Design of a Digital Prenatal Telemonitoring System to Improve Continuity of Care in a Resource-Limited Hospital: A Case Study of the Regional Hospital Center of Ziniare (Burkina Faso)

Abstract

The Regional Hospital Center of Ziniare records approximately 775 prenatal consultations per year in a context where medical records are primarily paper-based, exposing clinical data to risks of loss and fragmentation. This study presents the design and pilot evaluation of a digital prenatal telemonitoring system integrating clinical data management and analysis. The system was developed using UML modeling and a client-server architecture combining HTML, CSS, JavaScript, CodeIgniter, and MySQL. It supports structured patient registration, prenatal consultation management, automated appointment reminders, and real-time clinical dashboards. A pilot study was conducted over four weeks involving 30 users. The system ensured full digital availability of medical records (0% data loss observed), while the reminder module achieved a delivery success rate exceeding 95%. Appointment attendance increased from an estimated baseline of 65% to approximately 82% during the pilot phase. In addition, access to structured medical records reduced consultation and decision-making time by approximately 15-25%. These results indicate that the proposed system improves data availability, continuity of care, and clinical workflow efficiency. This work contributes to digital health implementation in resource-limited settings by providing a practical and context-adapted telemonitoring solution integrating clinical decision-support indicators.