Evidence map›Paper›PMID 39924301›Full record

ArticleJMIR medical informatics2025

Implementation of WHO SMART Guidelines-Digital Adaptation Kits in Pathfinder Countries in Africa: Processes and Early Lessons Learned.

Rosemary K Muliokela, Kuwani Banda, Abdulaziz Mohammed Hussen, Sarai Bvulani Malumo, Andrew Kashoka, Angel Mwiche, Innocent Chiboma, Maria Barreix, Muyereka Nyirenda, Zvanaka Sithole and 13 more

Abstract read
In one paragraph

Article in JMIR medical informatics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors.

Rosemary K MuliokelaDepartment of Sexual Reproductive Health and Research, World Health Organization, Avenue Appia 20, 1211, Geneva, Switzerland, 41 22 791 21 11.ORCID 0000-0003-0614-3646
Kuwani BandaIHM Southern Africa, Lusaka, Zambia.ORCID 0009-0000-1429-2444
Abdulaziz Mohammed HussenCollege of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.ORCID 0000-0003-1609-8498
Sarai Bvulani MalumoImmunization Maternal Newborn Child Health Cluster, World Health Organization, Country Office, Addis Ababa, Ethiopia.ORCID 0000-0001-5212-9963
Andrew KashokaDepartment of Information Communication Technology (ICT), Ministry of Health, Lusaka, Zambia.ORCID 0000-0003-4581-7842
Angel MwicheDepartment of Public Health, Ministry of Health, Lusaka, Zambia.ORCID 0000-0001-6155-3491
Innocent ChibomaDepartment of Information Communication Technology (ICT), Ministry of Health, Lusaka, Zambia.ORCID 0009-0000-5776-6443
Maria BarreixDepartment of Sexual Reproductive Health and Research, World Health Organization, Avenue Appia 20, 1211, Geneva, Switzerland, 41 22 791 21 11.ORCID 0000-0003-3613-9672
Muyereka NyirendaUniversal Health Coverage and Lifecourse Cluster, World Health Organization, Country Office, Lusaka, Zambia.ORCID 0000-0003-2922-0173
Zvanaka SitholeReproductive, Maternal, Newborn Child and Adolescent Health, World Health Organization, Country Office, Harare, Zimbabwe.ORCID 0000-0002-0972-326X
Natschja RatanaprayulDepartment of Digital Health and Innovations, World Health Organization, Geneva, Switzerland.ORCID 0000-0003-0085-2900
Berhanu Fikadie EndehabtuCenter for Digital Health Implementation Science, University of Gondar, Addis Abba, Ethiopia.ORCID 0000-0001-7117-6407
Hanna Abayneh TelakeCollege of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.ORCID 0009-0001-0623-8808
Adane WeldeabCollege of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.ORCID 0000-0003-0321-8542
William J M ProbertDepartment of Global HIV, Hepatitis, and STIs Programmes, World Health Organization, Geneva, Switzerland.ORCID 0000-0002-3437-759X
Ӧzge TunçalpDepartment of Sexual Reproductive Health and Research, World Health Organization, Avenue Appia 20, 1211, Geneva, Switzerland, 41 22 791 21 11.ORCID 0000-0002-5370-682X
Ernest MayaSchool of Public Health, University of Ghana, Accra, Ghana.ORCID 0000-0001-6050-6837
Mulatu WoldetsadikImmunization Maternal Newborn Child Health Cluster, World Health Organization, Country Office, Addis Ababa, Ethiopia.ORCID 0000-0003-1223-9003
Binyam TilahunDepartment of Health Informatics, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.ORCID 0000-0002-1813-167X
Chris GuureSchool of Public Health, University of Ghana, Accra, Ghana.ORCID 0000-0001-6768-8215
Kafui SenyaHIV, TB and Hepatitis (HTH) unit, World Health Organization, Country Office, Accra, Ghana.ORCID 0000-0001-9168-2542
Lale SayDepartment of Sexual Reproductive Health and Research, World Health Organization, Avenue Appia 20, 1211, Geneva, Switzerland, 41 22 791 21 11.ORCID 0000-0002-1377-1328
Tigest TamratDepartment of Sexual Reproductive Health and Research, World Health Organization, Avenue Appia 20, 1211, Geneva, Switzerland, 41 22 791 21 11.ORCID 0000-0001-8579-5698

Funding

World Health Organization 001
6 · The paper itself

Abstract

Background: The adoption of digital systems requires processes for quality assurance and uptake of standards to achieve universal health coverage. The World Health Organization developed the Digital Adaptation Kits (DAKs) within the SMART (Standards-based, Machine-readable, Adaptive, Requirements-based, and Testable) guidelines framework to support the uptake of standards and recommendations through digital systems. DAKs are a software-neutral mechanism for translating narrative guidelines to support the design of digital systems. However, a systematic process is needed to implement and ensure the impact of DAKs in country contexts. Objective: This paper details the structured process and stepwise approach to customize the DAKs to the national program and digital context in 5 countries in Africa with diverse program guideline uptake and significant digital health investments: Ethiopia, Ghana, Malawi, Zambia, and Zimbabwe. All these countries have existing digital systems, which have the potential to be updated with the DAKs. Methods: A DAK assessment tool was developed and used to assess guideline digitization readiness and opportunities for system uptake in each country. Multistakeholder teams were established to conduct the content review and alignment of the generic DAK to national guidelines and protocols through a series of stakeholder consultations, including stakeholder orientation, content review and alignment, content validation, and software update meetings. Unlabelled: Country adaptation processes identified requirements for national-level contextualization and highlighted opportunities for refinement of DAKs. Quality assurance of the content during the content review and validation processes ensured alignment with national protocols. Adaptation processes also facilitated the adoption of the DAKs approach into national guidelines and strategic documents for sexual and reproductive health. Conclusions: Country experiences offered early insights into the opportunities and benefits of a structured approach to digitalizing primary health care services. They also highlighted how this process can be continuously refined and sustained to enhance country-level impact.

Indexed as

Guidelines as TopicPractice Guidelines as TopicWorld Health OrganizationAfricaHumansantenatal careclinical decision supportclinical decision support systemsdigital healthdigital health governanceelectronic health recordelectronic medical recordsfamily planningguidelinesHIV/AIDSinteroperabilitymaternal healthreproductive healthstandardssystem uptake

Identifiers

PMID39924301
PMCPMC11830483

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.