ArticleBMC health services research2017
Cost-effectiveness of an electronic clinical decision support system for improving quality of antenatal and childbirth care in rural Tanzania: an intervention study.
Article in BMC health services research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01409824 (Health Care Intervention Research-Quality of Prenatal and Maternal Care), which is not on this map. Cited by 6 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Health Care Intervention Research-Quality of Prenatal and Maternal Care: Bridging the Know-do Gap (QUALMAT)
Who cites it
6 citing papers in PubMed.
- Impact and cost-effectiveness of Neotree, a digital data capture and decision support tool designed to improve neonatal survival in Zimbabwe: an interrupted time series analysis and economic evaluation.BMJ global health · 2026Article
- The Safe Assessment Form to Evaluate Risks ('SAFER') chart - a clinical practice evaluation study following introduction of electronic risk identification in pregnancies in Scotland.NIHR open research · 2025Article
- Clinical decision support systems for maternity care: a systematic review and meta-analysis.EClinicalMedicine · 2024Article
- Development and Pilot Implementation of Neotree, a Digital Quality Improvement Tool Designed to Improve Newborn Care and Survival in 3 Hospitals in Malawi and Zimbabwe: Cost Analysis Study.JMIR mHealth and uHealth · 2023Article
- Pregnant women's perceptions of antenatal care and utilisation of digital health tools in Magu District, Tanzania: a qualitative study.Sexual and reproductive health matters · 2023Article
- Clinical Decision Support Systems.Visceral medicine · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundQUALMAT project aimed at improving quality of maternal and newborn care in selected health care facilities in three African countries. An electronic clinical decision support system was implemented to support providers comply with established standards in antenatal and childbirth care. Given that health care resources are limited and interventions differ in their potential impact on health and costs (efficiency), this study aimed at assessing cost-effectiveness of the system in Tanzania.
methodsThis was a quantitative pre- and post- intervention study involving 6 health centres in rural Tanzania. Cost information was collected from health provider's perspective. Outcome information was collected through observation of the process of maternal care. Incremental cost-effectiveness ratios for antenatal and childbirth care were calculated with testing of four models where the system was compared to the conventional paper-based approach to care. One-way sensitivity analysis was conducted to determine whether changes in process quality score and cost would impact on cost-effectiveness ratios.
resultsEconomic cost of implementation was 167,318 USD, equivalent to 27,886 USD per health center and 43 USD per contact. The system improved antenatal process quality by 4.5% and childbirth care process quality by 23.3% however these improvements were not statistically significant. Base-case incremental cost-effectiveness ratios of the system were 2469 USD and 338 USD per 1% change in process quality for antenatal and childbirth care respectively. Cost-effectiveness of the system was sensitive to assumptions made on costs and outcomes.
conclusionsAlthough the system managed to marginally improve individual process quality variables, it did not have significant improvement effect on the overall process quality of care in the short-term. A longer duration of usage of the electronic clinical decision support system and retention of staff are critical to the efficiency of the system and can reduce the invested resources. Realization of gains from the system requires effective implementation and an enabling healthcare system.
trial registrationRegistered clinical trial at www.clinicaltrials.gov ( NCT01409824 ). Registered May 2009.
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