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PARTNERSHIPS FOR ENHANCED ENGAGEMENT IN RESEARCH (PEER)
Cycle 7 (2018 Deadline)


Facilitating access to reproductive health services for refugee women in Morocco


PI: Ali Idri (ali.idri@um5.ac.ma), 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:

The first year of this PEER project, according to Dr. Idri, has been particularly successful with the team achieving original project objectives and augmenting the developmental impacts through the involvement of other parties and through expansion of scientific research in the field of reproductive health. Digital solutions intended  to provide women with reliable pregnancy monitoring, assist them throughout their postnatal period, and help them gain understanding of different contraception methods and bolster their decision regarding the most suitable birth control method, have been fully developed and are currently going through tests and scrupulous evaluation from a medical perspective. According to Dr. Idri, medical staff of Maternity Les Orangers have shown great commitment to the assessment of digital solutions and suggested numerous modifications to improve the overall quality, enhance usability and ergonomics of the apps. Meetings scheduled between the project team’s members and medical staff of Maternity Les Orangers continue to provide an important opportunity for an informal exchange of opinions and perceptions about the status of reproductive health in Morocco. During these meetings, software engineering and gynecology/obstetrics are intertwined, which create a win-win situation for attendees for knowledge acquisition is therefore mutual.  In parallel with these meetings, a number of scientific papers are published on a continuous basis in international journals and conferences in efforts to expand the impact of the project and endorse the importance of promoting reproductive health care services worldwide.

At a local and regional level, the impact of the project is being amplified thanks to engagement of motivated individuals and organizations. Associations that care for migrants and refugees and which are located in Rabat have been approached or contacted by phone and email during the recruitment phase of potential participants (pregnant and non-pregnant refugee women), who would assess the quality, acceptability, and effectiveness of the three reproductive health solutions. Technical sheet memos with the main objectives of the project and expected outcomes highlighted were sent out to associations’ contacts. To further this goal, a workshop was organized in January 2020 for the benefit of the presidents of these associations to introduce the project’s members, the objectives, achievements, and to detail the evaluation phase of the reproductive health solutions as an essential part in which the associations are anticipated to intervene.

During the reporting period, Dr. Idri received the USG Partner travel supplement, and his USG Partner Leanne Redman with her colleague Suzanne Phelan from California Polytechnic University are planning their March 2020  trip to Morocco to conduct PEER team training. In conjunction with the upcoming visit, Dr. Idri is planning a meeting with USAID mission as well.
 
Outreach and collaborations:
In addition to the partnership already developed with the reproductive health centre "Les Oranges" and the the research team Software Engineering at the University of Murcia, two collaborations were launched:
1- Royal Academy of Medicine in Murcia: during the visit of Pr. Ali Idri (October 27 - November 03, 2019), the team agreed to co-supervise a Ph,D. thesis on the use of Machine Learning techniques in ehealth.
2- Immigrants and refugee associations were contacted to partner and engage in the  PEER project. All the contacted associations have accepted, and a workshop  during the week of January 22020 introducing them to
  the project was organized. The objective is to motivate these associations to assist and help the team recruit refugee women in the evaluation of our ICT solution.
 
Publications:
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.

Technical research presentations:
1-Pr. Ali Idri gave an oral presentation titled "Software Engineering and Machine Learning for eHealt", at Royal Academy of Medicine of Murcia, Spain, October 28, 2019
2- A Paper titled ""Mobile health applications for postnatal care” was accepted and presented by Pr. Ali Idri at the 29th International Conference on Nursing Education and Research”, December 05-06, 2019, Dubai, UAE. (https://nursingeducation.alliedacademies.com/)
3- Pr. Ali Idri gave an oral presentation (Keynote Speaker) titled : " Mobile Applications for Reproductive Health Services ", International Conference on Smart Applications, Communications and Networking December 17-19, 2019, Sharm El Sheikh – Egypt (https://smartnets.ieee.tn/keynote-speakers/)
 

 
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