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Pregnant women’s experiences with an integrated diagnostic and decision support device for antenatal care in Ghana
BACKGROUND: Quality antenatal care (ANC) is recognised as an opportunity for screening and early identification of pregnancy-related complications. In rural Ghana, challenges with access to diagnostic services demotivate women from ANC attendance and referral compliance, leading to absent or late id...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5989381/ https://www.ncbi.nlm.nih.gov/pubmed/29871596 http://dx.doi.org/10.1186/s12884-018-1853-7 |
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author | Abejirinde, Ibukun-Oluwa Omolade Douwes, Renate Bardají, Azucena Abugnaba-Abanga, Rudolf Zweekhorst, Marjolein van Roosmalen, Jos De Brouwere, Vincent |
author_facet | Abejirinde, Ibukun-Oluwa Omolade Douwes, Renate Bardají, Azucena Abugnaba-Abanga, Rudolf Zweekhorst, Marjolein van Roosmalen, Jos De Brouwere, Vincent |
author_sort | Abejirinde, Ibukun-Oluwa Omolade |
collection | PubMed |
description | BACKGROUND: Quality antenatal care (ANC) is recognised as an opportunity for screening and early identification of pregnancy-related complications. In rural Ghana, challenges with access to diagnostic services demotivate women from ANC attendance and referral compliance, leading to absent or late identification and management of high-risk women. In 2016, an integrated diagnostic and clinical decision support system tagged ‘Bliss4Midwives’ (B4M), was piloted in Northern Ghana. The device facilitated non-invasive screening of pre-eclampsia, gestational diabetes and anaemia at the point-of-care. This study aimed to explore the experiences of pregnant women with B4M, and its influence on service utilisation (“pull effect”) and woman-provider relationships (“woman engagement”). METHODS: Through an embedded study design, qualitative methods including individual semi-structured interviews and non-participant observation were employed. Interviews were conducted with 20 pregnant women and 10 health workers, supplemented by ANC observations in intervention facilities. Secondary data on ANC registrations over a one-year period were extracted from health facility records to support findings on the perceived influence of B4M on service utilisation. RESULTS: Women’s first impressions of the device were mostly emotive (excitement, fear), but sometimes neutral. Although it is inconclusive whether B4M increased ANC registration, pregnant women generally valued the availability of diagnostic services at the point-of-care. Additionally, by fostering some level of engagement, the intervention made women feel listened to and cared for. Process outcomes of the B4M encounter also showed that it was perceived as improving the skills and knowledge of the health worker, which facilitated trust in diagnostic recommendations and was therefore believed to motivate referral compliance. CONCLUSIONS: This study suggests that mHealth diagnostic and decision support devices enhance woman engagement and trust in health workers skills. There is need for further inquiry into how these interventions influence maternal health service utilization and women’s expectations of pregnancy care. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12884-018-1853-7) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-5989381 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-59893812018-06-20 Pregnant women’s experiences with an integrated diagnostic and decision support device for antenatal care in Ghana Abejirinde, Ibukun-Oluwa Omolade Douwes, Renate Bardají, Azucena Abugnaba-Abanga, Rudolf Zweekhorst, Marjolein van Roosmalen, Jos De Brouwere, Vincent BMC Pregnancy Childbirth Research Article BACKGROUND: Quality antenatal care (ANC) is recognised as an opportunity for screening and early identification of pregnancy-related complications. In rural Ghana, challenges with access to diagnostic services demotivate women from ANC attendance and referral compliance, leading to absent or late identification and management of high-risk women. In 2016, an integrated diagnostic and clinical decision support system tagged ‘Bliss4Midwives’ (B4M), was piloted in Northern Ghana. The device facilitated non-invasive screening of pre-eclampsia, gestational diabetes and anaemia at the point-of-care. This study aimed to explore the experiences of pregnant women with B4M, and its influence on service utilisation (“pull effect”) and woman-provider relationships (“woman engagement”). METHODS: Through an embedded study design, qualitative methods including individual semi-structured interviews and non-participant observation were employed. Interviews were conducted with 20 pregnant women and 10 health workers, supplemented by ANC observations in intervention facilities. Secondary data on ANC registrations over a one-year period were extracted from health facility records to support findings on the perceived influence of B4M on service utilisation. RESULTS: Women’s first impressions of the device were mostly emotive (excitement, fear), but sometimes neutral. Although it is inconclusive whether B4M increased ANC registration, pregnant women generally valued the availability of diagnostic services at the point-of-care. Additionally, by fostering some level of engagement, the intervention made women feel listened to and cared for. Process outcomes of the B4M encounter also showed that it was perceived as improving the skills and knowledge of the health worker, which facilitated trust in diagnostic recommendations and was therefore believed to motivate referral compliance. CONCLUSIONS: This study suggests that mHealth diagnostic and decision support devices enhance woman engagement and trust in health workers skills. There is need for further inquiry into how these interventions influence maternal health service utilization and women’s expectations of pregnancy care. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12884-018-1853-7) contains supplementary material, which is available to authorized users. BioMed Central 2018-06-05 /pmc/articles/PMC5989381/ /pubmed/29871596 http://dx.doi.org/10.1186/s12884-018-1853-7 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Abejirinde, Ibukun-Oluwa Omolade Douwes, Renate Bardají, Azucena Abugnaba-Abanga, Rudolf Zweekhorst, Marjolein van Roosmalen, Jos De Brouwere, Vincent Pregnant women’s experiences with an integrated diagnostic and decision support device for antenatal care in Ghana |
title | Pregnant women’s experiences with an integrated diagnostic and decision support device for antenatal care in Ghana |
title_full | Pregnant women’s experiences with an integrated diagnostic and decision support device for antenatal care in Ghana |
title_fullStr | Pregnant women’s experiences with an integrated diagnostic and decision support device for antenatal care in Ghana |
title_full_unstemmed | Pregnant women’s experiences with an integrated diagnostic and decision support device for antenatal care in Ghana |
title_short | Pregnant women’s experiences with an integrated diagnostic and decision support device for antenatal care in Ghana |
title_sort | pregnant women’s experiences with an integrated diagnostic and decision support device for antenatal care in ghana |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5989381/ https://www.ncbi.nlm.nih.gov/pubmed/29871596 http://dx.doi.org/10.1186/s12884-018-1853-7 |
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