Evidence map›Paper›PMID 40549801›Full record

ArticlePLOS digital health2025

Adapting the WHO ANC digital module for the NAMAI study: Formative research to inform implementation science interventions for enhanced quality service delivery following the WHO SMART guidelines approach.

Nachela Chelwa, Bernard R Ngabo, Muyereka Nyirenda, Musange F Sabine, María Barreix, Tigest Tamrat, Natasha Okpara, Chifundo Phiri, Nathalie K Murindahabi, David Nzeyimana and 12 more

Abstract read
In one paragraph

Article in PLOS digital health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Article
  2. Article
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

22 authors.

Nachela ChelwaPopulation Council, Lusaka, Zambia.
Bernard R NgaboSchool of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
Muyereka NyirendaZambia Country Office, World Health Organization, Lusaka, Zambia.
Musange F SabineSchool of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
María BarreixUNDP/UNFPA/UNICEF/World Bank Special Program of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research (SRH), World Health Organization, Geneva, Switzerland.ORCID https://orcid.org/0000-0003-3613-9672
Tigest TamratUNDP/UNFPA/UNICEF/World Bank Special Program of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research (SRH), World Health Organization, Geneva, Switzerland.
Natasha OkparaPopulation Council, Lusaka, Zambia.
Chifundo PhiriPopulation Council, Lusaka, Zambia.
Nathalie K MurindahabiSchool of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
David NzeyimanaSchool of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.ORCID https://orcid.org/0000-0002-1389-7107
Tobias MakaiBlue code Systems, Lusaka, Zambia.
Gilbert Uwayezu1000Hills Solutions, Kigali, Rwanda.
Gladys YabalwaziBlue code Systems, Lusaka, Zambia.
Mwamba KangwaBlue code Systems, Lusaka, Zambia.
Rosemary K MuliokelaUNDP/UNFPA/UNICEF/World Bank Special Program of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research (SRH), World Health Organization, Geneva, Switzerland.
Hedieh MehrtashUNDP/UNFPA/UNICEF/World Bank Special Program of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research (SRH), World Health Organization, Geneva, Switzerland.ORCID https://orcid.org/0000-0003-4991-616X
Caren ChizuniMinistry of Health Zambia, Lusaka, Zambia.
Vincent MutabaziRwanda Country Office, World Health Organization, Kigali, Rwanda.
Felix SayinzogaRwanda Biomedical Center, Kigali, Rwanda.
Michael T MbizvoPopulation Council, Lusaka, Zambia.
Maurice BucaguSchool of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
Özge TunçalpUNDP/UNFPA/UNICEF/World Bank Special Program of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research (SRH), World Health Organization, Geneva, Switzerland.

Funding

Gates Foundation INV-001304World Health Organization 001
6 · The paper itself

Abstract

The Ministries of Health in Zambia and Rwanda have adapted and validated their national antenatal care (ANC) guidelines in line with WHO 2016 recommendations. Both countries conducted implementation research, composed of five implementation strategies to support the adapted ANC package service delivery. One implementation strategy deploys a digital module, a point of service digital tool that encompasses clinical decision support and person-centric record management to support health workers in implementing the adapted ANC packages. The formative phase of the study, included countries' adaptation of the WHO digital ANC module to their contexts in three steps: (i) the reference module was tailored to create Rwanda and Zambia ANC digital modules and training materials; (ii) health workers were trained to use the module and provide feedback; (iii) country research teams conducted qualitative assessments to understand the health worker experience using the adapted ANC module. ANC health workers at selected facilities completed a three-day training on the use of the module. Qualitative methods were used to understand health worker's perspectives on the module's use for service provision and feedback for its refinement. The three major themes emerged: i) experiences using digital interventions in the health profession; ii) strengths and challenges related to the use of digital interventions; iii) considerations for improving the use of digital interventions within health systems. Rwanda and Zambia ANC modules were modified to improve their use for ANC services delivery. Initial testing led to the identification and fixing of bugs in the system. The module was updated to include dashboards to support facility-based monitoring of ANC indicators. Training materials were also improved based on feedback from interviews of health workers. The iterative process in developing country-adapted digital ANC modules is key to their deployments for routine use and a key proof of concept for the WHO SMART guideline approach.

Identifiers

PMID40549801
PMCPMC12184926

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.