Evidence map›Paper›PMID 41513309›Full record

ArticleBMJ global health2026

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.

Tom Palmer, Simbarashe Chimhuya, Nushrat Khan, Mario Cortina-Borja, Emma Wilson, Tim Hull-Bailey, Hannah Gannon, Tarisai Chiyaka, Aditi Rao, Felicity Fitzgerald and 5 more

Abstract read
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In one paragraph

Article in BMJ global health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

15 authors.

Tom PalmerInstitute for Global Health, University College London, London, UK t.palmer@ucl.ac.uk.ORCID 0000-0002-9526-0045
Simbarashe ChimhuyaDepartment of Child Adolescent and Women's Health, University of Zimbabwe, Harare, Zimbabwe.
Nushrat KhanGreat Ormond Street institute of Child Health, University College London, London, UK.ORCID 0000-0002-4521-0920
Mario Cortina-BorjaGreat Ormond Street institute of Child Health, University College London, London, UK.
Emma WilsonGreat Ormond Street institute of Child Health, University College London, London, UK.ORCID 0000-0001-7091-2417
Tim Hull-BaileyGreat Ormond Street institute of Child Health, University College London, London, UK.
Hannah GannonGreat Ormond Street institute of Child Health, University College London, London, UK.
Tarisai ChiyakaBiomedical Research and Training Institute, Harare, Zimbabwe.
Aditi RaoGreat Ormond Street institute of Child Health, University College London, London, UK.
Felicity FitzgeraldDepartment of Infectious Disease, Imperial College London, London, UK.ORCID 0000-0001-9594-3228
Karlos MadzivaBiomedical Research and Training Institute, Harare, Zimbabwe.
Sophie Sutcliffe GoodmanNeotree charity, London, UK.
Yali SassoonSnowplow Analytics, London, UK.
Hassan Haghparast-BidgoliInstitute for Global Health, University College London, London, UK.
Michelle HeysGreat Ormond Street institute of Child Health, University College London, London, UK.ORCID 0000-0002-1458-505X

Funding

Wellcome Trust
6 · The paper itself

Abstract

introductionMany neonatal deaths are avoidable using existing low-cost evidence-based interventions. This study evaluated the effectiveness and cost-effectiveness of Neotree, a digital quality improvement tool combining data capture with education and clinical decision support, implemented in a Zimbabwean hospital.

methodsNeotree was implemented in Chinhoyi Provincial Hospital (CPH) in December 2020. Using data collected for all neonates admitted to CPH from March 2020 to October 2023, a single group interrupted time series analysis was conducted to estimate the impact of Neotree implementation. Subgroup analyses explored the impact in low birth weight (1.5-2.5 kg) neonates, a key group targeted by the intervention.Activity-based costing and expenditure approaches estimated costs of developing and implementing Neotree in CPH from a provider perspective. Both total within-study costs and total costs at scale were estimated and used to derive cost per life saved, cost per life year saved and cost per healthy life year (HLY) gained.

resultsAnalysis suggests reduced overall mortality in the post-implementation period, though this difference was not statistically significant (RR: 0.877, 95% CI 0.541 to 1.423, p

conclusionNeotree is a potentially low-cost and highly cost-effective digital quality improvement tool to improve newborn care, morbidity and survival, while also providing quality data. This study contributes to limited economic evidence of mHealth tools in low-income and middle-income settings.

Indexed as

Decision Support Systems, ClinicalInfant MortalityQuality ImprovementCost-Benefit AnalysisCost-Effectiveness AnalysisFemaleHumansInfant, Low Birth WeightInfant, NewbornInterrupted Time Series AnalysisZimbabweChild healthHealth economicsMaternal health

Identifiers

PMID41513309
PMCPMC12820858

What OpenQuestion holds

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LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.