Community Research and Development Information Service - CORDIS


HEALTHMPOWR Report Summary

Project ID: 617639
Funded under: FP7-IDEAS-ERC
Country: Norway

Periodic Report Summary 2 - HEALTHMPOWR (A New Paradigm for Public Health Surveillance: Unlocking the Potential of Data to Empower Women and Health Systems)

Universal coverage of health care with quality content and continuity of care is essential for countries to meet the Sustainable Development Goals of ending preventable maternal and child deaths by 2030.

Without seamless, sustainable, and secure data and information exchanges at all levels of the health system, public health and clinical care cannot be delivered safely, with high quality, and in a cost-effective manner. Scarce workforce resources for maternal and child health programs in low- and middle-income countries are wasting time and deprived of the power of data to improve quality, by inefficient health information systems. Care providers in low- and middle-income countries typically spend large proportions of their time acting as data collectors, manually aggregating and transferring data from duplicative paper records, forms and register books into another set of forms and tables of one or more disconnected health information systems. It does not serve their clinical work, nor the information needs of the women and children they serve, and they hardly ever see the data again.

The electronic health registries (eRegistries) we study in HEALTHMPOWR represent the ground-breaking innovation of health information systems that can change all this. In an ecosystem of health information, the care provider adds individual clinical data to interactive checklists at the point-of-care, and it responds to her with clinical decision-support. From the online server, records can be shared at all care levels to facilitate continuity and referrals; automated personalized SMS-messaging provides reminders, empowerment and behavior-change communication to her women; and autonomous individualized performance feedback supports her provision of quality care. Simultaneously, her reporting burden is eliminated, as the system automatically generates performance indicators and standardized reports to supervisors and the health system owners.

The HEALTMPOWR project aims to demonstrate the feasibility and effectiveness of eRegistries, and provide high quality evidence for policy makers. We are implementing an eRegistry for maternal and child health in the West Bank of Palestine. Our four research questions look at whether we improve the quality of health care and the health of pregnant women and their babies with the eRegistry’s automated: 1) electronic checklist with clinical decision support, 2) individualized sms reminders and behavior change communication to women, 3) individualized performance feedback to the care providers, and 4) all of the above combined.

The research design we use is cluster randomized controlled trials. This means we compare the performance of care providers and the health outcomes for women and babies from a large number of primary health clinics selected by pure chance to receive the eRegistry interventions, with others that did not.

So far we have succeeded in developing, testing and deploying the eRegistry together with multi-disciplinary Palestinian stakeholders and users of the system – to make sure it fits their needs. We have assisted Palestinian authorities in developing good governance rules for the eRegistry to ensure privacy, safety and ethical use of the data, and our research has been approved by ethics committees both in Palestine and Norway. We have trained over 300 care providers in using the system, and included 133 primary health clinics in the study to answer our research question 1), and today we are half way through our recruitment period. By the end of the summer 2017 another 110 clinics will be using the eRegistry to answer our questions 2) to 4).

The funding from ERC for the HEALTMPOWR project has served as a catalyst to secure additional funding from the Norwegian Research Council, the Norwegian Agency for Development Cooperation, the Norwegian Ministry of Foreign Affairs, as well as in-kind support from the World Health Organization and the Palestinian Ministry of Health, securing national deployment of the eRegistry in both the West Bank and Gaza by the end of 2018.

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