Implementation of an international standardized set of outcome indicators in pregnancy and childbirth in Kenya: Utilizing mobile technology to collect patient-reported outcomes

Limited data exist on health outcomes during pregnancy and childbirth in low- and middle-income countries. This is a pilot of an innovative data collection tool using mobile technology to collect patient-reported outcome measures (PROMs) selected from the International Consortium of Health Outcomes...

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Published in:PloS one 2019, Vol.14 (10), p.e0222978-e0222978
Main Authors: Al-Shammari, Ishtar, Roa, Lina, Yorlets, Rachel R, Akerman, Christina, Dekker, Annelies, Kelley, Thomas, Koech, Ramona, Mutuku, Judy, Nyarango, Robert, Nzorubara, Doriane, Spieker, Nicole, Vaidya, Manasi, Meara, John G, Ljungman, David
Format: Article
Language:English
Subjects:
Adult
Aftercare - economics
Aftercare - organization & administration
Aftercare - statistics & numerical data
Births
Breast feeding
Cell Phone
childbirth
Childbirth & labor
Children & youth
Clinical outcomes
cohort analysis
Consortia
controlled study
Data collection
Data Collection - methods
dyspareunia
Feasibility Studies
feasibility study
feces incontinence
Female
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
follow up
Health care
Health Plan Implementation
hospital mortality
Hospitals
human
Humans
Infant, Newborn
information processing
International standardization
Kenya
Low income groups
major clinical study
Maternal & child health
Maternal mortality
Medicine and Health Sciences
Mental disorders
Mental health
Mobile Applications
Morbidity
obstetric delivery
Obstetrics
Obstetrics, Gynecology and Reproductive Medicine
Parturition
patient referral
Patient Reported Outcome Measures
Patient satisfaction
patient-reported outcome
People and Places
Perinatal Care - economics
Perinatal Care - organization & administration
Perinatal Care - statistics & numerical data
Pilot Projects
pilot study
Polls & surveys
postnatal care
Postpartum
Pregnancy
prenatal care
prospective study
Public health
Public Health, Global Health, Social Medicine and Epidemiology
puerperium
Quality
Quality Indicators, Health Care - standards
Reproduktionsmedicin och gynekologi
Research and Analysis Methods
Social change
Social Sciences
Surgery
Technology
Telemedicine - economics
Telemedicine - organization & administration
Telemedicine - statistics & numerical data
Text messaging
third trimester pregnancy
Urinary incontinence
urine incontinence
Womens health
Young Adult
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cited_by cdi_FETCH-LOGICAL-c564t-d2050e29fb8136edf4d980218032c1f1e7c9b8330898c40aef05fbbd79d0150c3
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creator Al-Shammari, Ishtar
Roa, Lina
Yorlets, Rachel R
Akerman, Christina
Dekker, Annelies
Kelley, Thomas
Koech, Ramona
Mutuku, Judy
Nyarango, Robert
Nzorubara, Doriane
Spieker, Nicole
Vaidya, Manasi
Meara, John G
Ljungman, David
description Limited data exist on health outcomes during pregnancy and childbirth in low- and middle-income countries. This is a pilot of an innovative data collection tool using mobile technology to collect patient-reported outcome measures (PROMs) selected from the International Consortium of Health Outcomes Measurement (ICHOM) Pregnancy and Childbirth Standard Set in Nairobi, Kenya. Pregnant women in the third trimester were recruited at three primary care facilities in Nairobi and followed prospectively throughout delivery and until six weeks postpartum. PROMs were collected via mobile surveys at three antenatal and two postnatal time points. Outcomes included incontinence, dyspareunia, mental health, breastfeeding and satisfaction with care. Hospitals reported morbidity and mortality. Descriptive statistics on maternal and child outcomes, survey completion and follow-up rates were calculated. In six months, 204 women were recruited: 50% of women returned for a second ante-natal care visit, 50% delivered at referral hospitals and 51% completed the postnatal visit. The completion rates for the five PROM surveys were highest at the first antenatal care visit (92%) and lowest in the postnatal care visit (38%). Data on depression, dyspareunia, fecal and urinary incontinence were successfully collected during the antenatal and postnatal period. At six weeks postpartum, 86% of women breastfeed exclusively. Most women that completed the survey were very satisfied with antenatal care (66%), delivery care (51%), and post-natal care (60%). We have demonstrated that it is feasible to use mobile technology to follow women throughout pregnancy, track their attendance to pre-natal and post-natal care visits and obtain data on PROM. This study demonstrates the potential of mobile technology to collect PROM in a low-resource setting. The data provide insight into the quality of maternal care services provided and will be used to identify and address gaps in access and provision of high quality care to pregnant women.
doi_str_mv 10.1371/journal.pone.0222978
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child health</subject><subject>Maternal mortality</subject><subject>Medicine and Health Sciences</subject><subject>Mental disorders</subject><subject>Mental health</subject><subject>Mobile Applications</subject><subject>Morbidity</subject><subject>obstetric delivery</subject><subject>Obstetrics</subject><subject>Obstetrics, Gynecology and Reproductive Medicine</subject><subject>Parturition</subject><subject>patient referral</subject><subject>Patient Reported Outcome Measures</subject><subject>Patient satisfaction</subject><subject>patient-reported outcome</subject><subject>People and Places</subject><subject>Perinatal Care - economics</subject><subject>Perinatal Care - organization &amp; administration</subject><subject>Perinatal Care - statistics &amp; numerical data</subject><subject>Pilot Projects</subject><subject>pilot study</subject><subject>Polls &amp; surveys</subject><subject>postnatal care</subject><subject>Postpartum</subject><subject>Pregnancy</subject><subject>prenatal care</subject><subject>prospective study</subject><subject>Public health</subject><subject>Public Health, Global Health, Social Medicine and Epidemiology</subject><subject>puerperium</subject><subject>Quality</subject><subject>Quality Indicators, Health Care - standards</subject><subject>Reproduktionsmedicin och gynekologi</subject><subject>Research and Analysis Methods</subject><subject>Social change</subject><subject>Social Sciences</subject><subject>Surgery</subject><subject>Technology</subject><subject>Telemedicine - economics</subject><subject>Telemedicine - organization &amp; 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Roa, Lina ; Yorlets, Rachel R ; Akerman, Christina ; Dekker, Annelies ; Kelley, Thomas ; Koech, Ramona ; Mutuku, Judy ; Nyarango, Robert ; Nzorubara, Doriane ; Spieker, Nicole ; Vaidya, Manasi ; Meara, John G ; Ljungman, David</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c564t-d2050e29fb8136edf4d980218032c1f1e7c9b8330898c40aef05fbbd79d0150c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Aftercare - economics</topic><topic>Aftercare - organization &amp; administration</topic><topic>Aftercare - statistics &amp; numerical data</topic><topic>Births</topic><topic>Breast feeding</topic><topic>Cell Phone</topic><topic>childbirth</topic><topic>Childbirth &amp; labor</topic><topic>Children &amp; youth</topic><topic>Clinical outcomes</topic><topic>cohort analysis</topic><topic>Consortia</topic><topic>controlled study</topic><topic>Data collection</topic><topic>Data Collection - methods</topic><topic>dyspareunia</topic><topic>Feasibility Studies</topic><topic>feasibility study</topic><topic>feces incontinence</topic><topic>Female</topic><topic>Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi</topic><topic>follow up</topic><topic>Health care</topic><topic>Health Plan Implementation</topic><topic>hospital mortality</topic><topic>Hospitals</topic><topic>human</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>information processing</topic><topic>International standardization</topic><topic>Kenya</topic><topic>Low income groups</topic><topic>major clinical study</topic><topic>Maternal &amp; child health</topic><topic>Maternal mortality</topic><topic>Medicine and Health Sciences</topic><topic>Mental disorders</topic><topic>Mental health</topic><topic>Mobile Applications</topic><topic>Morbidity</topic><topic>obstetric delivery</topic><topic>Obstetrics</topic><topic>Obstetrics, Gynecology and Reproductive Medicine</topic><topic>Parturition</topic><topic>patient referral</topic><topic>Patient Reported Outcome Measures</topic><topic>Patient satisfaction</topic><topic>patient-reported outcome</topic><topic>People and Places</topic><topic>Perinatal Care - economics</topic><topic>Perinatal Care - organization &amp; administration</topic><topic>Perinatal Care - statistics &amp; numerical data</topic><topic>Pilot Projects</topic><topic>pilot study</topic><topic>Polls &amp; surveys</topic><topic>postnatal care</topic><topic>Postpartum</topic><topic>Pregnancy</topic><topic>prenatal care</topic><topic>prospective study</topic><topic>Public health</topic><topic>Public Health, Global Health, Social Medicine and Epidemiology</topic><topic>puerperium</topic><topic>Quality</topic><topic>Quality Indicators, Health Care - standards</topic><topic>Reproduktionsmedicin och gynekologi</topic><topic>Research and Analysis Methods</topic><topic>Social change</topic><topic>Social Sciences</topic><topic>Surgery</topic><topic>Technology</topic><topic>Telemedicine - economics</topic><topic>Telemedicine - organization &amp; administration</topic><topic>Telemedicine - statistics &amp; numerical data</topic><topic>Text messaging</topic><topic>third trimester pregnancy</topic><topic>Urinary incontinence</topic><topic>urine incontinence</topic><topic>Womens health</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Al-Shammari, Ishtar</creatorcontrib><creatorcontrib>Roa, Lina</creatorcontrib><creatorcontrib>Yorlets, Rachel R</creatorcontrib><creatorcontrib>Akerman, Christina</creatorcontrib><creatorcontrib>Dekker, Annelies</creatorcontrib><creatorcontrib>Kelley, Thomas</creatorcontrib><creatorcontrib>Koech, Ramona</creatorcontrib><creatorcontrib>Mutuku, Judy</creatorcontrib><creatorcontrib>Nyarango, Robert</creatorcontrib><creatorcontrib>Nzorubara, Doriane</creatorcontrib><creatorcontrib>Spieker, Nicole</creatorcontrib><creatorcontrib>Vaidya, Manasi</creatorcontrib><creatorcontrib>Meara, John G</creatorcontrib><creatorcontrib>Ljungman, David</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological &amp; 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Medical Complete (Alumni)</collection><collection>ProQuest Materials Science Database</collection><collection>Nursing &amp; Allied Health Database (Alumni Edition)</collection><collection>Meteorological &amp; Geoastrophysical Abstracts - Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agriculture Science Database</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>ProQuest Engineering Database</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>ProQuest Advanced Technologies &amp; Aerospace Database</collection><collection>ProQuest Advanced Technologies &amp; Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Göteborgs universitet</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Al-Shammari, Ishtar</au><au>Roa, Lina</au><au>Yorlets, Rachel R</au><au>Akerman, Christina</au><au>Dekker, Annelies</au><au>Kelley, Thomas</au><au>Koech, Ramona</au><au>Mutuku, Judy</au><au>Nyarango, Robert</au><au>Nzorubara, Doriane</au><au>Spieker, Nicole</au><au>Vaidya, Manasi</au><au>Meara, John G</au><au>Ljungman, David</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Implementation of an international standardized set of outcome indicators in pregnancy and childbirth in Kenya: Utilizing mobile technology to collect patient-reported outcomes</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2019</date><risdate>2019</risdate><volume>14</volume><issue>10</issue><spage>e0222978</spage><epage>e0222978</epage><pages>e0222978-e0222978</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><notes>These authors are both first co-authors on this work.</notes><notes>Competing Interests: IA, CA and TK worked for the International Consortium of Health Outcomes Measurement (ICHOM). The feasibility of implementing one of the ICHOM Standard Set was piloted in this study. The financers also do not alter our adherence to PLOS ONE policies on sharing data and materials.</notes><abstract>Limited data exist on health outcomes during pregnancy and childbirth in low- and middle-income countries. This is a pilot of an innovative data collection tool using mobile technology to collect patient-reported outcome measures (PROMs) selected from the International Consortium of Health Outcomes Measurement (ICHOM) Pregnancy and Childbirth Standard Set in Nairobi, Kenya. Pregnant women in the third trimester were recruited at three primary care facilities in Nairobi and followed prospectively throughout delivery and until six weeks postpartum. PROMs were collected via mobile surveys at three antenatal and two postnatal time points. Outcomes included incontinence, dyspareunia, mental health, breastfeeding and satisfaction with care. Hospitals reported morbidity and mortality. Descriptive statistics on maternal and child outcomes, survey completion and follow-up rates were calculated. In six months, 204 women were recruited: 50% of women returned for a second ante-natal care visit, 50% delivered at referral hospitals and 51% completed the postnatal visit. The completion rates for the five PROM surveys were highest at the first antenatal care visit (92%) and lowest in the postnatal care visit (38%). Data on depression, dyspareunia, fecal and urinary incontinence were successfully collected during the antenatal and postnatal period. At six weeks postpartum, 86% of women breastfeed exclusively. Most women that completed the survey were very satisfied with antenatal care (66%), delivery care (51%), and post-natal care (60%). We have demonstrated that it is feasible to use mobile technology to follow women throughout pregnancy, track their attendance to pre-natal and post-natal care visits and obtain data on PROM. This study demonstrates the potential of mobile technology to collect PROM in a low-resource setting. The data provide insight into the quality of maternal care services provided and will be used to identify and address gaps in access and provision of high quality care to pregnant women.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>31618249</pmid><doi>10.1371/journal.pone.0222978</doi><orcidid>https://orcid.org/0000-0003-4369-3209</orcidid><orcidid>https://orcid.org/0000-0001-6552-4452</orcidid><oa>free_for_read</oa></addata></record>
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identifier ISSN: 1932-6203
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1932-6203
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source Publicly Available Content Database; PubMed Central
subjects Adult
Aftercare - economics
Aftercare - organization & administration
Aftercare - statistics & numerical data
Births
Breast feeding
Cell Phone
childbirth
Childbirth & labor
Children & youth
Clinical outcomes
cohort analysis
Consortia
controlled study
Data collection
Data Collection - methods
dyspareunia
Feasibility Studies
feasibility study
feces incontinence
Female
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
follow up
Health care
Health Plan Implementation
hospital mortality
Hospitals
human
Humans
Infant, Newborn
information processing
International standardization
Kenya
Low income groups
major clinical study
Maternal & child health
Maternal mortality
Medicine and Health Sciences
Mental disorders
Mental health
Mobile Applications
Morbidity
obstetric delivery
Obstetrics
Obstetrics, Gynecology and Reproductive Medicine
Parturition
patient referral
Patient Reported Outcome Measures
Patient satisfaction
patient-reported outcome
People and Places
Perinatal Care - economics
Perinatal Care - organization & administration
Perinatal Care - statistics & numerical data
Pilot Projects
pilot study
Polls & surveys
postnatal care
Postpartum
Pregnancy
prenatal care
prospective study
Public health
Public Health, Global Health, Social Medicine and Epidemiology
puerperium
Quality
Quality Indicators, Health Care - standards
Reproduktionsmedicin och gynekologi
Research and Analysis Methods
Social change
Social Sciences
Surgery
Technology
Telemedicine - economics
Telemedicine - organization & administration
Telemedicine - statistics & numerical data
Text messaging
third trimester pregnancy
Urinary incontinence
urine incontinence
Womens health
Young Adult
title Implementation of an international standardized set of outcome indicators in pregnancy and childbirth in Kenya: Utilizing mobile technology to collect patient-reported outcomes
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