Background: iDeliver, a digital clinical support system for maternal and neonatal care, was developed to support quality of care improvements in Kenya.
Objective: Taking an implementation research approach, we evaluated the adoption and fidelity of iDeliver over time and assessed the feasibility of its use to provide routine Ministry of Health (MOH) reports.
Methods: We analyzed routinely collected data from iDeliver, which was implemented at the Transmara West Sub-County Hospital from December 2018 to September 2020. To evaluate its adoption, we assessed the proportion of actual facility deliveries that was recorded in iDeliver over time. We evaluated the fidelity of iDeliver use by studying the completeness of data entry by care providers during each stage of the labor and delivery workflow and whether the use reflected iDeliver's envisioned function. We also examined the data completeness of the maternal and neonatal indicators prioritized by the Kenya MOH.
Results: A total of 1164 deliveries were registered in iDeliver, capturing 45.31% (1164/2569) of the facility's deliveries over 22 months. This uptake of registration improved significantly over time by 6.7% (SE 2.1) on average in each quarter-year (P=.005), from 9.6% (15/157) in the fourth quarter of 2018 to 64% (235/367) in the third quarter of 2020. Across iDeliver's workflow, the overall completion rate of all variables improved significantly by 2.9% (SE 0.4) on average in each quarter-year (P<.001), from 22.25% (257/1155) in the fourth quarter of 2018 to 49.21% (8905/18,095) in the third quarter of 2020. Data completion was highest for the discharge-labor summary stage (16,796/23,280, 72.15%) and lowest for the labor signs stage (848/5820, 14.57%). The completion rate of the key MOH indicators also improved significantly by 4.6% (SE 0.5) on average in each quarter-year (P<.001), from 27.1% (69/255) in the fourth quarter of 2018 to 83.75% (3346/3995) in the third quarter of 2020.
Conclusions: iDeliver's adoption and data completeness improved significantly over time. The assessment of iDeliver' use fidelity suggested that some features were more easily used because providers had time to enter data; however, there was low use during active childbirth, which is when providers are necessarily engaged with the woman and newborn. These insights on the adoption and fidelity of iDeliver use prompted the team to adapt the application to reflect the users' culture of use and further improve the implementation of iDeliver.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9253974 | PMC |
| http://dx.doi.org/10.2196/34741 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Mandibular trabecular bone pattern before and two years after medical or surgical obesity treatment in young Swedish women.
Clin Oral Investig
January 2025
Department of Behavioral and Community Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, P.O. Box 450, Gothenburg, SE-40530, Sweden.
Objective: To investigate if changes in body mass index (BMI) result in changes of the mandibular trabecular bone structure.
Materials And Methods: Females (18-35 years at baseline, mean BMI 42,3) were followed from before (n = 117) until two years (n = 66) after obesity treatment (medical or surgical). The mandibular bone trabeculation was classified as sparse, dense, or mixed on intraoral radiographs (Lindh's index).
Influence of buccal mucosa width/height ratio, emergence profile and buccal bone width on peri-implant tissues: a prospective one-year study.
BMC Oral Health
January 2025
4th Division, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, No. 22, Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China.
Background: The stability of soft and hard tissues surrounding the implant is not only a matter of aesthetics, but also affects the long-term stability of the implant. The present study was to explore the influence of buccal mucosa width/height (W/H) ratio, emergence profile and buccal bone width on peri-implant soft and hard tissue changes in the posterior region.
Methods: Fifty-eight posterior implant restoration cases were recruited in this study.
Bayesian network for predicting mandibular third molar extraction difficulty.
BMC Oral Health
January 2025
Sub-Institute of Public Safety Standardization, China National Institute of Standardization, No.4 Zhichun Road, Haidian District, Beijing, 100191, PR China.
Background: This study aimed to establish a model for predicting the difficulty of mandibular third molar extraction based on a Bayesian network to meet following requirements: (1) analyse the interaction of the primary risk factors; (2) output quantitative difficulty-evaluation results based on the patient's personal situation; and (3) identify key surgical points and propose surgical protocols to decrease complications.
Methods: Relevant articles were searched to identify risk factors. Clinical knowledge and experience were used to analyse the risk factors to establish the Bayesian network.
Fit accuracy and fracture resistance evaluation of advanced lithium disilicate crowns (in- vitro study).
BMC Oral Health
January 2025
Division of Fixed Prosthodontics, Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
Background: Increasing demand for durable and aesthetically pleasing dental restorations, including laminates, inlays, onlays, and crowns, has led to advancements in all-ceramic systems, particularly with the development of advanced lithium disilicate materials. However, limited data on the fit accuracy and fracture resistance of these materials restricts their wider application in clinical restorative practices.
Aim Of The Study: This in vitro study aims to compare the marginal and internal fit, assess the fracture resistance, and evaluate the failure modes of crowns fabricated from advanced and conventional lithium disilicate materials.
Young, Empowered & strong (YES): a study protocol paper for a randomized controlled trial of an mHealth symptom monitoring and self-management intervention for adolescent and young adult (AYA) breast cancer survivors.
BMC Public Health
January 2025
Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
Background: Compared to older adults with breast cancer (BC), adolescents and young adults (AYAs) develop more aggressive disease necessitating more intensive therapy with curative intent, which is disruptive to planned life trajectories. The burden of unmet needs among AYA BC survivors exists in two domains: (1) symptoms (e.g.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!