| Indicator ID | H7 |
|---|---|
| Indicator full statement | % of maternal, newborn and under-5 child health (MNCH) consultations performed with the use of an integrated digital health approach. |
Purpose
| Importance | This indicator measures the adoption and use of digital health technologies in delivering maternal, newborn, and child health (MNCH) services where Tdh is conducting related activities. Digital health solutions—such as e-learning toolboxes, digitalized protocols (ANC, PNC, IMCI), electronic medical records, and decision-support tools—enhance access to quality healthcare, particularly in resource-limited settings. It provides insights into the extent to which services adhere to expected standards through these digital tools, helping identify improvements in quality of care due to increased adherence to clinical protocols. |
|---|---|
| ToC pathway | The indicator tracks how well national protocols are followed during client examinations and treatment, which is essential for identifying health issues and providing appropriate care. Monitoring the percentage of MNCH consultations conducted digitally reflects health systems' capacity to integrate technology to improve maternal and child health outcomes. This aligns with global efforts to promote digital health and health system strengthening as a strategy for achieving the World Health Organization’s (WHO) Global Strategy on Digital Health 2020-2025 and Sustainable Development Goals (SDGs) such as SDG 3.8 (Universal Health Coverage) and SDG 9.5 (Innovation in Health Technologies), aimed at reducing maternal and child mortality by 2030. Additionally, it directly relates to the Tdh Theory of Change, contributing to the three inter-related pathways of change: local health systems, communities, and families. |
| Related services | It is used depending on the service provided by Tdh, and can also be linked to Tdh’s IeDA maternity. |
Definition
The percentage of MNCH consultations (for maternal, newborn, and under-5 children) that incorporate digital health technologies supported by Tdh in a defined period, such as the use of e-learning trainings, guide decision making, digitalized protocols or supervisory support to increase standard adherence.
Digital health tools are defined as technologies or systems that 1) aid healthcare providers in diagnosing, treating, or managing patient care, including digital clinical decision-making platforms (CDSS), 2) patient register (EMR or REC), 3) data reporting, 4) e-learning trainings and 5) digitalized protocols.
In order to fit the indicator, at least one of the sub-mentioned technology or system is integrated into routine clinical practice by trained and skilled health personnel to improve healthcare quality, service delivery, and patient outcomes.
Healthcare facilities include primary healthcare centers, community health clinics, and rural or urban health posts providing maternal, newborn, and child health (MNCH) services, as well as other preventive and curative health services.
How to collect & analyse the data
| What do we count? | Consultations |
|---|---|
| How to calculate the indicator's value | Numerator: Number of MNCH consultations performed with the support of digital tools supported by Tdh conducted in a specific period Denominator: Total number of MNCH consultations in primary healthcare facilities in Tdh's area of intervention (health facilities where Tdh is currently developing digital health projects’ activities) conducted in the same specific period Formula: (Number of MNCH consultations performed with the support of digital tools / Total number of MNCH consultations in primary healthcare facilities in Tdh's area of intervention) x 100 Note on method of estimation: The service provision assessment (SPA) will be repeated annually to evaluate changes over time at a given facility or at a set of facilities at periodic intervals (i.e., 3-5 years). With a representative sample, the picture of preparedness should accurately reflect the overall situation at a given level of analysis. It is important to note that the two indicators (population-level and facility-level) are not comparable. |
| Data sources | Routine facility data sources: Facility-based data capturing all consultations using digital health tools, where available. Digital health platform records: Data from digital health platform that track the number of consultations conducted digitally. |
| Data collection methods and tools | Secondary data review |
| Disaggregation | Data should be disaggregated by - where appropriate depending on the data source :
|
| Important considerations | Frequency and timing Monthly, quarterly, and annual reporting from health facilities, though this may only reflect facility-based care. Baseline, mid-term and endline studies through health facility assessment, REC. |
Limitations and precautions
This indicator assesses the quality-of-care provision at healthcare facilities but does not measure the availability of inputs like diagnostic testing or treatment. While digital consultations, especially those guided by clinical protocols, are assumed to improve quality and diagnostic accuracy, this indicator does not directly evaluate health outcomes or patient satisfaction from digital MNCH consultations.
It focuses solely on consultations that utilize digital tools, potentially overlooking the quality of non-digital care, especially in resource-constrained settings where dual record-keeping might lead to misreporting. Access to digital infrastructure can influence this indicator, as rural areas may have lower adoption rates due to challenges like poor internet connectivity and unreliable electricity.
To ensure effective use of digital MNCH consultation tools, healthcare workers need high-quality training and technical support, as well as motivation and acceptance of the technology. Relying solely on this indicator may not reveal gaps in facilities' readiness and skills, highlighting the need for follow-up assessments to evaluate training retention and practical application.
Factors such as motivation (understanding the impact on health outcomes), restraint (perceptions of technology), and commitment (integration into Ministry of Health strategies) should also be assessed for a comprehensive analysis. Furthermore, digital tools may be concentrated in urban areas, potentially excluding healthcare workers in rural regions. Disaggregating data by geography and facility type is crucial to ensure digital health literacy reaches all relevant healthcare providers.
Health staff turnover and rotation should also be considered when analyzing the indicator’s impact and planning further actions. Collaboration with technology providers, government ministries, and international organizations is recommended to scale up digital health initiatives, particularly in underserved areas.
Note: Always consider the demographic context, as it may be affecting the denominator (i.e., IDPs, population movements, healthcare center attendance etc...).
What further analysis are we interested in?
This indicator allows to track the adoption and integration of digital tools into routine MNCH services, comparing usage and disparities rates across geographic areas and facility types.
It can reveal barriers to digital health tools utilization to be further investigated.
This indicator shows the progress in the projects’ development in terms of coverage.
To understand the impact of the use of digital MNCH consultation tools on the service delivery and outcomes, we can cross-analyse with other health indicators (i.e., maternal and neonatal mortality rates, proportion of emergency referrals, and other child health indicators) over time.
Additional guidance
Resources: Under the technical assistance of HQ, Tdh M&E and operational teams in each delegation should work closely with health authorities to deploy and integrate the digital tools, collect and interpret the data.
Countries with limited health system infrastructure may consider partnerships with international organizations (e.g., WHO, UNICEF) and academic institutions to support capacity-building for data collection and MNCH service delivery.
Global strategy on Digital Health 2020-2025. Available at: https://www.who.int/docs/default-source/documents/gs4dhdaa2a9f352b0445bafbc79ca799dce4d.pdf (Accessed: 11 September 2024).