Use of WhatsApp messaging technology to strengthen obstetric referrals in the Greater Accra Region, Ghana: Findings from a feasibility study

Owen, Medge D.; Ismail, Hebah; Batakji, Mariam; Kim, Sung Min; Olufolabi, Adeyemi J.; Srofenyoh, Emmanuel

doi:10.1371/journal.pone.0266932

Cited by 10 publications

(5 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While limited novel interventions aimed to reduce the "third delay" and improve obstetric triage within facilities have been piloted in some LMIC settings, few have proposed interventions to encompass care delivery from the pre-hospital to facility setting [20][21][22]. A feasibility study in Ghana utilized WhatsApp as a platform for referring obstetric patients to higher care centers, with findings demonstrating usability by various health care professionals from different types of health centers, long variations in arrival time to facility for obstetric patients, and decreased arrival time when patients were accompanied by midwives [23]. Combining our findings with this pilot program suggest that a WAT-RT System, when assessed and implemented with appropriate adaptation, could provide a platform for obstetric triage in West Africa.…”

Section: Discussionmentioning

confidence: 99%

“…WhatsApp, a commonly used mobile communication platform throughout much of the world, including SSA, has demonstrated usability as an mHealth intervention. Piloted in studies covering infectious disease [14], medical education and research [15,16], and preventive medicine [17], WhatsApp holds promise as a commonly used, low-cost, and secure data messaging system but has been underexplored as a potential platform to address delays in obstetric care [18]. Midwives and community health assistants (CHAs) serve as the frontline providers for obstetric care in rural Liberia.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Acceptability of a Whatsapp Triage, Referral, and Transfer System for Obstetric Patients in Rural Liberia

Reynolds,

Horton,

Lee

et al. 2023

agh

View full text Add to dashboard Cite

Background: Maternal mortality continues to disproportionately affect low- and middle-income countries, including Liberia. Though the relationship between obstetric triage systems and improved maternal outcomes is well documented, standardized triage protocols are lacking in rural Liberia. Mobile health interventions are a promising method to triage obstetric patients. Objectives: This study explores the acceptability of a WhatsApp Triage, Referral, and Transfer (WAT-RT) system among Liberian midwives and community health assistants. Methods: Individual interviews and focus group discussions were conducted among midwives (n = 18) and community health assistants (n = 112). Interviews were designed to understand the current referral system in rural Liberia, how a WAT-RT System can address referral limitations, and the acceptability of the WAT-RT System. Data were audio recorded, transcribed, and translated into English. Data analysis was conducted via NVivo12 with independent and cooperative techniques among multiple researchers. Findings: The current referral system is not standardized with limitations including a lack of triage protocols, transportation difficulties, and inconsistent communication of patient information, which could be addressed by a WAT-RT System. The acceptability for the WAT-RT System was high. Facilitators to implementation included utilizing a pre-existing communication and referral infrastructure, access and competency surrounding mobile phones, and increased opportunities for training and inter-provider collaboration. Barriers included disproportionate phone access between midwives and community health assistants, network reliability, and a lack of data standards. Recommendations for successful implementation included centralizing phone financing and standardizing triage protocols. Conclusions: The WAT-RT System demonstrated high acceptability among frontline health care providers in rural Liberia. Barriers to program success could be reasonably addressed with simple interventions and planning. Multiple benefits included addressing care delays for obstetric patients, promoting bidirectional provider communication, and increasing the quality of obstetric triage. Future studies should focus on piloting the WAT-RT System among this population and recruiting other key stakeholders to determine intervention feasibility.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Acceptability of a Whatsapp Triage, Referral, and Transfer System for Obstetric Patients in Rural Liberia

Reynolds,

Horton,

Lee

et al. 2023

agh

View full text Add to dashboard Cite

show abstract

“…A study showed statistically significant improvements, with a mean increase in knowledge from 11.21 to 13.68 following a health education intervention focusing on noncommunicable diseases via digital media, i.e., WhatsApp [24]. The adoption of elearning for training healthcare professionals has surged exponentially, with several studies affirming its effectiveness [25,26,27,28,29]. Furthermore, using social media and mHealth apps in pregnancy care has shown considerable effectiveness, yielding moderate to large effect sizes in enhancing maternal health and knowledge among healthcare professionals [30,31].…”

Section: Discussionmentioning

confidence: 99%

Assessing the effectiveness of digital media platforms on birth preparedness and complication readiness knowledge among healthcare professionals

Mahmood,

Zulfiqar,

Bano

et al. 2023

J Soc Health Sci

View full text Add to dashboard Cite

The integration of modern technology in healthcare education, mainly through digital media platforms, is pivotal for enhancing healthcare professionals' proficiency in birth preparedness and complication readiness (BP/CR). This study aimed to assess the effectiveness of digital media interventions on BP/CR knowledge among healthcare providers, reflecting on broader implications for global healthcare delivery and patient education. In this quasi-experimental study, 70 healthcare professionals were recruited using a nonprobability convenience sampling method. The training protocol was developed after an in-depth literature review, while the evaluation questionnaire incorporated provider-level index indicators aligned with Johns Hopkins University's BP/CR guidelines to ensure a comprehensive assessment framework. The intervention utilized widely accessible digital platforms, i.e., WhatsApp and email, aimed to deliver educational content, with its effectiveness gauged through pre- and postintervention assessments analyzed using SPSS 25.00. The study findings demonstrated significant improvements in BP/CR knowledge postintervention across various care domains. The results showed significant increases in BP/CR knowledge postintervention: focused antenatal care knowledge improved from 34.00% to 69.00% (p < 0.001), and knowledge of third-stage labor management increased from 21.00% to 56.00% (p < 0.001). Furthermore, significant improvements were also observed in neonatal care and emergency obstetric and neonatal care management knowledge (p < 0.001). These results affirm the role of digital media in improving healthcare education, suggesting its integration into healthcare policies to reduce maternal mortality and support professionals in resource-limited settings.

show abstract

“…WhatsApp, one of the most popular communication platforms worldwide has been examined as a potential means to streamline the obstetric referral process between communities, RHFs, and hospitals. [9][10][11] Several feasibility and acceptability studies conducted in Ghana and Liberia found that the use of WhatsApp for obstetric referral is feasible and acceptable among community health workers, nurses, and midwives. [9][10][11] Building upon these studies, this study piloted a mobile obstetric emergency system (MORES) using the free WhatsApp platform as an obstetric referral intervention examining the association between the implementation of the MORES intervention and transfer times, maternal outcome, and newborn outcomes.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The use of a mobile obstetric emergency system to improve obstetric referrals in Bong County, Liberia: A pre‐post study

Lee,

Dahn,

Sieka

et al. 2023

Intl J Gynecology & Obste

View full text Add to dashboard Cite

ObjectiveLiberia experiences an unmet need for cesarean section with about 5% population coverage, lower than 9%–19% coverage associated with improved maternal and newborn outcomes. Delays in the referral process for comprehensive emergency obstetric and newborn care (CEmONC) services due to ineffective communication between a rural health facility (RHF) and a district hospital contribute to the low CS rate. This study examined the association between mobile obstetric emergency system (MORES) implementation and referral time for obstetric emergencies as well as maternal/newborn outcomes.MethodsA pre‐post descriptive analysis was conducted on data collected from 20 rural health facilities (RHFs) and two hospitals in Bong County. Women with referral data from both RHFs and hospitals were matched and information including transfer time, reasons for referral, and maternal and newborn outcomes were extracted. Descriptive analysis and logistic regression models examined the relationship between the intervention's implementation and mode of delivery, maternal outcome, newborn outcome, and transfer time from RHF to district hospital. Ethics approval was obtained from two study centers.ResultsWomen had higher odds of undergoing a CS at endline (OR: 1.86 95% CI: 0.99–3.46) compared to baseline. Additionally, newborns had lower odds of showing non‐vigorous symptoms (OR: 0.31; 95% CI: 0.14–0.68), defined as a newborn with poor respiratory effort, muscle tone, or heart rate. There was no significant association between the intervention's implementation and transfer time.ConclusionThe MORES intervention is a promising means to increase timely care seeking along the referral pathway which may enhance access to cesarean section as well as improved newborn outcome in low‐ and middle‐income countries.

show abstract

Use of WhatsApp messaging technology to strengthen obstetric referrals in the Greater Accra Region, Ghana: Findings from a feasibility study

Cited by 10 publications

References 30 publications

Acceptability of a Whatsapp Triage, Referral, and Transfer System for Obstetric Patients in Rural Liberia

Acceptability of a Whatsapp Triage, Referral, and Transfer System for Obstetric Patients in Rural Liberia

Assessing the effectiveness of digital media platforms on birth preparedness and complication readiness knowledge among healthcare professionals

The use of a mobile obstetric emergency system to improve obstetric referrals in Bong County, Liberia: A pre‐post study

Contact Info

Product

Resources

About