ArticleBMJ open2025
Impact of digital antenatal care intervention on paper-based antenatal care recordkeeping: a before-and-after study in primary healthcare facilities in Nepal.
Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- The implementation realities of a digital antenatal care improvement intervention: Insights from ethnographic work in primary health facilities in Nepal.PLOS digital health · 2026Article
- Pregnant women's and health workers' perceptions and experiences on the Rwandan ANC digital module intervention at selected health centres.PLOS digital health · 2026Article
- Trends in DTP3 Vaccination in Asia (2012-2023).Vaccines · 2025Article
- PredictMed-CDSS: Artificial Intelligence-Based Decision Support System Predicting the Probability to Develop Neuromuscular Hip Dysplasia.Bioengineering (Basel, Switzerland) · 2025Article
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo assess the impact of introducing electronic decision support systems (EDSS)-electronic data entry implemented alongside existing paper-based antenatal care (ANC) records-on the completeness and agreement of ANC records.
designTwo-phase cross-sectional (before and after) substudy of the mobile health integrated model of hypertension, diabetes and ANC (mIRA project) process evaluation.
settingFour rural districts in Bagmati Province, Nepal, in 19 primary healthcare facilities.
participantsANC records from pregnant women attending facilities before (n=136) and after (n=138) EDSS implementation.
main outcome measuresFor selected indicators in the ANC card and ANC register, we estimated the percentage completeness (any value recorded) and agreement (whether values matched) before and after EDSS implementation. We also reported the completeness of indicators in the EDSS and calculated the agreement between the ANC card and EDSS. χ
resultsCompleteness of paper-based ANC records was high before implementation (>90%) for all indicators, except tetanus vaccination (<80%). After EDSS implementation, there was >15% improvement in the completeness of tetanus vaccination date in paper-based ANC records (77.0%-96.4% for ANC cards and 81.9%-98.9% for ANC register). Agreement between the ANC card and ANC register increased slightly for all indicators after implementation, and the tetanus vaccination date showed the largest increase (38.2%-57.2%). Indicator completeness in the EDSS was low, ranging from 38.2% to 88.7%.
conclusionWe found slight improvements in the completeness and agreement of paper-based ANC records following EDSS implementation. The lower percentage of completeness in the EDSS suggests that any large-scale implementation should consider how to integrate digital and paper-based records to decrease the data entry burden on ANC providers. However, the study's small sample size limited the ability to examine variation in effects.
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