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Digital Health Solution (DHS) for Perinatal Care in Cambodia

Dear Sir or Madam, please take a few minutes of your time to complete the following questionnaire.

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Digital Health Solution (DHS) for Perinatal Care in Cambodia


Informed Consent Form


Study Title: Feasibility Study: Digital Health Solution (DHS) for Perinatal Care in Cambodia

Introduction: You are invited to take part in a research study conducted by the Czech Development Agency and Vita et Futura Endowment Fund. Before you agree to participate, please read the following information carefully.

Purpose of the Study: This study aims to assess the feasibility of implementing a digital health solution in Cambodian healthcare facilities. You may be asked to complete a short questionnaire and/or participate in a focus group discussion about your experiences and access to digital tools in your workplace.

What Your Participation Involves:

If completing a questionnaire: it will take approximately 15–20 minutes and include questions about your experience using technology at work.

No personal or patient-identifiable information will be collected.

Voluntary Participation: Your participation is completely voluntary. You may decline to answer any question or withdraw at any time without consequence.

Confidentiality: Your responses will be kept confidential and used only for research purposes. For focus groups, while we encourage mutual respect for privacy, complete confidentiality cannot be guaranteed due to the group setting. Your name will not be used in any report.

Benefits and Risks: There are no direct benefits or risks to you for participating. However, your input will help improve healthcare practices in Cambodia.

Contact: If you have any questions about the study, you can contact the research team at sioratanak@gmail.com, +420 730 176 456 (Telegram or WhatsApp).

1

Consent Statement: By participating, I confirm that I have read this form, understand the aim of the study and agree to take part.

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Digital Health Solution (DHS) for Perinatal Care in Cambodia

Section 1: Personal Information

2

What is your position in the healthcare facility?

Choose one option that best describes your workplace.
3

Where do you work?

Choose one option that best describes your workplace.
4

How old are you?

Select the age range that fits your current age.
5

Which communication apps or platforms do you use? (Tick all that apply)

Tick all that apply and provide your contact
6

Do you have access to a smartphone or tablet outside of work?

Choose one option that best describes your workplace.
7

How do you usually access the internet outside of work? (Tick all that apply)

Select one or more answers

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Digital Health Solution (DHS) for Perinatal Care in Cambodia

Section 2: Access to Digital Tools & Infrastructure at workplace

8

Do you use any digital devices at work (e.g., smartphone, tablet)?

Select the option that best describes your current access to digital devices.
9

Does your healthcare facility provide internet access for staff?

Select the option that best describes your current access to digital devices.
10

How reliable is the internet connection at your healthcare facility?

Select the option that best describes your current access to digital devices.
11

How often do you use the internet for work-related tasks (e.g., research, patient records, communication with colleagues)?

Select the option that best describes your current access to digital devices.
12

How reliable is the electricity supply at your facility?

Select the option that best describes your current access to digital devices.
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Digital Health Solution (DHS) for Perinatal Care in Cambodia

Section 3: Digital Skills & Workflow Integration

13

Have you used any digital system (e.g., electronic patient records, digital referrals) before?

Select the option that best describes your current access to digital devices.
14

If a digital system were introduced, how confident would you be in using it?

Select the option that best describes your current access to digital devices.
15

What type of training would help you feel more comfortable using a digital system? (Tick all that apply)

Select one or more answers
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Digital Health Solution (DHS) for Perinatal Care in Cambodia

Section 4: System Integration

16

How does your facility collect patient data?

Select the option that best describes your current access to digital devices.
17

Do you currently enter patient information into any digital system?

Select the option that best describes your current access to digital devices.
18

If yes, what system do you use?

Short text answer
19

How easy or difficult do you find transitioning from paper to digital records?

Select the option that best describes your current access to digital devices.
20

Do you think that a digital system can improve patient care?

Select the option that best describes your current access to digital devices.
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Digital Health Solution (DHS) for Perinatal Care in Cambodia

Section 5: Sustainability & Security

21

Who should be responsible for maintaining and managing a digital system?

Select the option that best describes your current access to digital devices.
22

What challenges do you think hospitals or staff might face in maintaining a digital system long-term?

Short text answer
23

What do you see as the biggest benefit or risk of introducing a digital system?

Short text answer
24

How concerned are you about data security and patient confidentiality in digital systems?

Select the option that best describes your current access to digital devices.
25

What measures would make you feel more comfortable using digital patient records? (Tick all that apply)

Select one or more answers
26

What other comments or concerns do you have about using a digital system?

Short text answer
27

Write me which city/province are you from?

If you choose other, please write the name of the city/province.
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Thank you for your time and your feedback.
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