Vital signs measurement can identify pregnant and postpartum women who require urgent treatment or referral. In low-resource settings, healthcare workers have limited access to accurate vital signs measuring devices suitable for their environment and training. The CRADLE Vital Signs Alert (VSA) is a novel device measuring blood pressure and pulse that is accurate in pregnancy and designed for low-resource settings. Its traffic light early warning system alerts healthcare workers to the need for escalation of care for women with hypertension, haemorrhage or sepsis. This study evaluated the usability and acceptability of the CRADLE VSA device.
Evaluation was conducted in community and primary care settings in India, Mozambique and Nigeria and tertiary hospitals in South Africa. Purposeful sampling was used to convene 155 interviews and six focus groups with healthcare workers using the device (n = 205) and pregnant women and their family members (n = 41). Interviews and focus groups were conducted in the local language and audio-recorded, transcribed and translated into English for analysis. Thematic analysis was undertaken using an a priori thematic framework, as well as an inductive approach.
Most healthcare workers perceived the CRADLE device to be easy to use and accurate. The traffic lights early warning system was unanimously reported positively, giving healthcare workers confidence with decision-making and a sense of professionalism. However, a minority in South Africa described manual inflation as tiring, particularly when measuring vital signs in obese and hypertensive women (n = 4) and a few South African healthcare workers distrusted the device’s accuracy (n = 7). Unanimously, pregnant women liked the CRADLE device. The traffic light early warning system gave women and their families a better understanding of the importance of vital signs in pregnancy and during the postpartum period.
The CRADLE device was well accepted by healthcare workers from a range of countries and levels of facility, including those with no previous vital signs measurement experience. The device motivated women to attend primary care and encouraged them to accept treatment and referral.
World Health Organization. mHealth: New horizons for health through mobile technologies. Global Observatory for eHealth series - Volume 3. GSMA mHA Mobile Health Summit, Cape Town, South Africa; 2011.
Roback K, Gäddlin P-O, Nelson N, Persson J. Adoption of medical devices: perspectives of professionals in Swedish neonatal intensive care. Technol Health Care. 2007;15(3):157–79. PubMed
Marshall C, Lewis D, Whittaker M. mHealth technologies in developing countries: a feasibility assessment and a proposed framework. Herston, Australia: University of Queensland 2013:1-47.
Källander K, Tibenderana JK, Akpogheneta OJ, Strachan DL, Hill Z, ten Asbroek AH, et al. Mobile health (mHealth) approaches and lessons for increased performance and retention of community health workers in low-and middle-income countries: a review. J Med Internet Res. 2013;15(1):e17. CrossRefPubMedPubMedCentral
Mohanan M, Hay K, Mor N. Quality of health care in India: challenges, priorities, and the road ahead. Health Aff (Millwood). 2016;35(10):1753–8. CrossRef
Rogers EM. Diffusion of innovations, 4th Edition 2010. New York: The Free Press; 2010.
Vidler M, Ramadurg U, Charantimath U, Katageri G, Karadiguddi C, Sawchuck D, et al. Utilization of maternal health care services and their determinants in Karnataka state. India Reproductive Health. 2016;13(1):55. CrossRef
Akeju DO, Oladapo OT, Vidler M, Akinmade AA, Sawchuck D, Qureshi R, et al. Determinants of health care seeking behaviour during pregnancy in Ogun state, Nigeria. Reprod Health. 2016;13(1):67. CrossRef
Payne B, von Dadelszen P, Bhutta Z, Magee L, Adetoro O, Sotunsa J. Protocol 13PRT/9313: the community level interventions for pre-eclampsia (CLIP) trials: four prospective cluster randomised controlled trials comparing a package of interventions directed towards improving maternal and perinatal outcomes related to pre-eclampsia with current standards of care (NCT01911494). Lancet 2015.
Biernacki P, Waldorf D. Snowball sampling: problems and techniques of chain referral sampling. Sociol Methods Res. 1981;10(2):141–63. CrossRef
Louise Barriball K, While A. Collecting data using a semi-structured interview: a discussion paper. J Adv Nurs. 1994;19(2):328–35. CrossRef
Finlay L. Negotiating the swamp: the opportunity and challenge of reflexivity in research practice. Qual Res. 2002;2(2):209–30. CrossRef
- The CRADLE vital signs alert: qualitative evaluation of a novel device designed for use in pregnancy by healthcare workers in low-resource settings
Hannah L. Nathan
Olalekan O. Adetoro
Mrutyunjaya B. Bellad
Annemarie de Greeff
David R. Hall
Peter von Dadelszen
Lucy C. Chappell
Andrew H. Shennan
the CLIP Working Group
- BioMed Central
Neu im Fachgebiet Gynäkologie und Geburtshilfe
Meistgelesene Bücher aus dem Fachgebiet
Mail Icon II