The CRADLE vital signs alert: qualitative evaluation of a novel device designed for use in pregnancy by healthcare workers in low-resource settings
Open accessAbstract
BACKGROUND: Vital signs measurement can identify pregnant and postpartum women who require urgent treatment or referral. In low-resource settings, healthcare workers have limited access to accurate vital signs measuring devices suitable for their environment and training. The CRADLE Vital Signs Alert (VSA) is a novel device measuring blood pressure and pulse that is accurate in pregnancy and designed for low-resource settings. Its traffic light early warning system alerts healthcare workers to the need for escalation of care for women with hypertension, haemorrhage or sepsis. This study evaluated the usability and acceptability of the CRADLE VSA device. METHODS: Evaluation was conducted in community and primary care settings in India, Mozambique and Nigeria and tertiary hospitals in South Africa. Purposeful sampling was used to convene 155 interviews and six focus groups with healthcare workers using the device (n = 205) and pregnant women and their family members (n = 41). Interviews and focus groups were conducted in the local language and audio-recorded, transcribed and translated into English for analysis. Thematic analysis was undertaken using an a priori thematic framework, as well as an inductive approach. RESULTS: Most healthcare workers perceived the CRADLE device to be easy to use and accurate. The traffic lights early warning system was unanimously reported positively, giving healthcare workers confidence with decision-making and a sense of professionalism. However, a minority in South Africa described manual inflation as tiring, particularly when measuring vital signs in obese and hypertensive women (n = 4) and a few South African healthcare workers distrusted the device's accuracy (n = 7). Unanimously, pregnant women liked the CRADLE device. The traffic light early warning system gave women and their families a better understanding of the importance of vital signs in pregnancy and during the postpartum period. CONCLUSION: The CRADLE device was well accepted by healthcare workers from a range of countries and levels of facility, including those with no previous vital signs measurement experience. The device motivated women to attend primary care and encouraged them to accept treatment and referral.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In that previous qualitative evaluation, most healthcare workers reported the CRADLE VSA was easy to use and perceived it to be accurate.
“Most healthcare workers reported that the device was easy to use and perceived it to be accurate, whilst pregnant women unanimously liked the device, reporting that it increased their understanding of vital signs monitoring [10].”
From Scale-up of a novel vital signs alert device to improve maternity care in Sierra Leone: a mixed methods evaluation of adoption (2023) · cites this paper as [10]
In that previous qualitative evaluation, pregnant women unanimously liked the CRADLE VSA and reported it increased their understanding of vital signs monitoring.
“Most healthcare workers reported that the device was easy to use and perceived it to be accurate, whilst pregnant women unanimously liked the device, reporting that it increased their understanding of vital signs monitoring [10].”
From Scale-up of a novel vital signs alert device to improve maternity care in Sierra Leone: a mixed methods evaluation of adoption (2023) · cites this paper as [10]
A previous qualitative evaluation found the CRADLE VSA to be well accepted by both healthcare workers and service users across a range of countries and healthcare settings.
“A previous qualitative evaluation of the CRADLE VSA found the device to be well accepted by both healthcare workers and service users, across a range of countries and healthcare settings.”
From Scale-up of a novel vital signs alert device to improve maternity care in Sierra Leone: a mixed methods evaluation of adoption (2023) · cites this paper as [10]
Respondents generally found the CRADLE device easy to use, but small errors in application (e.g. incorrect positioning) could lead to staff mistrust.
“In keeping with earlier CRADLE studies [10, 12, 27], respondents generally found the device easy to use, but small errors in application (e.g. incorrect positioning) could lead to staff mistrust.”
From Scale-up of a novel vital signs alert device to improve maternity care in Sierra Leone: a mixed methods evaluation of adoption (2023) · cites this paper as [10]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
The citation lists haven’t been fetched yet
References 35 · Cited by 41
- Authors
- the CLIP Working Group, Nathan, H. L., Boene, H., Munguambe, K., Sevene, E., Akeju, D., Adetoro, O. O., Charanthimath, U., Bellad, M. B., de Greeff, A., Anthony, J., Hall, D. R., Steyn, W., Vidler, M., von Dadelszen, P., Chappell, L. C., Sandall, J., & Shennan, A. H.
- Affiliations
- King's College London (GB)
- Manhiça Health Research Centre (MZ)
- Eduardo Mondlane University (MZ)
- University of Lagos (NG)
- Jawaharlal Nehru Medical College (IN)
- University of Cape Town (ZA)
- Stellenbosch University (ZA)
- University of British Columbia (CA)
- Corresponding author
- Nathan, Hannah L.
- ORCID
- Venue
- Reproductive Health
- Published
- 2018-01-05
- Volume
- 15
- Issue
- 1
- Pages
- 5-5
- ISSN
- 1742-4755 (ISSN-L)
- PMC
- PMC5756409
- OpenAlex
- W2781760266
- Cited by
- 41
- References
- 35
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 4 · 2023: 4 · 2022: 5 · 2021: 5 · 2020: 7 · 2019: 8 · 2018: 3
- FWCI
- 8.78
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Reproductive Health (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- cIRcle (University of British Columbia) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Research Portal (King's College London) (submittedVersion, cc-by)
- Open University of Cape Town (University of Cape Town) (submittedVersion, cc-by)
- UTS ePRESS (University of Technology Sydney) (submittedVersion)
- SUNScholar (Stellenbosch University) (submittedVersion)
- Funders
- Bill and Melinda Gates Foundation (OPP1086183)
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
- Keywords
- vital signs measurement, pregnancy, blood pressure measurement, pulse measurement, early warning systems, traffic light system, hypertension in pregnancy, postpartum hemorrhage, sepsis, resource-limited settings, acceptability, device accuracy, maternal health, obstetric referral
- MeSH terms
- Workforce, Adult, Community Health Workers, Community Health Services, Equipment and Supplies, Equipment Design, Feasibility Studies, Female, Humans, India, Maternal Health Services, Monitoring, Physiologic, Mozambique, Nigeria, Poverty Areas, Pregnancy, Pregnancy Complications, Primary Health Care, South Africa, Qualitative Research, Early Diagnosis, Vital Signs
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
