Implementation of an international standardized set of outcome indicators in pregnancy and childbirth in Kenya: Utilizing mobile technology to collect patient-reported outcomes

Autoři: Ishtar Al-Shammari aff001;  Lina Roa aff002;  Rachel R. Yorlets aff004;  Christina Akerman aff001;  Annelies Dekker aff005;  Thomas Kelley aff001;  Ramona Koech aff005;  Judy Mutuku aff006;  Robert Nyarango aff006;  Doriane Nzorubara aff005;  Nicole Spieker aff005;  Manasi Vaidya aff005;  John G. Meara aff002;  David Ljungman aff002
Působiště autorů: International Consortium for Health Outcomes Measurement (ICHOM), Boston, Massachusetts, United States of America aff001;  Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, United States of America aff002;  Department of Obstetrics & Gynecology, University of Alberta, Edmonton, Canada aff003;  Department of Plastic & Oral Surgery, Boston Children’s Hospital, Boston, Massachusetts, United States of America aff004;  PharmAccess (PAI), Amsterdam, The Netherlands aff005;  Gertrude’s Children’s Hospital, Nairobi, Kenya aff006;  Department of Surgery, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden aff007
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0222978



Limited data exist on health outcomes during pregnancy and childbirth in low- and middle-income countries. This is a pilot of an innovative data collection tool using mobile technology to collect patient-reported outcome measures (PROMs) selected from the International Consortium of Health Outcomes Measurement (ICHOM) Pregnancy and Childbirth Standard Set in Nairobi, Kenya.


Pregnant women in the third trimester were recruited at three primary care facilities in Nairobi and followed prospectively throughout delivery and until six weeks postpartum. PROMs were collected via mobile surveys at three antenatal and two postnatal time points. Outcomes included incontinence, dyspareunia, mental health, breastfeeding and satisfaction with care. Hospitals reported morbidity and mortality. Descriptive statistics on maternal and child outcomes, survey completion and follow-up rates were calculated.


In six months, 204 women were recruited: 50% of women returned for a second ante-natal care visit, 50% delivered at referral hospitals and 51% completed the postnatal visit. The completion rates for the five PROM surveys were highest at the first antenatal care visit (92%) and lowest in the postnatal care visit (38%). Data on depression, dyspareunia, fecal and urinary incontinence were successfully collected during the antenatal and postnatal period. At six weeks postpartum, 86% of women breastfeed exclusively. Most women that completed the survey were very satisfied with antenatal care (66%), delivery care (51%), and post-natal care (60%).


We have demonstrated that it is feasible to use mobile technology to follow women throughout pregnancy, track their attendance to pre-natal and post-natal care visits and obtain data on PROM. This study demonstrates the potential of mobile technology to collect PROM in a low-resource setting. The data provide insight into the quality of maternal care services provided and will be used to identify and address gaps in access and provision of high quality care to pregnant women.

Klíčová slova:

Antenatal care – Finance – Incontinence – Kenya – Labor and delivery – Mental health and psychiatry – Pregnancy – Surveys


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2019 Číslo 10