  
pp. 1093-1102
Author(s):  
Flore Vallet ◽  
Mostepha Khouadjia ◽  
Ahmed Amrani ◽  
Juliette Pouzet
Keyword(s):  
Decision Making ◽  
Public Transportation ◽  
Transportation Network ◽  
Visual Exploration ◽  
Problem Solution ◽  
Analysis Tool ◽  
Complex Data ◽  
Data Visualisation ◽  
Ex Post ◽  
Passenger Flows

AbstractMassive data are surrounding us in our daily lives. Urban mobility generates a very high number of complex data reflecting the mobility of people, vehicles and objects. Transport operators are primary users who strive to discover the meaning of phenomena behind traffic data, aiming at regulation and transport planning. This paper tackles the question "How to design a supportive tool for visual exploration of digital mobility data to help a transport analyst in decision making?” The objective is to support an analyst to conduct an ex post analysis of train circulation and passenger flows, notably in disrupted situations. We propose a problem-solution process combined with data visualisation. It relies on the observation of operational agents, creativity sessions and the development of user scenarios. The process is illustrated for a case study on one of the commuter line of the Paris metropolitan area. Results encompass three different layers and multiple interlinked views to explore spatial patterns, spatio-temporal clusters and passenger flows. We join several transport network indicators whether are measured, forecasted, or estimated. A user scenario is developed to investigate disrupted situations in public transport.

scholarly journals The implementation of a mobile application to support community-based health workers

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A C F Martins ◽  
P L Pereira ◽  
A C C N Mafra ◽  
J L Miraglia ◽  
C N Monteiro ◽  
...  
Keyword(s):  
Health Care ◽  
Mobile Application ◽  
Total Population ◽  
Health Workers ◽  
Data Entry ◽  
Population Data ◽  
Administrative Staff ◽  
Economic Data ◽  
Process Change ◽  
Community Based

Abstract Issue Real-time access to up-to-date population information is essential to the strategic planning of primary health care (PHC). In the Brazilian public health system community-based health workers (CHWs), working as part of PHC teams, collect health, demographic and socio-economic data from individuals mainly through paper-based forms that are later entered manually into electronic information systems. Mobile applications could help to improve the quality and speed of this process facilitating the CHWs day-to-day work while improving the access to the collected information. Description of the Problem During September of 2019, a mobile application installed in tablets for the collection of health, demographic and socio-economic data was deployed for 432 CHWs of 87 PHC teams in the southern region of São Paulo, Brazil, serving a total population of 283,324 individuals. During implementation, the acceptability and challenges faced by CHWs were evaluated and the time taken to complete data entry. Results Seventy-two hours of training were offered to CHWs and other 139 professionals including managers, nurses and administrative staff (AS). Some CHWs reported concerns about the process change and fear of not being able to operate the application, especially those unfamiliar to the technology. With training and team support, fear was transformed into satisfaction with the realization of the benefits of the system. The main infrastructure challenge was the need for installation of Wi-Fi routers in some health care units, in addition to the replacement 4.4% of damaged tablets. In four months 97.6% of the total population was registered in the application. Lessons A WhatsApp group was created to clarify AS doubts, receive suggestions and disseminate guidelines. AS remained as the reference point at healthcare units and data completeness still needs to be reinforced. Key messages A mobile application was well-accepted by CHWs and could facilitate the collection of population data. A tablet app proved to be a useful tool to generate information for the PHC teams.

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