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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Study Justification:
– The study aims to improve the quality of maternal care services in rural Burkina Faso, where a significant number of women die due to pregnancy-related causes.
– The introduction of a computerized clinical decision support system (CDSS) is expected to enhance healthcare workers’ ability to provide effective care.
– Healthcare information technology applications have the potential to improve healthcare provision, but there are challenges in terms of underuse or resistance to CDSS and the fit between the system and clinical needs.
Study Highlights:
– The study found that healthcare workers in rural Burkina Faso have a willingness to adapt and use modern technologies like computers to enhance their learning in the workplace.
– There is a positive attitude towards easy access to guidelines and the implementation of decision-support using computers in the workplace.
– However, there is a fear that the CDSS would require more working time and lead to double-work.
– The CDSS is perceived as complicated and requires substantial computer training and extensive instructions for full implementation.
Study Recommendations:
– The design, implementation, and maintenance of the CDSS should address the motivators and barriers identified in the study.
– Proper training and support should be provided to healthcare workers to ensure effective use of the CDSS.
– Efforts should be made to minimize the additional working time and potential double-work associated with the CDSS.
– The CDSS should be user-friendly and intuitive to overcome the perceived complexity.
Key Role Players:
– Healthcare workers in rural Burkina Faso
– Researchers and developers of the CDSS
– Policy makers and government officials responsible for healthcare provision in Burkina Faso
Cost Items for Planning Recommendations:
– Training programs for healthcare workers on CDSS usage
– Development and implementation of the CDSS software
– Technical support and maintenance for the CDSS
– Infrastructure and equipment required for CDSS implementation (computers, internet connectivity, etc.)
– Evaluation and monitoring of the CDSS effectiveness and impact on maternal care services.

The strength of evidence for this abstract is 7 out of 10.
The evidence in the abstract is moderately strong. The study provides qualitative data collected through semi-structured interviews with 45 informants in rural Burkina Faso. The findings highlight both motivators and barriers to the use of a computerized clinical decision support system (CDSS) in maternal and neonatal care. However, the study does not provide quantitative data or a large sample size, which limits the generalizability of the findings. To improve the strength of the evidence, future research could include a larger sample size and incorporate quantitative measures to complement the qualitative data.

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. © 2014 Elsevier Ireland Ltd.

The recommendation to improve access to maternal health in rural areas of Burkina Faso is the development and implementation of a computerized clinical decision support system (CDSS). This recommendation is based on a study conducted in two rural districts of Burkina Faso, which found that healthcare workers expressed a willingness to adapt and use modern technologies like computers to enhance their knowledge and skills in the workplace. The study also revealed a positive attitude towards easy access to guidelines and the implementation of decision-support using computers.

However, the study also identified potential barriers to the successful implementation of the CDSS. Healthcare workers expressed concerns about the system requiring more working time and leading to double-work. They also perceived the CDSS as complicated and requiring substantial computer training and extensive instructions to fully implement.

To ensure the successful adoption of the CDSS, it is crucial to address these motivators and barriers. This can be achieved through careful consideration of the design, implementation, and maintenance of the CDSS at the point of care. Adequate training and support should be provided to healthcare workers to ensure their comfort and proficiency in using the system. Additionally, efforts should be made to minimize any additional workload and streamline the integration of the CDSS into existing workflows.

By implementing a CDSS tailored to the specific needs and attitudes of healthcare workers in rural Burkina Faso, access to maternal health can be improved. This technology can provide healthcare workers with easy access to guidelines and decision-support, ultimately enhancing the quality of maternal care services in the region.
AI Innovations Description
The recommendation to improve access to maternal health is the development and implementation of a computerized clinical decision support system (CDSS) in rural areas of Burkina Faso. This recommendation is based on a study conducted in two rural districts of Burkina Faso, which found that healthcare workers expressed a willingness to adapt and use modern technologies like computers to enhance their knowledge and skills in the workplace. The study also revealed a positive attitude towards easy access to guidelines and the implementation of decision-support using computers.

However, the study also identified potential barriers to the successful implementation of the CDSS. Healthcare workers expressed concerns about the system requiring more working time and leading to double-work. They also perceived the CDSS as complicated and requiring substantial computer training and extensive instructions to fully implement.

To ensure the successful adoption of the CDSS, it is crucial to address these motivators and barriers. This can be achieved through careful consideration of the design, implementation, and maintenance of the CDSS at the point of care. Adequate training and support should be provided to healthcare workers to ensure their comfort and proficiency in using the system. Additionally, efforts should be made to minimize any additional workload and streamline the integration of the CDSS into existing workflows.

By implementing a CDSS tailored to the specific needs and attitudes of healthcare workers in rural Burkina Faso, access to maternal health can be improved. This technology can provide healthcare workers with easy access to guidelines and decision-support, ultimately enhancing the quality of maternal care services in the region.
AI Innovations Methodology
To simulate the impact of the main recommendations on improving access to maternal health, the following methodology can be employed:

1. Study Design: Conduct a pre-post intervention study design in rural areas of Burkina Faso. Select two rural districts as the intervention group and two rural districts as the control group.

2. Intervention: Implement a computerized clinical decision support system (CDSS) in the intervention group. Ensure that the CDSS is tailored to the specific needs and attitudes of healthcare workers in rural Burkina Faso, taking into account the motivators and barriers identified in the study.

3. Data Collection: Collect data before and after the implementation of the CDSS. Use a combination of quantitative and qualitative methods to capture the impact on access to maternal health. This can include surveys, interviews, and observations.

4. Quantitative Analysis: Analyze the quantitative data using appropriate statistical methods. Compare indicators such as the number of maternal health visits, adherence to guidelines, and maternal health outcomes between the intervention and control groups.

5. Qualitative Analysis: Analyze the qualitative data using content analysis. Identify themes and patterns related to healthcare workers’ perceptions, attitudes, and experiences with the CDSS. Explore any changes in their willingness to adapt and use modern technologies, attitudes towards easy access to guidelines, and concerns about the system.

6. Comparison: Compare the findings from the intervention and control groups to determine the impact of the CDSS on improving access to maternal health. Assess whether the CDSS has addressed the motivators and barriers identified in the study.

7. Recommendations: Based on the findings, provide recommendations for further improvements in the design, implementation, and maintenance of the CDSS. Consider the need for additional training and support for healthcare workers, as well as strategies to minimize any additional workload and streamline the integration of the CDSS into existing workflows.

By following this methodology, researchers can assess the impact of implementing a CDSS on improving access to maternal health in rural Burkina Faso and make informed recommendations for future interventions.

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