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Itanyi IU, Iwelunmor J, Olawepo JO, Gbadamosi S, Ezeonu A, Okoli A, Ogidi AG, Conserve D, Powell B, Onoka CA, Ezeanolue EE. Acceptability and user experiences of a patient-held smart card for antenatal services in Nigeria: a qualitative study. BMC Pregnancy Childbirth 2023; 23:198. [PMID: 36949403 PMCID: PMC10031993 DOI: 10.1186/s12884-023-05494-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 03/03/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND Poor maternal, newborn and child health outcomes remain a major public health challenge in Nigeria. Mobile health (mHealth) interventions such as patient-held smart cards have been proposed as effective solutions to improve maternal health outcomes. Our objectives were to assess the acceptability and experiences of pregnant women with the use of a patient-held smartcard for antenatal services in Nigeria. METHODS Using focus group discussions, qualitative data were obtained from 35 pregnant women attending antenatal services in four Local Government Areas (LGAs) in Benue State, Nigeria. The audio-recorded data were transcribed and analyzed using framework analysis techniques such as the PEN-3 cultural model as a guide. RESULTS The participants were 18-44 years of age (median age: 24 years), all were married and the majority were farmers. Most of the participants had accepted and used the smartcards for antenatal services. The most common positive perceptions about the smartcards were their ability to be used across multiple health facilities, the preference for storage of the women's medical information on the smartcards compared to the usual paper-based system, and shorter waiting times at the clinics. Notable facilitators to using the smartcards were its provision at the "Baby showers" which were already acceptable to the women, access to free medical screenings, and ease of storage and retrieval of health records from the cards. Costs associated with health services was reported as a major barrier to using the smartcards. Support from health workers, program staff and family members, particularly spouses, encouraged the participants to use the smartcards. CONCLUSION These findings revealed that patient-held smart card for maternal health care services is acceptable by women utilizing antenatal services in Nigeria. Understanding perceptions, barriers, facilitators, and supportive systems that enhance the use of these smart cards may facilitate the development of lifesaving mobile health platforms that have the potential to achieve antenatal, delivery, and postnatal targets in a resource-limited setting.
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Affiliation(s)
- Ijeoma Uchenna Itanyi
- Department of Community Medicine, College of Medicine, University of Nigeria Nsukka, Enugu, Nigeria
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria
| | - Juliet Iwelunmor
- Department of Behavioral Science and Health Education, Saint Louis University, Saint Louis, USA
| | - John Olajide Olawepo
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria
- Department of Health Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA
| | - Semiu Gbadamosi
- Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
| | - Alexandra Ezeonu
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria
| | - Adaeze Okoli
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria
| | - Amaka Grace Ogidi
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria
| | - Donaldson Conserve
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, USA
| | - Byron Powell
- Brown School, Washington University in St. Louis, Washington, USA
| | - Chima Ariel Onoka
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria
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Olawepo JO, Ezeanolue EE, Ekenna A, Ogunsola OO, Itanyi IU, Jedy-Agba E, Egbo E, Onwuchekwa C, Ezeonu A, Ajibola A, Olakunde BO, Majekodunmi O, Ogidi AG, Chukwuorji J, Lasebikan N, Dakum P, Okonkwo P, Oyeledun B, Oko J, Khamofu H, Ikpeazu A, Nwokwu UE, Aliyu G, Shittu O, Rositch AF, Powell BJ, Conserve DF, Aarons GA, Olutola A. Building a national framework for multicentre research and clinical trials: experience from the Nigeria Implementation Science Alliance. BMJ Glob Health 2022; 7:bmjgh-2021-008241. [PMID: 35450861 PMCID: PMC9024272 DOI: 10.1136/bmjgh-2021-008241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 02/25/2022] [Indexed: 01/21/2023] Open
Abstract
There is limited capacity and infrastructure in sub-Saharan Africa to conduct clinical trials for the identification of efficient and effective new prevention, diagnostic and treatment modalities to address the disproportionate burden of disease. This paper reports on the process to establish locally driven infrastructure for multicentre research and trials in Nigeria known as the Nigeria Implementation Science Alliance Model Innovation and Research Centres (NISA-MIRCs). We used a participatory approach to establish a research network of 21 high-volume health facilities selected from all 6 geopolitical zones in Nigeria capable of conducting clinical trials, implementation research using effectiveness-implementation hybrid designs and health system research. The NISA-MIRCs have a cumulative potential to recruit 60 000 women living with HIV and an age-matched cohort of HIV-uninfected women. We conducted a needs assessment, convened several stakeholder outreaches and engagement sessions, and established a governance structure. Additionally, we selected and trained a core research team, developed criteria for site selection, assessed site readiness for research and obtained ethical approval from a single national institutional review board. We used the Exploration, Preparation, Implementation, Sustainment framework to guide our reporting of the process in the development of this network. The NISA-MIRCs will provide a nationally representative infrastructure to initiate new studies, support collaborative research, inform policy decisions and thereby fill a significant research infrastructure gap in Africa’s most populous country.
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Affiliation(s)
- John Olajide Olawepo
- Department of Health Sciences, Northeastern University, Boston, Massachusetts, USA.,Center for Translation and Implementation Research (CTAIR), University of Nigeria, Nsukka, Enugu, Nigeria
| | - Echezona Edozie Ezeanolue
- Center for Translation and Implementation Research (CTAIR), University of Nigeria, Nsukka, Enugu, Nigeria .,Healthy Sunrise Foundation, Las Vegas, Nevada, USA
| | - Adanma Ekenna
- Center for Translation and Implementation Research (CTAIR), University of Nigeria, Nsukka, Enugu, Nigeria.,Department of Community Medicine, University of Nigeria, Nsukka, Enugu, Nigeria
| | | | - Ijeoma Uchenna Itanyi
- Center for Translation and Implementation Research (CTAIR), University of Nigeria, Nsukka, Enugu, Nigeria.,Department of Community Medicine, University of Nigeria, Nsukka, Enugu, Nigeria
| | | | - Emmanuel Egbo
- Center for Translation and Implementation Research (CTAIR), University of Nigeria, Nsukka, Enugu, Nigeria
| | | | - Alexandra Ezeonu
- Center for Translation and Implementation Research (CTAIR), University of Nigeria, Nsukka, Enugu, Nigeria
| | - Abiola Ajibola
- Center for Integrated Health Programs (CIHP), Abuja, FCT, Nigeria
| | - Babayemi O Olakunde
- Center for Translation and Implementation Research (CTAIR), University of Nigeria, Nsukka, Enugu, Nigeria.,Department of Community Prevention and Care Services, National Agency for Control of AIDS (NACA), Abuja, FCT, Nigeria
| | | | - Amaka G Ogidi
- Center for Translation and Implementation Research (CTAIR), University of Nigeria, Nsukka, Enugu, Nigeria
| | - JohnBosco Chukwuorji
- Center for Translation and Implementation Research (CTAIR), University of Nigeria, Nsukka, Enugu, Nigeria.,Department of Psychology, University of Nigeria, Nsukka, Enugu, Nigeria
| | - Nwamaka Lasebikan
- Center for Translation and Implementation Research (CTAIR), University of Nigeria, Nsukka, Enugu, Nigeria.,Oncology Center, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu, Nigeria
| | - Patrick Dakum
- Institute of Human Virology Nigeria, Abuja, FCT, Nigeria
| | | | - Bolanle Oyeledun
- Center for Integrated Health Programs (CIHP), Abuja, FCT, Nigeria
| | - John Oko
- Caritas Nigeria, Abuja, FCT, Nigeria
| | | | - Akudo Ikpeazu
- National AIDS, Viral Hepatitis and Sexually Transmitted Infections Control Programme, Federal Ministry of Health, Abuja, FCT, Nigeria
| | | | - Gambo Aliyu
- National Agency for the Control of AIDS (NACA), Abuja, FCT, Nigeria
| | - Oladapo Shittu
- Federal University of Health Sciences Otukpo, Otukpo, Benue State, Nigeria
| | - Anne F Rositch
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Byron J Powell
- Center for Mental Health Services Research, Brown School at Washington University in St Louis, St Louis, Missouri, USA
| | - Donaldson F Conserve
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Gregory A Aarons
- Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
| | - Ayodotun Olutola
- Center for Clinical Care and Clinical Research, Abuja, FCT, Nigeria
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