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Cycle 7 (2018 Deadline)

Facilitating access to reproductive health services for refugee women in Morocco

PI: Ali Idri (, Ecole Nationale Superieure d'Informatique et d'Analyse des Systemes (ENSIAS-UMV), University of Mohammed V in Rabat
U.S. Partner: Leanne M. Redman, Pennington Biomedical Research Center
Dates: January 2019 - December 2020

Project Overview

7-246 Visit-PhD-students-LesOranges
Project team members Mariam Bachiri (Ph.D. student), Lamyae Sardi (Ph.D. student), Manal Kharbouch (Master student) visit the reproductive health centre Les Oranges in Rabat to collect the requirements for the apps [Photo courtesy of Dr. Ali Idri]
The project seeks to institute a comprehensive reproductive health services dedicated to refugee women in Morocco including contraception, prenatal/obstetric and postpartum care services. This project is intended to stand upon rigorous scientific studies addressing guidelines and processes of development of solutions to improve the quality of reproductive health services. Moreover, empirical evaluations of the proposed solutions, through case studies, surveys or retrospective evaluations, are planned in order to evaluate their usefulness.

The project has four key scientific aims: (1) develop/evaluate a requirements’ catalogue for pregnancy monitoring mobile Personal Health Records (mPHR) and Electronic Health Records (EHR); (2) develop and evaluate a datamining-based intelligent system for the management and prioritization of software requirements according to each stakeholder’s profile (patient, caregiver, etc.); (3) use an ISO 25010-based framework for the quality evaluation of pregnancy mPHR and HER; and (4) develop and evaluate a set of gamification techniques for contraception and postnatal mobile applications.

Pregnancy monitoring mPHR will be evaluated using quality framework to ensure its overall compliance with the requirements catalogue. In the same vein, a quality framework will be set up for pregnancy EHR and will be used for the quality evaluation of the resulting pregnancy monitoring EHR. Moreover, a requirements’ catalogue for pregnancy monitoring mPHR and EHR will be defined based on the main related software engineering standards and e-Health technology standards. With respect to the requirements prioritization, a Datamining based decision system will be developed and evaluated to set up the appropriate set of requirements for each stakeholder based on their profile. For the contraception and postnatal mobile applications, a set of gamification elements will be incorporated to enhance women’ engagement with the apps. The USG partner of this project will participate to develop the scientifically sound research projects (case-studies, surveys, cross-sectional analyses) that will evaluate the changes in reproductive health outcomes for women who are not seeking pregnancy or maternal and infant outcomes for those who are pregnant/postpartum. Given that the focus of the recent USG-supported research has been in gestational weight gain, the USG partner will also evaluate the diet, physical activity, mood, and infant feeding styles of the refugee women.

Anticipated outcomes of the study will include measuring the compliance of the refugee women with the contraception and postnatal apps along with the mPHR for pregnancy monitoring, in addition to the EHR from the gynecologists, which are considered as measures for the potential of the proposed ICT solution in improving the accessibility and quality of reproductive health services for refugee women. The core quality characteristics to be implemented in an ICT-based reproductive health solution to improve its usability and usefulness will also be measured

7-246_Idri meeting in Feb7-246 Idri staff
Seated from right to left: Manal Kharbouch (Master's student), Lamyae Sardi (PhD student), and Mariam Bachiri (PhD student). Standing from right to left: Dr. Najlaa Tijani (Obsterician/Gynecologist), Pr. Ali Idri (PI), Pr. Hassan Alami (Obsterician/Gynecologist), and Pr. Rachid Bezad (Obsterician/Gynecologist and Director of the center Les Oranges). Photo courtesy of Dr. Ali Idri.

Outreach and Collaborations:

University Hosptal Avicenne in Rabat will be the pilot center of the project. First, the team started the identification of requirements of the three apps by planning several visits to Contraception, Postnatal and Prenatal services of the center during January 2019. When these three apps will be developed, tests will be carried out by gynecologists and patients of this center. Thereafter, recruitment of cohorts (pregnant and non-pregnant refugee women) to empirically evaluate the usefulness of the three apps will be done from the patients of the center.

Collaboration with the research team “Software Engineering” of the Computer Science Department, University of Murcia has been established. Within this framework, the Master student Manal Kharbouch obtained a 4-month scholarship to carry out her Final internship project at the University of Murcia, March 15 to July 15, with the topic: “Developing and Evaluating a Contraception App” under the supervision of Pr. Jose Luis Fernandez-Aleman and Pr. Ali Idri.

Project updates:

During March-June 2019 reporting period, the efficient involvement of different parties  has taken the entire project to a substantial level of progress. Along with these lines, pilot solutions for reproductive health are currently being developed of which a mobile application is dedicated to birth control and contraception, another mobile application is intended to assist new mothers during their postnatal period, and a system connecting a Mobile Personal Health Records (mPHR) and an Electronic Health Records (EHR) are being built to promote prenatal care. Almost 80% of the functionalities have been already implemented in the three reproductive health solutions and are being tested on real devices progressively. In addition to the four Masters’ students to whom the development of the pilot solutions has been assigned, an assistant professor who is thoroughly acquainted with mobile technologies and programming languages has been invited to participate in the project as a technical supervisor. From the design phase of the solutions, he has been given the responsibility to identify and resolve problems associated with the tools and frameworks being used to build the digital solutions.

Further, the challenging aspects of the digital solutions in terms of their richness in functionalities and features and the restricted time allocated to their developmental cycle have significantly helped the four developers sharpen their technical and managerial skills. Along with their individual efforts to learn about mobile technologies, the technical proficiency of the supervisor has largely helped the four developers master new tools and learn the best coding practices. In order to ensure the good course of the development phase, regular meetings have been scheduled by the members of the project’s team to plan and follow-up the activities encompassed in the software design document of each solution. This has therefore enhanced the ability of the developers in managing tasks, estimating task duration and respecting deadlines.

Upon the completion of the solutions’ development, the impact of the project is expected to be significantly expanding to a wider population of participants, particularly medical staff, pregnant women and new mothers to perform meticulous testing of the digital solutions.

In September 2019,  a paper titled "Sizing Prenatal mPHRs using COSMIC Measurement Method", co-authored by Dr. Idri, has been published in the Journal of Medical Systems, Springer.


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