Health workers’ experiences with the Safe Delivery App in West Wollega Zone, Ethiopia: a qualitative study

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Background

Health workers in many low-income countries are not adequately trained to deliver pregnant women safely. The Safe Delivery App (SDA) was developed in response to this situation, providing animated clinical instruction videos in basic emergency obstetric and neonatal care. SDA aims to improve knowledge and skills of health workers located in the periphery of the health system in order to improve quality of care and potentially save the lives of mothers and newborns. The objective of this qualitative study is to explore users’ experiences with using SDA and in which ways the app influences their work situation and their perceived ability to conduct safe deliveries.

Methods

Eleven focus group discussions and four individual interviews were conducted with 56 midwives, nurses and health extension workers from five districts in West Wollega Zone, Oromiya region of Ethiopia. The data further include observations and informal conversations. All interviews were recorded, transcribed verbatim, checked for corrections and analysed using systematic text condensation.

Results

The findings indicate that health workers perceive the SDA as a useful tool, which helps them memorize and update knowledge and skills, and improves their confidence. The app is used in varying ways depending on internal and external factors such as own competencies, availability of equipment and frequency of births attended. User patterns follow the relevance of the tool according to the health workers’ context – those who conduct more deliveries have used the app more often in emergency situations, whereas those who conduct fewer deliveries tend to use it to improve their knowledge and to provide health education to pregnant women. Health workers experienced that community members showed more recognition and trust in their abilities and ascribed this to their increased confidence in assisting in deliveries. The increased recognition from communities may also be associated with the use of medical technology.

Conclusion

Health workers perceive the SDA as having improved their ability to manage complications during childbirth and have gained increased community recognition and trust.


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