Guidelines for maternal and neonatal “point of care”: Needs of and attitudes towards a computerized clinical decision support system in rural Burkina Faso

Zakane, S Alphonse; Gustafsson, Lars L; Tomson, Göran; Loukanova, Svetla; Sié, Ali; Nasiell, Josefine; Bastholm-Rahmner, Pia

doi:10.1016/j.ijmedinf.2014.01.013

Cited by 48Electronic Health Records SystemsICT in Developing CommunitiesClinical practice guidelines implementation

Guidelines for maternal and neonatal “point of care”: Needs of and attitudes towards a computerized clinical decision support system in rural Burkina Faso

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Zakane, S Alphonse, Gustafsson, Lars L, Tomson, Göran, Loukanova, Svetla, Sié, Ali, Nasiell, Josefine, Bastholm-Rahmner, Pia·2014·International Journal of Medical Informatics

DOI 10.1016/j.ijmedinf.2014.01.013

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Abstract

Background In 2010, 245,000 women died due to pregnancy-related causes in sub-Saharan Africa and southern Asia. Our study is nested into the QUALMAT project and seeks to improve the quality of maternal care services through the introduction of a computerized clinical decision support system (CDSS) to help healthcare workers in rural areas. Healthcare information technology applications in low-income countries may improve healthcare provision but recent studies demonstrate unintended consequences with underuse or resistance to CDSS and that the fit between the system and the clinical needs does present challenges. Aims To explore and describe perceived needs and attitudes among healthcare workers to access WHO guidelines using CDSS in maternal and neonatal care in rural Burkina Faso. Methods Data were collected with semi-structured interviews in two rural districts in Burkina Faso with 45 informants. Descriptive statistics were used for the analysis of the quantitative part of the interview corresponding to informants' background. Qualitative data were analyzed using manifest content analysis. Results Four main findings emerged: (a) an appreciable willingness among healthcare workers for and a great interest to adapt and use modern technologies like computers to learn more in the workplace, (b) a positive attitude to easy access of guidelines and implementation of decision-support using computers in the workplace, (c) a fear that the CDSS would require more working time and lead to double-work, and (d) that the CDSS is complicated and requires substantial computer training and extensive instructions to fully implement. Conclusions The findings can be divided into aspects of motivators and barriers in relation to how the CDSS is perceived and to be used. These aspects are closely connected to each other as the motivating aspects can easily be turned into barriers if not taken care of properly in the final design, during implementation and maintenance of the CDSS at point of care.

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Global examples revealed high levels of acceptance and willingness to learn despite lack of experience with such tools.
“Global examples revealed high levels of acceptance and willingness to learn despite lack of experience with such tools [31-33].”
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The usefulness of the mHealth app for CHWs is centered on the ease of integration into the routine workflow, improved capacity to deliver follow-up services, less paperwork, organization of data, and abolishing the paper-based registers.
“The usefulness of the mHealth app for CHWs is centered on the ease of integration into the routine workflow, improved capacity to deliver follow-up services, less paperwork, organization of data, and abolishing the paper-based registers [30-41].”
From Operability, Usefulness, and Task-Technology Fit of an mHealth App for Delivering Primary Health Care Services by Community Health Workers in Underserved Areas of Pakistan and Afghanistan: Qualitative Study (2020) · cites this paper as [33]
Studies conducted with frontline health workers prior to the integration of new technologies into their workflow have revealed high levels of acceptance and willingness to learn, despite the lack of experience with such tools.
“Studies conducted with frontline health workers prior to the integration of new technologies into their workflow have revealed high levels of acceptance and willingness to learn, despite the lack of experience with such tools [64, 68, 69].”
From Qualitative Assessment of the Feasibility, Usability, and Acceptability of a Mobile Client Data App for Community-Based Maternal, Neonatal, and Child Care in Rural Ghana (2016) · cites this paper as [68]

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Authors: Zakane, S. A., Gustafsson, L. L., Tomson, G., Loukanova, S., Sié, A., Nasiell, J., & Bastholm-Rahmner, P.
Affiliations: Karolinska University Hospital (SE)
Heidelberg University (DE)
Centre de Recherche en Santé de Nouna (BF)
ORCID: Gustafsson, Lars L
Loukanova, Svetla
Sié, Ali
Venue: International Journal of Medical Informatics
Publisher: Elsevier BV
Published: 2014-06
Volume: 83
Issue: 6
Pages: 459-469
ISSN: 1386-5056 (ISSN-L)
DOI: 10.1016/j.ijmedinf.2014.01.013
OpenAlex: W2021470326
Cited by: 48
References: 35
Citations by year: 2026: 1 · 2025: 2 · 2024: 3 · 2023: 3 · 2022: 8 · 2021: 2 · 2020: 4 · 2019: 5 · 2018: 3 · 2017: 6 · 2016: 2 · 2015: 5 · 2014: 4
FWCI: 9.83
Type: journal article
Language: en
Open access: green
zenodo.org
Licence: other-oa
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: International Journal of Medical Informatics (publishedVersion)
PubMed (publishedVersion)
Zenodo (CERN European Organization for Nuclear Research) (submittedVersion, other-oa)
Funders: European Commission
Vetenskapsrådet
Muhimbili University of Health and Allied Sciences
Topics: Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
Physical Sciences › Computer Science › Information Systems › ICT in Developing Communities
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
Keywords: clinical decision support systems, maternal care, neonatal care, clinician attitudes, technology adoption barriers, rural health care, computerized clinical decision support, Burkina Faso
MeSH terms: Adult, Attitude of Health Personnel, Burkina Faso, Female, Health Personnel, Humans, Male, Maternal Health Services, Middle Aged, Motivation, Pregnancy, Prenatal Care, Quality Assurance, Health Care, Rural Health, Practice Guidelines as Topic, Decision Support Systems, Clinical

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Guidelines for maternal and neonatal “point of care”: Needs of and attitudes towards a computerized clinical decision support system in rural Burkina Faso

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