The Development and Usability Testing of a Decision Support Mobile App for the Essential Care for Every Baby (ECEB) Program

Abstract

mHealth is a pervasive and ubiquitous technology which has revolutionized the healthcare system for both health providers and patients (Wang et al. 2016). Each year, globally, about 15 million babies are born too soon (premature) or too small (low birthweight small for gestational age); among these 2.7 million newborns die every year due to complications from prematurity (Every New Born 2014). Common complications of prematurity like feeding problems, and hypothermia lead to high rates of morbidity and mortality among prematurely born babies each year. Delivery of evidence-based essential newborn care interventions, from birth through the first 24 h of postnatal life, has been shown to improve health and well-being, and reduce mortality, among newborns. However, due to a variety of barriers, bottlenecks, and challenges, many babies born in resource-limited settings do not receive the full complement of these lifesaving interventions. In order to address these challenges, the American Academy of Pediatrics (AAP) has developed an integrated educational and training curriculm for health care providers and family stakeholders in LMICs called Essential Care for Every Baby (ECEB). ECEB has an Action Plan, which serves as a decision support tool and job aid for health care providers. (Figure 1), by synthesizing research over a decade on helping babies survive (Essential Care for Every Baby 2018). This program teaches health care providers essential newborn care practices to keep all babies healthy from the time of birth to discharge from the facility. Yet, the nuances of monitoring, tracking and taking care of multiple babies simultaneously in neonatal wards has a big cognitive load on nurses, who must perform tasks every few minutes on each baby. The care is divided into three phases based on the time after birth: Phase 1 (0–60 min), Phase 2 (60–90 min), Phase 3 (90 min-24 h). We iteratively developed and tested the usability of the ECEB action plan, as part of the mobile Helping Babies Survive (mHBS) suite of apps, and plan to field test the app in the near future.