Medical Decision Support Technology for Better Antenatal Care of the Mother, Under-Five Child Survival and Child Health in Rural India

Abstract

Aim: To develop a decision support technology that can be used by the primary health care providers to take appropriate decisions while rendering health services to Mothers in antenatal Period, Mothers in Postnatal Period, Children below the age of 5 years. Materials and Methods: “Integrated Management of Childhood and Neonatal Illness” was chosen for prototyping for implementation as it was readily available. The developed software prototype was given to the protocol development unit and field trial unit for the initial feedback. We tested our decision support system (DSS) for maternal and childcare in two phases. The first phase involved live testing of the DSS in the urban hospital and in second phase it was given to Village Health workers (VHWs) in two rural Primary Health Centers. Result: We achieved nearly nil mismatches in the 0-2 months category and maternal care. The software for 2months-5years category found some mismatch in diagnosis. Apart from “acute severe malnutrition”; other disease classification found Kappa value to be above 0.9 Conclusion: Village Health worker together with clinical Decision Support System as one unit perform almost as good as a clinician in primary health care. The Decision Support System model may prove to be a highly replicable model.