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 5–10min 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.

Acknowledgments

Marc Mitchell was the principal investigator for the study and led the design, analysis, and drafting of this article. Maya Getchell assisted with the data analysis and drafting of this article. Melania Nkaka and Daniel Msellemu assisted with the data collection and transcription. Jan van Esch assisted with the study design and editing of manuscript. Bethany Hedt-Gauthier assisted with the editing and submission process and participated in the design of the quantitative study.

The larger study was funded by the Rockefeller Foundation. D-Tree covered the cost of the qualitative data collection, entry, and analysis.