Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Dec 26;22(1):1581.
doi: 10.1186/s12913-022-08940-0.

Effects of computerized decision support on maternal and neonatal health-worker performance in the context of combined implementation with performance-based incentivisation in Upper East Region, Ghana: a qualitative study of professional perspectives

Gifty Apiung Aninanya #  1 , John E Williams  2 , Afua Williams  3 , Easmon Otupiri  4 , Natasha Howard #  5   6
Affiliations

Effects of computerized decision support on maternal and neonatal health-worker performance in the context of combined implementation with performance-based incentivisation in Upper East Region, Ghana: a qualitative study of professional perspectives

Gifty Apiung Aninanya et al. BMC Health Serv Res. .

Abstract

Background: Computerized decision support systems (CDSS) and performance-based incentives (PBIs) can improve health-worker performance. However, there is minimal evidence on the combined effects of these interventions or perceived effects among maternal and child healthcare providers in low-resource settings. We thus aimed to explore the perceptions of maternal and child healthcare providers of CDSS support in the context of a combined CDSS-PBI intervention on performance in twelve primary care facilities in Ghana's Upper East Region.

Methods: We conducted a qualitative study drawing on semi-structured key informant interviews with 24 nurses and midwives, 12 health facility managers, and 6 district-level staff familiar with the intervention. We analysed data thematically using deductive and inductive coding in NVivo 10 software.

Results: Interviewees suggested the combined CDSS-PBI intervention improved their performance, through enhancing knowledge of maternal health issues, facilitating diagnoses and prescribing, prompting actions for complications, and improving management. Some interviewees reported improved morbidity and mortality. However, challenges described in patient care included CDSS software inflexibility (e.g. requiring administration of only one intermittent preventive malaria treatment to pregnant women), faulty electronic partograph leading to unnecessary referrals, increased workload for nurses and midwives who still had to complete facility forms, and power fluctuations affecting software.

Conclusion: Combining CDSS and PBI interventions has potential to improve maternal and child healthcare provision in low-income settings. However, user perspectives and context must be considered, along with allowance for revisions, when designing and implementing CDSS and PBIs interventions.

Keywords: Computerised-decision support system; Ghana; Maternal and neonatal health; Performance-based incentives; mHealth.

PubMed Disclaimer

Conflict of interest statement

None declared.

References

    1. Rowe AK, De Savigny D, Lanata CF, Victora CG. How can we achieve and maintain high-quality performance of health workers in low-resource settings? Lancet. 2005;366(9490):1026–35. doi: 10.1016/S0140-6736(05)67028-6. - DOI - PubMed
    1. Fort AL, Voltero L. Factors affecting the performance of maternal health care providers in Armenia. Hum Resour Health. 2004;2:1–22. doi: 10.1186/1478-4491-2-8. - DOI - PMC - PubMed
    1. Dreesch N, Dolea C, Dal Poz MR, Goubarev A, Adams O, Aregawi M, et al. An approach to estimating human resource requirements to achieve the Millennium Development Goals. Health Policy Plan. 2005;20(5):267–76. doi: 10.1093/heapol/czi036. - DOI - PubMed
    1. Escribano-Ferrer B, Cluzeau F, Cutler D, Akufo C, Chalkidou K. Quality of health care in Ghana: mapping of interventions and the way forward. Ghana Med J. 2016;50(4):238–47. - PMC - PubMed
    1. von Koerber K, Bader N, Waldenmaier J, Leitzmann C, Lintzmeyer A, Schwab T. Concept of sustainable nutrition – implementation via ESD in Munich. Ensure healthy Lives and promote well-being for all. Experiences of Community Health, Hygiene, Sanitation and Nutrition. 2018. p. 121–135. Available from: https://www.oneplanetnetwork.org/sites/default/files/university_koerber_....

LinkOut - more resources