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A digitalized program to improve antenatal health care in a rural setting in North-Western Burundi: Early evidence-based lessons

In Burundi, the north-western region continues to grapple with the lowest level of antenatal care (ANC) attendance rate which is constantly about half the national average of 49% ANC4 coverage. Despite a dearth of empirical evidence to understand the determinants of this suboptimal attendance of ANC...

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Autores principales: Misago, Nadine, Habonimana, Desire, Ciza, Roger, Ndayizeye, Jean Paul, Kimaro, Joyce Kevin Abalo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10109494/
https://www.ncbi.nlm.nih.gov/pubmed/37068064
http://dx.doi.org/10.1371/journal.pdig.0000133
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author Misago, Nadine
Habonimana, Desire
Ciza, Roger
Ndayizeye, Jean Paul
Kimaro, Joyce Kevin Abalo
author_facet Misago, Nadine
Habonimana, Desire
Ciza, Roger
Ndayizeye, Jean Paul
Kimaro, Joyce Kevin Abalo
author_sort Misago, Nadine
collection PubMed
description In Burundi, the north-western region continues to grapple with the lowest level of antenatal care (ANC) attendance rate which is constantly about half the national average of 49% ANC4 coverage. Despite a dearth of empirical evidence to understand the determinants of this suboptimal attendance of ANC, widespread evidence informs that women forget scheduled ANC appointments. We designed and tested a digital intervention that uses a reminder model aimed at increasing the number of women who attend at least 4 ANC visits in this region. We enrolled a cohort of 132 pregnant women who were followed until childbirth using a single arm pre- and post-test design. The digital model builds on the collaboration between midwives or nurses, community health workers (CHWs), and pregnant women who are centrally connected through regular automated communications generated by the cPanel of the digital intervention. In addition to ANC attendances, we nested a cross-sectional survey to understand mothers’ perceptions and acceptability of the digital intervention using the acceptability framework by Sekhon et al. (2017). Descriptive analyses were performed to observe the trend in ANC attendance and logistic regressions fitted to seize determinants affecting mothers’ acceptability of the intervention. Of 132 enrolled pregnant women, 1 (0.76%) dropped out. From a baseline of 23%, nearly 73.7% of mothers attended their subsequent ANC visits after the start of the intervention. From the third month of intervention, about 80% of mothers constantly attended ANC appointments; which corresponds to greater than 200% increase from the baseline. Findings showed that 96.2% of mothers expressed satisfaction, 77.1% positively reacted to automated reminders (attitudes), 70.2% expressed willingness to participate, and 86.3% had the ability to actively participate to the intervention. Conversely, half of mothers confirmed that participation to this programme somewhat affected their time management. A key learning is that digital interventions have a lot of promise to improve pregnancy monitoring in rural settings. However, the overall user acceptability was low especially among mothers lacking personal mobile phone.
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spelling pubmed-101094942023-04-18 A digitalized program to improve antenatal health care in a rural setting in North-Western Burundi: Early evidence-based lessons Misago, Nadine Habonimana, Desire Ciza, Roger Ndayizeye, Jean Paul Kimaro, Joyce Kevin Abalo PLOS Digit Health Research Article In Burundi, the north-western region continues to grapple with the lowest level of antenatal care (ANC) attendance rate which is constantly about half the national average of 49% ANC4 coverage. Despite a dearth of empirical evidence to understand the determinants of this suboptimal attendance of ANC, widespread evidence informs that women forget scheduled ANC appointments. We designed and tested a digital intervention that uses a reminder model aimed at increasing the number of women who attend at least 4 ANC visits in this region. We enrolled a cohort of 132 pregnant women who were followed until childbirth using a single arm pre- and post-test design. The digital model builds on the collaboration between midwives or nurses, community health workers (CHWs), and pregnant women who are centrally connected through regular automated communications generated by the cPanel of the digital intervention. In addition to ANC attendances, we nested a cross-sectional survey to understand mothers’ perceptions and acceptability of the digital intervention using the acceptability framework by Sekhon et al. (2017). Descriptive analyses were performed to observe the trend in ANC attendance and logistic regressions fitted to seize determinants affecting mothers’ acceptability of the intervention. Of 132 enrolled pregnant women, 1 (0.76%) dropped out. From a baseline of 23%, nearly 73.7% of mothers attended their subsequent ANC visits after the start of the intervention. From the third month of intervention, about 80% of mothers constantly attended ANC appointments; which corresponds to greater than 200% increase from the baseline. Findings showed that 96.2% of mothers expressed satisfaction, 77.1% positively reacted to automated reminders (attitudes), 70.2% expressed willingness to participate, and 86.3% had the ability to actively participate to the intervention. Conversely, half of mothers confirmed that participation to this programme somewhat affected their time management. A key learning is that digital interventions have a lot of promise to improve pregnancy monitoring in rural settings. However, the overall user acceptability was low especially among mothers lacking personal mobile phone. Public Library of Science 2023-04-17 /pmc/articles/PMC10109494/ /pubmed/37068064 http://dx.doi.org/10.1371/journal.pdig.0000133 Text en © 2023 Misago et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Misago, Nadine
Habonimana, Desire
Ciza, Roger
Ndayizeye, Jean Paul
Kimaro, Joyce Kevin Abalo
A digitalized program to improve antenatal health care in a rural setting in North-Western Burundi: Early evidence-based lessons
title A digitalized program to improve antenatal health care in a rural setting in North-Western Burundi: Early evidence-based lessons
title_full A digitalized program to improve antenatal health care in a rural setting in North-Western Burundi: Early evidence-based lessons
title_fullStr A digitalized program to improve antenatal health care in a rural setting in North-Western Burundi: Early evidence-based lessons
title_full_unstemmed A digitalized program to improve antenatal health care in a rural setting in North-Western Burundi: Early evidence-based lessons
title_short A digitalized program to improve antenatal health care in a rural setting in North-Western Burundi: Early evidence-based lessons
title_sort digitalized program to improve antenatal health care in a rural setting in north-western burundi: early evidence-based lessons
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10109494/
https://www.ncbi.nlm.nih.gov/pubmed/37068064
http://dx.doi.org/10.1371/journal.pdig.0000133
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