Qualitative Interview Results With SDA Users in Intervention Facilities (n=8)

DomainsIllustrative Quotes
Knowledge“When we hear and see [the information] at the same time it teaches a lot.”
“We did things blindly before with what we learned in school and it wasn't enough.”
Skills“Training gave us the skills to use the app.”
Beliefs about capabilities“We see that misoprostol is effective [for PPH].”
“Had many PPH deaths before … PPH resolves if you use what is in the video.”
“Now we see less fever in children after NR when we give antibiotics.”
“With info in the video for NR, you see the newborn coming back. It's really encouraging.”
Reinforcement“We watched videos about every 3 days during free time at maternity [ward] alone or with maternity team. Also used during a case of manual removal of placenta and MVA.”
“One can re-watch the video as many times as one wants.”
Intentions“It changed our old habits”
“Now we take vital signs and use the partogram during delivery.”
“Before for AMSTL we put the baby off to the side; now we put baby skin-to-skin and encourage breastfeeding.”
“We aspirated all babies; now we only aspirate when we need to.”
“Before we held the baby upside down after delivery and gave mouth-to-mouth brutally if needed; now we use the Ambu bag, which gives a good result. We learned that we must position the baby and the mask in order to do NR.”
“Before for respiratory distress we did mouth to mouth and gave hydrocortisone IM, no antibiotics, and saw high rate of fever. Now, we give antibiotics, and we see less fever.”
“Before we didn't do uterine massage or use misoprostol or IV fluids for PPH management; now we use massage, misoprostol, and IV fluids … with good results.”
“Now we do uterine massage [with PPH] and use a urinary catheter, and we see the uterus contracts.”
“Before we pushed the uterus down during 3rd stage; now we support the uterus and use controlled traction on the cord.”
“Now with premature rupture of membranes we give antibiotics.”
Memory, attention, and decision processes“mLearning with the app is good, the learner sees the information, hears it and then can do it themselves. It helps participants to remember the visual images or auditory information.”
Environmental context and resources“Only 2 of us were trained back in 2012 but need others to be trained, and we need formative supervision more often.”
“Need uniforms, tops, shoes, eye protective equipment, aprons, soap. We work in our own clothes and shoes, we risk to contaminate our children.”
“We earn nothing–12,700 Francs per month. Put yourself in our place. We work hard for nothing.”
Emotion“It's amusing and relaxing. It's good for educating adults. There is variety.”
“App should be made more widely available–in pediatrics and the operating room.”
“Animated graphics were interesting. Other trainings, they talk and talk.”
“We are very happy with the intervention. It's very encouraging.”
  • Abbreviations: AMSTL, active management of the third stage of labor; IM, intramuscular; IV, intravenous; MVA, manual vacuum aspiration; PPH, postpartum hemorrhage; NR, neonatal resuscitation; SDA, Safe Delivery App.