Protocol for an intervention development and pilot implementation evaluation study of an e-health solution to improve newborn care quality and survival in two low-resource settings, Malawi and Zimbabwe: Neotree
Hassan Haghparast-Bidgoli,
Michelle Heys,
Caroline Crehan,
Erin Kesler,
Monica Lakhanpaul,
Emma Wilson,
Fabiana Lorencatto,
Felicity Fitzgerald,
Mario Cortina Borja,
Msandeni Chiume,
Hannah Gannon,
Simbarashe Chimhuya,
Gwendoline Chimhini,
Tim Hull-Bailey,
Tarisai Chiyaka,
Yali Sassoon,
Deliwe Nkhoma,
Nushrat Khan,
Alexander G. Stevenson,
Kristina Curtis
Affiliations
Hassan Haghparast-Bidgoli
UCL Institute for Global Health, London, UK
Michelle Heys
Department of Population, Policy & Practice, UCL Great Ormond Street Institute of Child Health, London, UK
Caroline Crehan
Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
Erin Kesler
3 Department of Pediatric General, Thoracic, and Fetal Surgery, The Children`s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
Monica Lakhanpaul
Department of Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
Emma Wilson
Centre for Public Health and Epidemiology, University of Nottingham, Nottingham, UK
Fabiana Lorencatto
Centre for Behaviour Change, University College London, London, UK
Felicity Fitzgerald
2 Infection, Immunity and Inflammation, UCL Great Ormond Street Institute of Child Health, London, UK
Mario Cortina Borja
Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
Msandeni Chiume
Department of Pediatrics, Kamuzu Central Hospital, Lilongwe, Malawi
Hannah Gannon
Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
Simbarashe Chimhuya
Unit of Child and Adolescent Health, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
Gwendoline Chimhini
3 Child and Adolescent Health Unit, University of Zimbabwe, Harare, Zimbabwe
Tim Hull-Bailey
Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
Tarisai Chiyaka
Centre for Sexual Health and HIV/AIDS Research (CeSHHAR) Zimbabwe, Harare, Zimbabwe
Yali Sassoon
Snowplow Analytics, London, UK
Deliwe Nkhoma
Parent and Child Health Initiative Trust, Lilongwe, Central Region, Malawi
Nushrat Khan
Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
Introduction Every year 2.4 million deaths occur worldwide in babies younger than 28 days. Approximately 70% of these deaths occur in low-resource settings because of failure to implement evidence-based interventions. Digital health technologies may offer an implementation solution. Since 2014, we have worked in Bangladesh, Malawi, Zimbabwe and the UK to develop and pilot Neotree: an android app with accompanying data visualisation, linkage and export. Its low-cost hardware and state-of-the-art software are used to improve bedside postnatal care and to provide insights into population health trends, to impact wider policy and practice.Methods and analysis This is a mixed methods (1) intervention codevelopment and optimisation and (2) pilot implementation evaluation (including economic evaluation) study. Neotree will be implemented in two hospitals in Zimbabwe, and one in Malawi. Over the 2-year study period clinical and demographic newborn data will be collected via Neotree, in addition to behavioural science informed qualitative and quantitative implementation evaluation and measures of cost, newborn care quality and usability. Neotree clinical decision support algorithms will be optimised according to best available evidence and clinical validation studies.Ethics and dissemination This is a Wellcome Trust funded project (215742_Z_19_Z). Research ethics approvals have been obtained: Malawi College of Medicine Research and Ethics Committee (P.01/20/2909; P.02/19/2613); UCL (17123/001, 6681/001, 5019/004); Medical Research Council Zimbabwe (MRCZ/A/2570), BRTI and JREC institutional review boards (AP155/2020; JREC/327/19), Sally Mugabe Hospital Ethics Committee (071119/64; 250418/48). Results will be disseminated via academic publications and public and policy engagement activities. In this study, the care for an estimated 15 000 babies across three sites will be impacted.Trial registration number NCT0512707; Pre-results
