Enhancing quality of health care delivered to under 5 children in Kibra informal settlement of Nairobi, Kenya, by using mHealth platform with electronic clinical decision support system.

ABSTRACT: This study evaluated an mHealth platform with embedded electronic clinical decision support system, which is compliant with World Health Organization and United Nations International Children's Emergency Fund recommended Integrated Management of Newborn and Childhood Illnesses (IMNCI) guidelines and designed to support health care providers (HCPs) to assess, diagnose and manage common childhood illnesses in low-resource settings. A quasi-experimental study was conducted between February 2019 and March 2020 in the Kibra informal settlement of Nairobi, Kenya, to evaluate the mHealth platform's effectiveness in improving the quality of child health services. The intervention included mHealth-supported service delivery, supportive supervision, community outreach, and targeted both public and private healthcare facilities. The primary outcome was increased adherence to IMNCI guidelines by HCPs, measured through comparisons between baseline and endline clinical assessments. Among the 89 HCPs utilizing the mHealth platform, the proportion selecting the World Health Organization recommended amoxicillin dispersible tablets for treating childhood pneumonia increased from 3% at baseline to 38% at endline. Additionally, HCP's awareness regarding the non-indicated use of antibiotics for simple diarrhea management increased from 14% to 50%. Over 90% of HCPs demonstrated compliance with IMNCI protocols at endline, and 85% reported increased clinical confidence attributable to use of the mHealth platform. Following these results, the program was scaled to eight additional sub-counties across Nairobi from 2021 to 2024 when 232 trained HCPs served 26 254 children under 5 years of age, using the mHealth platform. These findings provide evidence to support implementing mHealth platforms with embedded electronic clinical decision support system to enhance IMNCI guideline adherence, increase provider confidence and improve the quality of pediatric care in resource-limited settings.

SUBMITTER: Abraham A 

PROVIDER: S-EPMC12698342 | biostudies-literature | 2025

REPOSITORIES: biostudies-literature