Upscaling health worker training on sepsis in South Eastern Nigeria using innovative digital strategies: an interventional study

IntroductionSepsis is a leading cause of morbidity and mortality worldwide. In low- to middle-income countries (LMICs) such as Nigeria, the disproportionately high mortality rate is linked to lack of awareness, poor recognition, and late implementation of sepsis care bundles among health workers. Training of health workers using digital platforms may improve knowledge and skills and lead to better patient outcomes. MethodsThis Cross-sectional study involved developing and deploying a sepsis module through an innovative application (FHIND/ARCS Sepsis tutorial app) to doctors in Calabar, Nigeria. We assessed quantitative pre- and post-intervention knowledge scores for those completing the electronic training module on sepsis between both assessments. A user satisfaction survey evaluated the content of the tutorial and the usability of the app. ResultsOne hundred and two doctors completed the course. There were more males than females (58.8% versus 41.2%). Over half (52%) were junior doctors, a minority were general practitioners and house officers (3% and 5%, respectively) and 72.6% had practiced for periods ranging from one to 15 years post qualification. Gender and age appeared to have no statistically significant association with pre- and post-test scores. The oldest age group (61-70) had the lowest mean pre- and post-test scores while general practitioners had higher mean pre- and post-test scores than other cadres. The majority (95%) of participants recorded higher post-test than pre-test scores demonstrated by a statistically significant overall increase in mean scores (25.5% {+/-}14.7, P<0.0001). Participants were satisfied with the content and multimodal delivery of the material and found the app useable. ConclusionDigital training in sub-Saharan Africa is feasible and can sustainably close the critical knowledge gap required to respond more effectively to medical emergencies such as sepsis in LMIC settings.