Opportunities and obstacles using a clinical decision support system for maternal care in Burkina Faso

Authors

  • Sidagna Alphonse Zakane 1. Centre de Recherche en Santé de Nouna, BP 02 Nouna, Burkina Faso 2. Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institutet at Karolinska University Hospital, SE-141 86, Stockholm, Sweden
  • Lars L Gustafsson Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institutet at Karolinska University Hospital , SE-141 86, Stockholm, Sweden
  • Ali Sie Centre de Recherche en Santé de Nouna, BP 02 Nouna, Burkina Faso
  • Göran Tomson 3. Health Systems and Policy, Department of Public Health Sciences, Karolinska Institutet, SE-17177 Stockholm, Sweden 4. Department of Learning, Informatics, Management and Ethics, Medical Management Centre (MMC), Karolinska Institutet, SE-17177 Stockholm, Sweden
  • Svetla Loukanova Department of General Practice and Health Services Research, Heidelberg University Hospital, Marsilius-Arkaden, Im Neuenheimer Feld 130.3, D-69120 Heidelberg
  • Pia Bastholm-Rahmner Department of Learning, Informatics, Management and Ethics, Medical Management Centre (MMC), Karolinska Institutet, SE-17177 Stockholm, Sweden

DOI:

https://doi.org/10.5210/ojphi.v9i2.7905

Abstract

Abstract

Objective:  Maternal and neonatal mortality is high in sub-Saharan Africa. To support Healthcare Workers (HCWs), a computerized decision support system (CDSS) was piloted at six rural maternal care units in Burkina Faso. During the two years of the study period, it was apparent from reports that the CDSS was not used regularly in clinical practice. This study aimed to explore the reasons why HCWs failed to use the CDSS.

Methods: A workshop, organised as group discussions and a plenary session, was performed with 13 participants to understand their experience with the CDSS and suggest improvements if pertinent. Workshop transcripts were analysed thematically. Socio-demographic and usage patterns of the CDSS were examined by a questionnaire and analysed descriptively.

Results: The participants reported that the contextual basic conditions for using the CDSS were not fulfilled. These included unreliable power supply, none user-friendly partograph, the CDSS was not integrated with workflow and staff lacked motivational incentives. Despite these limitations, the HCWs reported learning benefits from guidance and alerts in the CDSS. Using the CDSS enabled them to discover problems earlier as they learned to focus on symptoms to prevent harmful situations.

Conclusion: The CDSS was not tailored to the needs and context of the users. The HCWs, defined their needs and suggested how the CDSS should be re-designed. This suggests that the successful and regular usage of any CDSS in rural settings requires the involvement of users throughout the construction and pilot-testing phases and not only during the early prototype design period.

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Published

2017-09-08

How to Cite

Zakane, S. A., Gustafsson, L. L., Sie, A., Tomson, G., Loukanova, S., & Bastholm-Rahmner, P. (2017). Opportunities and obstacles using a clinical decision support system for maternal care in Burkina Faso. Online Journal of Public Health Informatics, 9(2). https://doi.org/10.5210/ojphi.v9i2.7905

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Section

Original Articles