为NAMAI研究调整世卫组织ANC数字模块:形成性研究,为实施科学干预措施提供信息,以根据世卫组织SMART指南方法提高服务质量。

IF 7.7
PLOS digital health Pub Date : 2025-06-23 eCollection Date: 2025-06-01 DOI:10.1371/journal.pdig.0000910
Nachela Chelwa, Bernard R Ngabo, Muyereka Nyirenda, Musange F Sabine, María Barreix, Tigest Tamrat, Natasha Okpara, Chifundo Phiri, Nathalie K Murindahabi, David Nzeyimana, Tobias Makai, Gilbert Uwayezu, Gladys Yabalwazi, Mwamba Kangwa, Rosemary K Muliokela, Hedieh Mehrtash, Caren Chizuni, Vincent Mutabazi, Felix Sayinzoga, Michael T Mbizvo, Maurice Bucagu, Özge Tunçalp
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引用次数: 0

摘要

赞比亚和卢旺达卫生部已根据世卫组织2016年的建议调整并验证了其国家产前保健指南。两国都进行了实施研究,包括五项实施战略,以支持经调整的非洲人免疫计划一揽子服务的提供。一项实施战略部署了一个数字模块,这是一个服务点数字工具,包括临床决策支持和以个人为中心的记录管理,以支持卫生工作者实施经过调整的ANC一揽子计划。研究的形成阶段包括各国分三步调整世卫组织数字ANC模块以适应其国情:(i)为创建卢旺达和赞比亚的ANC数字模块和培训材料量身定制参考模块;㈡培训保健工作人员使用该模块并提供反馈;(三)国家研究小组进行了定性评估,以了解卫生工作者使用经调整的非洲国民保健计划模块的经验。选定设施的非洲人国民大会保健工作人员完成了关于使用该模块的为期三天的培训。采用定性方法了解卫生工作者对该模块用于提供服务的看法,并为改进该模块提供反馈。出现了三个主要主题:i)在卫生专业中使用数字干预措施的经验;Ii)与使用数字干预措施相关的优势和挑战;㈢在卫生系统内改进数字干预措施使用的考虑。对卢旺达和赞比亚的非国大模块进行了修改,以改进其在非国大服务提供方面的使用。最初的测试导致了系统中错误的识别和修复。该模块已更新为包括仪表板,以支持基于设施的ANC指标监测。根据对卫生工作者的访谈反馈,还改进了培训材料。适应发展中国家的数字ANC模块的迭代过程是将其部署用于常规使用的关键,也是世卫组织SMART指南方法的关键概念证明。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Adapting the WHO ANC digital module for the NAMAI study: Formative research to inform implementation science interventions for enhanced quality service delivery following the WHO SMART guidelines approach.

The Ministries of Health in Zambia and Rwanda have adapted and validated their national antenatal care (ANC) guidelines in line with WHO 2016 recommendations. Both countries conducted implementation research, composed of five implementation strategies to support the adapted ANC package service delivery. One implementation strategy deploys a digital module, a point of service digital tool that encompasses clinical decision support and person-centric record management to support health workers in implementing the adapted ANC packages. The formative phase of the study, included countries' adaptation of the WHO digital ANC module to their contexts in three steps: (i) the reference module was tailored to create Rwanda and Zambia ANC digital modules and training materials; (ii) health workers were trained to use the module and provide feedback; (iii) country research teams conducted qualitative assessments to understand the health worker experience using the adapted ANC module. ANC health workers at selected facilities completed a three-day training on the use of the module. Qualitative methods were used to understand health worker's perspectives on the module's use for service provision and feedback for its refinement. The three major themes emerged: i) experiences using digital interventions in the health profession; ii) strengths and challenges related to the use of digital interventions; iii) considerations for improving the use of digital interventions within health systems. Rwanda and Zambia ANC modules were modified to improve their use for ANC services delivery. Initial testing led to the identification and fixing of bugs in the system. The module was updated to include dashboards to support facility-based monitoring of ANC indicators. Training materials were also improved based on feedback from interviews of health workers. The iterative process in developing country-adapted digital ANC modules is key to their deployments for routine use and a key proof of concept for the WHO SMART guideline approach.

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