Implementation of WHO SMART Guidelines-Digital Adaptation Kits in Pathfinder Countries in Africa: Processes and Early Lessons Learned.

IF 3.1 3区 医学 Q2 MEDICAL INFORMATICS
Rosemary K Muliokela, Kuwani Banda, Abdulaziz Mohammed Hussen, Sarai Bvulani Malumo, Andrew Kashoka, Angel Mwiche, Innocent Chiboma, Maria Barreix, Muyereka Nyirenda, Zvanaka Sithole, Natschja Ratanaprayul, Berhanu Fikadie Endehabtu, Hanna Abayneh Telake, Adane Weldeab, William J M Probert, Ӧzge Tunçalp, Ernest Maya, Mulatu Woldetsadik, Binyam Tilahun, Chris Guure, Kafui Senya, Lale Say, Tigest Tamrat
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引用次数: 0

Abstract

Background: The adoption of digital systems requires processes for quality assurance and uptake of standards to achieve universal health coverage. The World Health Organization developed the Digital Adaptation Kits (DAKs) within the SMART (Standards-based, Machine-readable, Adaptive, Requirements-based, and Testable) guidelines framework to support the uptake of standards and recommendations through digital systems. DAKs are a software-neutral mechanism for translating narrative guidelines to support the design of digital systems. However, a systematic process is needed to implement and ensure the impact of DAKs in country contexts.

Objective: This paper details the structured process and stepwise approach to customize the DAKs to the national program and digital context in 5 countries in Africa with diverse program guideline uptake and significant digital health investments: Ethiopia, Ghana, Malawi, Zambia, and Zimbabwe. All these countries have existing digital systems, which have the potential to be updated with the DAKs.

Methods: A DAK assessment tool was developed and used to assess guideline digitization readiness and opportunities for system uptake in each country. Multistakeholder teams were established to conduct the content review and alignment of the generic DAK to national guidelines and protocols through a series of stakeholder consultations, including stakeholder orientation, content review and alignment, content validation, and software update meetings.

Unlabelled: Country adaptation processes identified requirements for national-level contextualization and highlighted opportunities for refinement of DAKs. Quality assurance of the content during the content review and validation processes ensured alignment with national protocols. Adaptation processes also facilitated the adoption of the DAKs approach into national guidelines and strategic documents for sexual and reproductive health.

Conclusions: Country experiences offered early insights into the opportunities and benefits of a structured approach to digitalizing primary health care services. They also highlighted how this process can be continuously refined and sustained to enhance country-level impact.

在非洲先行国家实施世卫组织智能指南-数字适应工具包:进程和早期经验教训。
背景:采用数字系统需要质量保证流程和采用实现全民健康覆盖的标准。世界卫生组织在SMART(基于标准、机器可读、自适应、基于需求和可测试)准则框架内制定了数字适应工具包,以支持通过数字系统采用标准和建议。dak是一种软件中立的机制,用于翻译叙述指南以支持数字系统的设计。然而,需要一个系统的过程来执行和确保发展中国家发展目标在国家背景下产生影响。目的:本文详细介绍了在埃塞俄比亚、加纳、马拉维、赞比亚和津巴布韦这五个具有不同规划指导方针和重大数字卫生投资的非洲国家,根据国家规划和数字环境定制DAKs的结构化过程和逐步方法。所有这些国家都有现有的数字系统,有可能用dak进行更新。方法:开发了一个DAK评估工具,用于评估每个国家指南数字化的准备情况和系统采用的机会。建立了多利益相关方团队,通过一系列利益相关方磋商,包括利益相关方导向、内容审查和对齐、内容验证和软件更新会议,对通用DAK进行内容审查并使其与国家指南和协议保持一致。未标明:国家适应进程确定了在国家一级进行背景化的要求,并强调了改进发展规划的机会。内容审查和验证过程中的内容质量保证确保与国家协议保持一致。适应进程还有助于将发展战略方针纳入性健康和生殖健康的国家准则和战略文件。结论:国家经验使我们初步认识到采用结构化方法实现初级卫生保健服务数字化的机会和益处。他们还强调了如何不断完善和维持这一进程,以加强国家一级的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
JMIR Medical Informatics
JMIR Medical Informatics Medicine-Health Informatics
CiteScore
7.90
自引率
3.10%
发文量
173
审稿时长
12 weeks
期刊介绍: JMIR Medical Informatics (JMI, ISSN 2291-9694) is a top-rated, tier A journal which focuses on clinical informatics, big data in health and health care, decision support for health professionals, electronic health records, ehealth infrastructures and implementation. It has a focus on applied, translational research, with a broad readership including clinicians, CIOs, engineers, industry and health informatics professionals. Published by JMIR Publications, publisher of the Journal of Medical Internet Research (JMIR), the leading eHealth/mHealth journal (Impact Factor 2016: 5.175), JMIR Med Inform has a slightly different scope (emphasizing more on applications for clinicians and health professionals rather than consumers/citizens, which is the focus of JMIR), publishes even faster, and also allows papers which are more technical or more formative than what would be published in the Journal of Medical Internet Research.
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