title: Perceived improvement in integrated management of childhood illness implementation through use of mobile technology: qualitative evidence from a pilot study in Tanzania.
abstract: This study examined health care provider and caretaker perceptions of electronic Integrated Management of Childhood Illness (eIMCI) in diagnosing and treating childhood illnesses. The authors conducted semi-structured interviews among caretakers (n = 20) and health care providers (n = 11) in the Pwani region of Tanzania. This qualitative study was nested within a larger quantitative study measuring impact of eIMCI on provider adherence to IMCI protocols. Caretakers and health care workers involved in the larger study provided their perceptions of eIMCI in comparison with the conventional paper forms. One health care provider from each participating health center participated in qualitative interviews; 20 caretakers were selected from 1 health center involved in the quantitative study. Interviews were conducted in Swahili and lasted 5-10 min each. Providers expressed positive opinions of eIMCI, noting that the personal digital assistants were faster and easier to use than were the paper forms and encouraged adherence to IMCI procedures. Caretakers also held a positive view of eIMCI, noting improved service from providers, more thorough examination of their child, and a perception that providers who used the personal digital assistants were more knowledgeable. Research indicates widespread nonadherence to IMCI guidelines, suggesting improved methods for implementing IMCI are necessary. The authors conclude that eIMCI represents a promising method for improving health care delivery because it improves health care provider and caretaker perception of the clinical encounter. Further investigation into this technology is warranted.
authors.affiliation: Department of Global Health and Populations, Harvard School of Public Health, and D-Tree International, Boston, Massachusetts, USA.
authors.forename: Marc
authors.initials: M
authors.lastname: Mitchell
authors.forename: Maya
authors.initials: M
authors.lastname: Getchell
authors.forename: Melania
authors.initials: M
authors.lastname: Nkaka
authors.forename: Daniel
authors.initials: D
authors.lastname: Msellemu
authors.forename: Jan
authors.initials: J
authors.lastname: Van Esch
authors.forename: Bethany
authors.initials: B
authors.lastname: Hedt-Gauthier
mesh_terms: D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D002648:Child; D002662:Child Health Services / Q000458:organization & administration*; D002985:Clinical Protocols; D034201:Computers, Handheld; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D019468:Disease Management; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D010865:Pilot Projects; D036301:Qualitative Research; D058996:Quality Improvement; D020377:Self Efficacy; D013636:Tanzania