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The Effect of a Decision-Support mHealth Application on Maternal and Neonatal Outcomes in Two District Hospitals in Rwanda: Quasi-Experimental Study
Aurore Nishimwe
University of the Witwatersrand Faculty of Health Sciences
Corresponding Author
ORCiD: https://orcid.org/0000-0002-8019-2561
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Globally, mobile health (mHealth) applications are known for their potential to improve healthcare providers’ access to relevant and reliable health information. Besides, electronic decision support tools, such as the Safe Delivery mHealth Application (SDA), help to reduce clinical errors and to ensure quality care at the point of service delivery. The current study assessed the effects of the SDA on basic emergency obstetric and newborn care (BEmONC) outcomes for the most frequent complications in Rwanda; post-partum haemorrhage (PPH) and newborn asphyxia and its complications.
Methods: The study adopted a quasi-experimental design. A pre-intervention record review of the BEmONC outcomes: Apgar score and PPH progressions, was conducted. The intervention took place in two district hospitals in Rwanda and entails the implementation of the SDA for six months. Six months’ post-intervention, the effect of the SDA on BEmONC outcomes was evaluated. The study included 327 participants (114 cases of PPH and 213 cases of neonatal complications). The analysis compared the outcome variables between the baseline and the endline data. Fisher’s exact test was used to compare the proportions and test between-group differences and significance level set at p<0.05.
Results: Unstable newborn outcome following neonatal resuscitation was recorded in 61.90% and 27.59% newborns cases at baseline and endline respectively, P-value = 0.000. Unstable maternal outcome following PPH management was recorded in 19.40 % and 6.38% maternal cases at baseline and endline respectively, P-value = 0.048. There was a significant association between the SDA intervention and newborns’ and maternal’ outcomes following neonatal resuscitation and PPH management, 6 months after baseline.
Conclusion: The use of the SDA supported nurses and midwives in the management of PPH and neonatal resuscitation thus improved maternal and neonatal outcomes after 6 months of the SDA intervention.
Keywords
Maternal Outcome, Neonatal Outcome, BEmONC, mHealth, Safe Delivery Application, Rwanda
Figure 1
Nancy Bolan
ORCiDcommented on 22 December, 2020
This work is quite similar to a study carried out in the DRCongo using the Safe Delivery App and published in 2018 but the research in DRC is neither mentioned nor cited. Since published research is supposed to discuss previous similar research, I am imagining this was an oversight? I would appreciate a response to this question. Thank you.
View 1 reply
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CURRENT STATUS: Under Review
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Posted 23 Sep, 2020
Community comments: 2
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On 07 Jan, 2021
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On 01 Nov, 2020
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Editor invited
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Subject Areas
Sexual & Reproductive Medicine
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This preprint is under consideration at Reproductive Health. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
The Effect of a Decision-Support mHealth Application on Maternal and Neonatal Outcomes in Two District Hospitals in Rwanda: Quasi-Experimental Study
Aurore Nishimwe
University of the Witwatersrand Faculty of Health Sciences
Corresponding Author
ORCiD: https://orcid.org/0000-0002-8019-2561
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 23 Sep, 2020
Community comments: 2
Reviewer #2 agreed
On 07 Jan, 2021
Reviewer #1 agreed
On 01 Nov, 2020
Reviewers invited
Invitations sent on 12 Oct, 2020
Editor assigned
On 21 Sep, 2020
Editor invited
On 20 Sep, 2020
Submission checks complete
On 19 Sep, 2020
First submitted
On 17 Sep, 2020
Metrics
Comments: 2
PDF Downloads: ...
HTML Views: ...
Subject Areas
Sexual & Reproductive Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Globally, mobile health (mHealth) applications are known for their potential to improve healthcare providers’ access to relevant and reliable health information. Besides, electronic decision support tools, such as the Safe Delivery mHealth Application (SDA), help to reduce clinical errors and to ensure quality care at the point of service delivery. The current study assessed the effects of the SDA on basic emergency obstetric and newborn care (BEmONC) outcomes for the most frequent complications in Rwanda; post-partum haemorrhage (PPH) and newborn asphyxia and its complications.
Methods: The study adopted a quasi-experimental design. A pre-intervention record review of the BEmONC outcomes: Apgar score and PPH progressions, was conducted. The intervention took place in two district hospitals in Rwanda and entails the implementation of the SDA for six months. Six months’ post-intervention, the effect of the SDA on BEmONC outcomes was evaluated. The study included 327 participants (114 cases of PPH and 213 cases of neonatal complications). The analysis compared the outcome variables between the baseline and the endline data. Fisher’s exact test was used to compare the proportions and test between-group differences and significance level set at p<0.05.
Results: Unstable newborn outcome following neonatal resuscitation was recorded in 61.90% and 27.59% newborns cases at baseline and endline respectively, P-value = 0.000. Unstable maternal outcome following PPH management was recorded in 19.40 % and 6.38% maternal cases at baseline and endline respectively, P-value = 0.048. There was a significant association between the SDA intervention and newborns’ and maternal’ outcomes following neonatal resuscitation and PPH management, 6 months after baseline.
Conclusion: The use of the SDA supported nurses and midwives in the management of PPH and neonatal resuscitation thus improved maternal and neonatal outcomes after 6 months of the SDA intervention.
Figure 1
Nancy Bolan
ORCiDcommented on 22 December, 2020
This work is quite similar to a study carried out in the DRCongo using the Safe Delivery App and published in 2018 but the research in DRC is neither mentioned nor cited. Since published research is supposed to discuss previous similar research, I am imagining this was an oversight? I would appreciate a response to this question. Thank you.
View 1 reply
Aurore Nishimwe
replied on 05 January, 2021
Dear Nancy Bolan, Thank you very much for your message which is very helpful and for providing information on the study carried out in the DRC using the Safe Delivery App. We will consider this research together with other comments received from reviewers. Thank you
Aurore Nishimwe
replied on 05 January, 2021
Dear Nancy Bolan, Thank you very much for your message which is very helpful and for providing information on the study carried out in the DRC using the Safe Delivery App. We will consider this research together with other comments received from reviewers. Thank you