Submission ID 118457
| Issue/Objective | Over 3 million children in low-resource settings die annually, partly due to scarce (human) resources. The IMPALA system combines robust, easy-to-use vital signs monitoring devices with intuitive software to aid health workers in risk assessment and early detection. IMPALA has been shown to be sustainable and both life- and cost-saving in pediatric care settings in Malawi. We present the first experiences from a routine neonatal care setting, in Rwanda. |
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| Methodology/Approach | This ongoing implementation study uses an explanatory mixed-methods design with data collected pre- and post- IMPALA implementation. Nyamata is a level II teaching hospital with a 32-bed neonatal intensive care unit that previously only used manual intermittent monitoring. Sixteen monitors, a local server and 2 decision support tablets were installed in September 2024 and staff trained. Here we present qualitative data on IMPALA usability perspectives, server-derived data on sustained usage and aggregated patient outcome data trends for the first months after introduction. |
| Results | Neonatal mortality dropped by 32% (from 10.9% to 7.4%, p=0.057) in the first 5 post-IMPALA months compared to the same months one year prior. Average admission duration increased by 10%, from 8.1 to 8.9 days. Health care providers narrated that they were better able to detect deterioration, to intervene timely and that having access to real-time and historical vital signs data improved clinical decision making. Having a central patient overview allowed rapid patient prioritization, ensuring optimal use of scarce nurse time. Respondents reported increased self-efficacy, time savings, and work fulfillment. Usage increased over time to >75% (average hours used / 24 hours). |
| Discussion/Conclusion | The results suggest that IMPALA is a sustainable intervention in severely resource-constraint settings, enabling neonatal care-providers to work more proactively, saving lives and time. If validated using individual level data from several contexts, this could provide a cost-effective solution for reducing neonatal mortality. |
| Presenters and affiliations | Roseline Dzekem Dine Rinda Ubuzima Darius KAYUMBA GOAL 3,'s Hertogenbosch, The Netherlands Onesphore Hakizimana Nyamata Level II teaching Hospital, Nyamata, Rwanda Eveline Geubbels GOAL 3,'s Hertogenbosch, The Netherlands Elise Rutaganira Rinda Ubuzima Niek Versteegde GOAL 3,'s Hertogenbosch, The Netherlands Eric Remera Rwanda Biomedical Centre Aline Uwimana Rwanda Biomedical Centre Marie Michele Umulisa Rinda Ubuzima Lisine Tuyisenge Rwanda Pediatric Association |
