Browsing by Author "Muttau, Nobutu"

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    Feasibility of Vital Signs Assessment by Community Health Workers during Antenatal Care Community Outreach in Lusaka, Zambia: A Qualitative Study
    (2022-09-13) Tembo, Taniya; Muttau, Nobutu; Manasyan, Albert; Mwamba, Chanda P.; Mwamba, Kabwe; Nyirenda, Herbert; Zulu, Tukiya K.; Hamweemba, Esther; Sharma, Anjali; Cauvel, Teresa; Shah, Sona; Nantume, Assumpta
    Abstract Introduction The integration of digital tools in health initiatives marks a pivotal shift in traditional healthcare delivery methods. Technology-supported antenatal care (ANC) interventions have helped healthcare providers and community health workers (CHWs) to choose the course of action for individual patients. This study aimed to explore the suitability, feasibility, and acceptability of a wearable monitor, neoSpot, for measuring vital signs among pregnant women attending routine ANC visits during community outreach in Lusaka, Zambia. Methods This pilot feasibility trial was implemented between March and May 2023 at Kanyama 1st Level Hospital. We conducted 24 in-depth interviews (IDIs) among 12 purposively selected pregnant women and 12 trained CHWs. NeoSpot was placed on a pregnant woman’s arm to monitor vital signs and blood pressure. Thematic framework analysis used inductive and deductive reasoning for coding using NVivo and Excel for data organization. Qualitative data was analysed using NVivo. The suitability-feasibility-acceptability (SFA) framework was used to evaluate the potential of neoSpot as a tool for monitoring vital signs during routine ANC community outreach activities. Results The study revealed that neoSpot was accepted by pregnant women and CHWs for its ability to comprehensively assess vital signs, including those not typically assessed at clinics. Participants valued its speed, efficiency, and user-friendliness, believing it could reduce waiting times at antenatal clinics. Initially, pregnant women expressed concerns and apprehension about the new device, fuelled by misinformation and fears of its impact on their unborn babies and their skin. Conclusion Overall, all the study participants found the use of neoSpot to be suitable, feasible, and acceptable, and for use during ANC community outreach, largely due to its time efficiency, ability to simultaneously measure multiple vital signs, comfortable design, portability, and rechargeable battery. Incorporating recommendations could enhance the device’s efficiencies and its acceptability by community members and CHWs.
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    "Testing Can Be Done Anywhere": A Qualitative Assessment of Targeted Community-Based Point-of-Care Early Infant Diagnosis of HIV in Lusaka, Zambia.
    (2022-Jun-29) Tembo, Tannia; Dale, Helen; Muttau, Nobutu ; Itoh, Megumi; Williamson, Dhelia; Mwamba, Chanda; Manasyan, Albert; Beard, Suzanne R.; Cox, Mackenzie H.; Herce, Michael E.
    INTRODUCTION: Delayed HIV diagnosis in HIV-exposed infants (HEIs) results in missed opportunities for early antiretroviral therapy (ART), causing significant morbidity and mortality. Early infant diagnosis (EID) depends on the availability of accessible and reliable testing services. We explored the acceptability, appropriateness, and feasibility of deploying a targeted community-based point-of-care (POC) EID testing model (i.e., "community POC model") to reach high-risk mother-infant pairs (MIPs) in Lusaka, Zambia. METHODS: We conducted in-depth interviews with a purposive sample of health care workers, study staff, and caregivers in high-risk MIPs at 6 health facilities included in a larger implementation research study evaluating the community POC model. We defined "high-risk MIPs" as mothers who did not receive antenatal testing or an attended delivery or infants who missed EID testing milestones. Interviews were audio-recorded, translated, and transcribed verbatim in English. Content and thematic analysis were done using NVivo 10 software. RESULTS: Health care workers (n=20) and study staff (n=12) who implemented the community POC model noted that the portability and on-screen prompts of the POC platform made it mobile and easy to use, but maintenance and supply chain management were key to field operations. Respondents also felt that the community POC model reached more infants who had never had EID testing, allowing them to find infants with HIV infection and immediately initiate them on ART. Caregivers (n=22) found the community POC model acceptable, provided that privacy could be ensured because the service was convenient and delivered close to home. CONCLUSION: We demonstrate the acceptability, appropriateness, and feasibility of implementing the community POC model in Zambia, while identifying potential challenges related to client privacy and platform field operations. The community POC model may represent a promising strategy to further facilitate active HIV case finding and linkage to ART for children with undiagnosed HIV infection in the community.