Introduction In contemporary society, Information and Communication Technology (ICT) is advancing inevitably, new technology is changing the way we live our lives every day, affecting the shape of healthcare services. This dramatic advances in ICT have transformed the way in which health care professionals deliver patient care (Lupiáñez-Villanueva, Hardey, Torrent, & Ficapal, 2011). It includes all digital technologies that support the electronic capture, storage, processing, and exchange of information in order to promote health, prevent illness, treat disease, manage chronic illness, and so on (Bashshur et al., 2009; Gagnon et al., 2012). In nursing, ICT refers to a set of projects or services that allow for remote nursing care (Tele-health), interdisciplinary clinical support, as well as knowledge transfer (Rouleau, Gagnon & côté, 2015). ICTs enable nurses to find, interpret, organize and evaluate information from a variety of sources for better decision-making and problem-solving within patient care (Lee, 2005). These technologies change how nurses plan, deliver, document, and review clinical care (Mohmmed, Mohammed & El-sol, 2017), and their correct and efficient use affects nursing as a profession (Kartal & Yazici, 2017). This is because the human interaction in healthcare is crucial for patients’ success; and therefore, critical to find the right balance between technology and the human nuances that make nursing and healthcare successful. Working with families, explaining procedures, and helping to take a patient’s mind off their sickness are all part of nursing jobs that ICT impacted.Improving maternal and newborn health and reducing mortality and morbidity requires the strengthening of healthcare systems (International confederation of midwives, n.d.). Midwives are designated primary care providers, and their care includes: gynecologic and family planning, preconception, pregnancy, childbirth and the postpartum period; care of normal newborn during the first 28 days of life; and treatment of male partners for sexually transmitted infections (American College of Nurse-Midwives, ACNM, 2012). Strengthening the roles of midwives using ICT can help in this respect. Midwifery Continuity of Care (MCC) are models of maternity care by a single midwife familiar to the woman, the primary midwife, back up by other colleagues. The primary midwife sees the woman consistently during pregnancy, labour and post-natal period and is supported by teams of specialists through referral (Sandall et al, 2016). The two main continuity of care models are case load model, in which one midwife cares and facilitate relational care for up to 45 women; and team midwifery model in which group of four to six midwives provide care for up to 360 women throughout the period of pregnancy, labour and post-natal period (World Health Organisation, WHO, 2016; Homer, Brodie & Leap, 2008).In the current health care environment, nurses are challenged to incorporate ICT into their regular routine (Smedley, 2005). Also, health care clients are increasingly willing to use ICT to advance their health (Åkesson et al., 2007). Despite these, the implementation of ICTs in nursing and midwifery practice remains difficult and involves changes at different levels, including with respect to patients, healthcare providers, and healthcare organizations (Mair et al., 2012). This paper will therefore discuss the interface of ICT, MCC and reducing maternal mortality. Midwifery continuity of care and domains of ICT in healthcare There is a wide range of ICTs use for supporting and providing health care. It can involve a telephone consultation between patient and a health care provider to triage symptoms, deliver instruction, monitor vital signs and provide guidance on the use of medication; telephone or text on health promotion advice and management or appointment reminders, patient-submitted health information using a mobile device for example, a mobile phone or hand-held computer applications. These could be used in midwifery continuity of care in providing counseling, advices, passing information and education to patients; managing symptoms, midwifery referral or consultation appointment, a remote consultation between a patient and a midwife using video conferencing, local internet-based support group with a chat room, blog or social network for sharing information with other users (Royal College of Nursing, cited in Rouleau et al., 2017). These are highly crucial and influential in reducing the maternal and child morbidity and mortality.Mair et al. (2009) suggested four general domains of eHealth that include a variety of ICTs including the management systems, communication systems, computerized decision support systems (CDSSs), and information systems. These four domains are applicable to midwifery continuity of care in curtailing the long-standing menace of pregnancy and post-partum periods. 1. Management systems allow for the acquisition, storage, transmission, and display of administrative or clinical activities related to patients, such as electronic health records (EHRs) or electronic medical records (EMRs). Through ICT, the midwife can get vital information and take prompt intervention and or prepare for referral or rescuing system. 2. Communication systems can be used for diagnostic, management, counseling, educational, or support purposes. They can be implemented to facilitate communication between health professionals or between health professionals and patients. In this case, between pregnant woman and her midwife. There are a wide range of communication systems, varying from email and mobile phones to telenursing and telecare systems.3. CDSSs are automated systems accessible from various devices, such as computer, mobile phone, or personal digital assistants (PDAs). They support decision-making for health professionals and assist them in practicing within clinical guidelines and care pathways. 4. Information systems, such as Web-based resources and eHealth portals, refer to the use of internet technology to access health-related information sources. A midwife may have a means of sharing information between pregnant women under her care. It could be through a website designed for that or any form of charting system.Tele communication and information in midwifery continuity of care Healthcare is an information intensive industry, in which quality and timely information is a critical resource (Australian Nursing Federation, 2007). One leadership skill that is critical for nurses is the ability to use technology that facilitates mobility as well as relationships, interactions, and operational processes (Huston, 2013). A lot of these challenges can be supported by the advocation of ICTs, particularly as hospitals are becoming more and more interested in reducing their costs and shifting care from hospital to home based. According to the Future of Nursing report by the Institute of Medicine (2010), nurses are expected to use a variety of technological tools and information management systems that require skills in analysis and synthesis to improve the quality of care.The process whereby nurses receive and review diagnostic information, make clinical decisions, communicate and socialize with patients and their relatives, and implement clinical interventions will be fundamentally modified with further integration of ICTs into nursing practice (Rouleau et al., 2017). Most maternal and infant deaths can be prevented if proper maternity services are provided before, during and immediately after pregnancy by competent midwives; if there are proper functional and adequately equipped referral facilities, communication, and transportation systems; if women have the information and means to access timely emergency obstetric and newborn care to avoid obstetric complications. (International confederation of midwives, n.d.). All these can be achieved if ICT is in-cooperated into midwifery continuity of care with minimal use of human and material resources.Telehealth has been defined as delivery of health services over a distance using telecommunications (Australian Nursing Federation, 2007). It is the sharing of health data, education and healthcare information between health personnel and patients, students and other health personnel, education, telecommunication, using telephone, computer, interactive television or a combination of them (Koch, 2006). This includes systems and procedures including a simple phone call, medical videoconferences, the ability of doctor/nurse to monitor the patient data online, video system usage for online doctor/patient/nurse visits, and teleconsulting. This system, provides a bidirectional communication between healthcare personnel and patients (Kartal & Yazici, 2017).The telehealth system provides for early identification and intervention of changes in the patient’s condition, reducing the number of home visits, urgent visits to the hospital and hospital admission, hospitalization, effective communication, reducing the cost of care, and increasing the patient’s self-care (Hain, Ng, Aronow, Swanson, & Bolton, 2009). Within the scope of tele nursing, telephone nursing, tele-triage and tele-home care nursing are applied to the patient. At the same time, patient education, high-risk group of patients, counseling and communication are maintained. It is helpful in early identification of pregnancy emergencies like bleeding in pregnancy, leading to early intervention. It also shortens the frequent visit of pregnant women to hospital, reduce pregnant women hospitalizations and thus, cost-effective and economical. Intelligent wearable patient tracking systems is designed for monitoring an individual for 24 hours a day and warn in case of necessary conditions can be used by pregnant women. Recipients include wearable items such as jewelery, eyeglass, watch, clothes (PWC Health Research Institute, 2014). This may include monitoring the individual’s glucose level, body weight, blood pressure, heart function, and the level of oxygen in the body can be recorded as well as the healthy life items such as the number of daily steps, sleeping period, meal level, stress level warning against possible dangers (Akbulut & Akan, 2015; Ananthanarayan & Siek, 2012); monitoring pregnancy, as well as maternal and fetal conditions. As a component of tele nursing; the data that intelligent wearable patient tracking systems provide are transmitted to health professionals and enables early diagnosis and intervention opportunities. At the same time, it enabled the patients to take more responsibility in their treatment and healthcare and reinforces health services provided at home. (Kartal & Yazici, 2017). Improving maternal safety, quality and efficiency of midwifery care with ICT Continuous monitoring of patients requires using information-communication system. It is essential for efficient and effective provision of health care (Jelec, Sukalic & Friganovic, 2016). Thus, ICTs are of great importance in managing and monitoring pregnant women from remote areas. The Institute of Medicine specified the use of information technology as one of the top five abilities that healthcare professionals needed, and also emphasized the importance of information technology in ensuring patient safety and the quality of healthcare (Gasim, Mohammed & El-sol, 2017). It is essential in making sure that pregnant women are safe, free from diseases and consequently reduce their mortality rate.Since one of the issues facing healthcare globally and especially in developing countries; and also, one of the factors that hinders the implementation of MCC is shortage of nurses and midwives, the use of ICTs can serve as a remedy. The use of ICTs has the potential to promote patient-centered healthcare at a lower cost, improve quality of care and information sharing, educate health professionals and patients, encourage a new form of relationship between patients and their health providers, reduce travel time, and so on (Bashshur et al., 2009; While & Dewsbury, 2011). It is therefor, economical for manpower and capital shortage to both government and patients.Emerging technologies are being integrated into nursing practice for reasons such as reducing medication errors, improving safety and efficiency, freeing workers from tasks, making health information accessible to patients, monitoring workforce, empowering patients to be involved in care, and coordinating care across settings. Technology systems are used for a variety of applications such as prevention of errors and side effects, decision support systems, nursing education, clinical guidelines, procedures and many more (Hegarty et al. 2009; Valiga, 2012; Doyle, Garrett, & Currie, 2015). Ash, Berg and Coiera (2004) opined that information technology has the potential to reduce health errors, improve the quality of patient care, improve nurse access to information, and improve the cost effectiveness of nursing care. Applying ICT to midwifery continuity of care can be helpful in women safety, thereby reducing the rate of morbidity and mortality among them. According to Garcia and Nell (2013), care providers that have implemented HIT and EHR systems have experienced significant safety improvements due to the real-time information accessibility afforded to all stakeholders. Easy access to information facilitates collaboration among multiple care providers. This transparency helps to eliminate errors and risks, such as conflicting prescriptions and treatments. Care providers use monitoring technology to trigger alerts when such discrepancies arise in patients’ electronic health records. A well-designed system or electronic health record can help nurses answer questions quickly, chart comprehensively and look up patient information effortlessly. All of this frees up time and increased care efficiency. ConclusionHealthcare is information and relational dependent, and ICT is well known in improving the information and relational supports among people. Most maternal and infant deaths can be prevented if proper maternity services are provided, and evidences from theoretical and empirical literatures show that ICT is highly vital and can be used in that respect. Effective use of ICT is paramount important for healthy and productive contemporary society. Applying ICT by midwives in providing MCC can boost the midwives’ ability to find, interpret, organize and evaluate information for effective and efficient intervention. This would inevitably help in reducing maternal and infants’ mortality. Thus, experienced and competent midwives are resource in providing maternal services before, during and immediately after pregnancy using ICT.
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