Gressier

This research aims to improve nighttime access to care and treatment for children in resource-limited settings, focusing on acute respiratory infections and diarrheal diseases, which are leading causes of death in children aged 1 month to 5 years globally. The study evaluates whether a digital clinical decision support dCDS tool used by a Telemedicine and Medication Delivery Service TMDS in Haiti can improve healthcare provider adherence to treatment guidelines. This effort builds on previous phases of research to develop a scalable telemedicine model called MotoMeds. The study compares two methods used by TMDS providers the existing paper-based clinical decision support tools and the new digital clinical decision support tool. Providers will use these tools to assess and generate treatment plans for pediatric patients during calls. The study includes two intervention periods of 16 months each, separated by a 2-week washout period. The goal is to see if the digital tool improves guideline adherence and affects call duration and medication delivery times. Participants include children 10 years old or younger with acute illnesses whose parents or guardians contact the TMDS during its hours of operation. Consent is obtained either by a waiver for phone-only contacts or written consentassent during household visits. Researchers will monitor outcomes such as the change in guideline adherence rates, clinical status at 10-day follow-up, call duration, and time to medication delivery. The study spans from September 2022 to September 2027, with ongoing assessments to measure the impact of the digital tool on care quality and delivery.