Using new fetal heart rate monitoring technology: Experiences and perceptions among skilled birth attendants and laboring women in Tanzania

Abstract

Each year, an estimated 5.2 million stillbirths and newborn deaths occur, primarily in low-resource settings. Regular fetal heart rate monitoring during labor and the early detection of fetal distress is one method to identify a fetus at risk and initiate action in order to reduce fresh stillbirth and neonatal mortality. Due to a lack of skilled birth attendants, among other factors, fetal heart rate monitoring is often not carried out as frequently as recommended. A newly developed electronic fetal heart rate monitor using doppler technology which can be strapped on a woman in labor for continuous fetal heart rate monitoring, was introduced in Tanzania in 2015. The monitor is called Moyo.

The main objective of this study was to gain a deeper understanding about the adoption and use of new technology (Moyo) among skilled birth attendants and laboring women in two urban hospitals in Tanzania. Using a qualitative approach, focus group discussions and semi-structured in-depth interviews carried out among health care providers and laboring women. The device was perceived to be useful and highly needed by all participants. Factors which negatively affected adoption of the device included a lack of knowledge about correct use of the device and its limitations. The skilled birth attendants expressed a need for more training about the use of the device, both through practical training and theoretical knowledge including how to respond to the device alerts of fetal distress. High staff turnover seemed to impede diffusion of knowledge about the use of the device. While new technological devices presents huge opportunities in low-resource settings in reducing morbidity and mortality, this study indicate that a tailored and long-term approach is needed to ensure that the device and its functions are well understood. This includes comprehensive training and support to users over time.