Int J Med Inform - Guidelines for maternal and neonatal point of care: needs of and attitudes towards a computerized clinical decision support system in rural Burkina Faso.

Tópicos

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Resumo

CKGROUND: 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.

Resumo Limpo

ckground women die due pregnancyrel caus subsaharan africa southern asia studi nest qualmat project seek improv qualiti matern care servic introduct computer clinic decis support system cdss help healthcar worker rural area healthcar inform technolog applic lowincom countri may improv healthcar provis recent studi demonstr unintend consequ underus resist cdss fit system clinic need present challengesaim explor describ perceiv need attitud among healthcar worker access guidelin use cdss matern neonat care rural burkina fasomethod data collect semistructur interview two rural district burkina faso inform descript statist use analysi quantit part interview correspond inform background qualit data analyz use manifest content analysisresult four main find emerg appreci willing among healthcar worker great interest adapt use modern technolog like comput learn workplac b posit attitud easi access guidelin implement decisionsupport use comput workplac c fear cdss requir work time lead doublework d cdss complic requir substanti comput train extens instruct fulli implementconclus find can divid aspect motiv barrier relat cdss perceiv use aspect close connect motiv aspect can easili turn barrier taken care proper final design implement mainten cdss point care

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