TY - JOUR
T1 - Acceptability and barriers to use of the asman provider-facing electronic platform for peripartum care in public facilities in Madhya Pradesh and Rajasthan, India
T2 - A qualitative study using the technology acceptance model-3
AU - Usmanova, Gulnoza
AU - Gresh, Ashley
AU - Cohen, Megan A.
AU - Kim, Young Mi
AU - Srivastava, Ashish
AU - Joshi, Chandra Shekhar
AU - Bhatt, Deepak Chandra
AU - Haws, Rachel
AU - Wadhwa, Rajni
AU - Sridhar, Pompy
AU - Bahl, Nupur
AU - Gaikwad, Pratibha
AU - Anderson, Jean
N1 - Funding Information:
Funding: The ASMAN program is designed and funded by five major development partners: Reliance Foundation, Tata Trusts, MSD for Mothers *, the Bill and Melinda Gates Foundation, and the United States Agency for International Development (USAID). This research was funded by Jhpiego with additional funding through the Johns Hopkins Global Women’s Health Fellowship. * This program was funded by, developed, and is being implemented in collaboration with MSD for Mothers, MSD’s $500 million initiative to help create a world where no woman dies giving life. MSD for Mothers is an initiative of Merck & Co., Inc., Kenilworth, NJ, USA.
Funding Information:
Acknowledgments: We thank all providers who participated in the study. The ASMAN program was designed, executed, and funded by five development partners: The Bill and Melinda Gates Foundation, MSD for Mothers, Reliance Foundation, Tata Trusts, and USAID. We sincerely thank the Project Management Unit, involved in driving the program interventions and review and finalization of the study, as well as both state governments for their continuous support and suggestions. We would also like to acknowledge the support provided by the technology development and Monitoring & Evaluation partners—Avalon, Bodhi and Sambodhi, without whom this project and the study would not have been possible. We thank our state team leaders Yashpal Jain, Mohammed Afzal, and program officers Robin Sharma, Prabhu Angamuthu, Jen Daniel, and Mohammed Imran DK for coordinating with study participants. We would like to acknowledge Hibest Assefa of Jhpiego for providing guidance and facilitating timely IRB approval; Adrienne Kols for reviewing the manuscript and providing substantive editorial support; and Saurabh Bhargava for providing inputs during the conceptualization of this study. Somesh Kumar of Jhpiego provided helpful suggestions for conceptualizing the study. We appreciate Bulbul Sood, Country Director of Jhpiego India Office, and Vivek Yadav and Kamlesh Lalchandani, ASMAN program directors, for their support during the data collection and finalization of the manuscript. We would also like to acknowledge Leslie Mancuso and Peter Johnson of Jhpiego, and Nancy Glass at the Johns Hopkins School of Nursing, for their support and mentorship of Cohen and Gresh during this project as part of the Johns Hopkins Global Women’s Health Fellowship. We also thank the reviewers of this manuscript, who helped to improve it with their comments and suggestions.
Publisher Copyright:
© 2020 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2020/11/2
Y1 - 2020/11/2
N2 - The evolving field of mobile health (mHealth) is revolutionizing collection, management, and quality of clinical data in health systems. Particularly in low-and middle-income countries (LMICs), mHealth approaches for clinical decision support and record-keeping offer numerous potential advantages over paper records and in-person training and supervision. We conducted a content analysis of qualitative in-depth interviews using the Technology Acceptance Model 3 (TAM-3) to explore perspectives of providers and health managers in Madhya Pradesh and Rajasthan, India who were using the ASMAN (Alliance for Saving Mothers and Newborns) platform, a package of mHealth technologies to support management during the peripartum period. Respondents uniformly found ASMAN easy to use and felt it improved quality of care, reduced referral rates, ensured timely referral when needed, and aided reporting requirements. The TAM-3 model captured many determinants of reported respondent use behavior, including shifting workflow and job performance. However, some barriers to ASMAN digital platform use were structural and reported more often in facilities where ASMAN use was less consistent; these affect long-term impact, sustainability, and scalability of ASMAN and similar mHealth interventions. The transitioning of the program to the government, ensuring availability of dedicated funds, human resource support, and training and integration with government health information systems will ensure the sustainability of ASMAN.
AB - The evolving field of mobile health (mHealth) is revolutionizing collection, management, and quality of clinical data in health systems. Particularly in low-and middle-income countries (LMICs), mHealth approaches for clinical decision support and record-keeping offer numerous potential advantages over paper records and in-person training and supervision. We conducted a content analysis of qualitative in-depth interviews using the Technology Acceptance Model 3 (TAM-3) to explore perspectives of providers and health managers in Madhya Pradesh and Rajasthan, India who were using the ASMAN (Alliance for Saving Mothers and Newborns) platform, a package of mHealth technologies to support management during the peripartum period. Respondents uniformly found ASMAN easy to use and felt it improved quality of care, reduced referral rates, ensured timely referral when needed, and aided reporting requirements. The TAM-3 model captured many determinants of reported respondent use behavior, including shifting workflow and job performance. However, some barriers to ASMAN digital platform use were structural and reported more often in facilities where ASMAN use was less consistent; these affect long-term impact, sustainability, and scalability of ASMAN and similar mHealth interventions. The transitioning of the program to the government, ensuring availability of dedicated funds, human resource support, and training and integration with government health information systems will ensure the sustainability of ASMAN.
KW - CDSS
KW - Health information technology
KW - Intrapartum care
KW - MHealth
KW - Maternal health
KW - Postpartum care
UR - http://www.scopus.com/inward/record.url?scp=85095968768&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85095968768&partnerID=8YFLogxK
U2 - 10.3390/ijerph17228333
DO - 10.3390/ijerph17228333
M3 - Article
C2 - 33187163
AN - SCOPUS:85095968768
SN - 1661-7827
VL - 17
SP - 1
EP - 21
JO - International journal of environmental research and public health
JF - International journal of environmental research and public health
IS - 22
M1 - 8333
ER -