Evaluating the impact of using eHealth tools to extend health services to remote populations in Nigeria using Satellite Communication

INTERVENTION: The use of two interventions are evaluated: 1) Clinical Patient Administration Kit (CliniPAK): A tablet computer‐enabled point‐of‐care data capture and decision support tool that allows health workers to capture patient health information and send appropriate data to remote servers through mobile networks. The CliniPAK software provides an electronic medical record that incorporates data on patient registration and demographics, vital signs, diagnosis, treatment, case review and administrative task support. The software triggers immediate alerts for at‐risk patients, referrals to secondary health systems and on‐demand reporting to enable health administrators increase productivity and improve patient clinical experience. CliniPAK was developed and is owned by Vecna Cares Charitable Trust, Cambridge, Massachusetts, USA. 2) Video training application (VTR): The VTR education intervention consists of a series of videos adapted from the ‘ORB platform’ (www.health‐orb.org/), with a set of quizzes administered via a derivative of the open source application ‐ OppiaMobile Application (App) on the tablet computers developed to test the users’ understanding of the training content. The intervention will be delivered to FHWs via a structured programme of bite‐size training films addressing antenatal care (ANC), basic obstetric care, perinatal care, postnatal care (PNC), and knowledge and skills requirements for FHWs. Relevant video content included in the training package was selected in consultation with State Ministries of Health (SMoH). Installed on the tablet computers held at Primary Health Centres (PHCs), the VTR package will provide high quality learning for FHWs, by delivering clear, engaging clinical scenarios and educational messages for motivating FHWs who lack basic resources to support their work. In this evaluation study, two clusters are selected across three separate states in Nigeria (Kano and Ondo States and the Federal Capital Territory), with each clus CONDITION: Frontline health workers and facility heads at intervention and non‐intervention facilities, pregnant women at participating primary health centres that benefit from the use of eHealth tools as part of service delivery, and policymakers and planners. ; Pregnancy and Childbirth ; Frontline health workers and facility heads at intervention and non‐intervention facilities, pregnant women at participating primary health centres that benefit from the use of eHealth tools as part of service delivery, and policymakers and planners. PRIMARY OUTCOME: Binary facility‐level indicator measuring whether the monthly NHMIS indicator “total number of ANC visits” is complete (i.e. available through the NHMIS) for every month between months 25 and 30 of the project (6‐month post‐intervention). SECONDARY OUTCOME: 1. Binary facility‐level indicators of whether the monthly NHMIS indicators “total PNC visits” and “percentage skilled birth attendance” are complete or not for every month between months 25 and 30 of the project (6‐month post‐intervention); 2. Monthly NHMIS indicators of “total number of ANC visits”, “total number of PNC visits” and “percentage of skilled birth attendance” INCLUSION CRITERIA: 1. Frontline health workers at intervention sites. 2. Adults aged 18 and older