Statistical analysis
With a power of 80 and 95% confidence intervals and an estimated baseline score of 40% and an increase to 60% in the intervention group, a sample size of 114 was needed.Scores for the OSATS and KFQ were double entered in SPSS (version 23, SPSS Inc.) from paper forms by an independent team.A linear mixed effect model was used to compare the differences in skills and knowledge in intervention and control groups. The model accounts for the correlation between health care workers from the same facility by including health care facility as a random factor. The intervention status was included as a fixed effect. Adjustments were made for individual factors strongly correlating with the outcome; experience with smartphones, profession and number of deliveries. Baseline data was used as covariate (linear effect) and the scores after 6 and 12 months were used as the dependent variables in two separate analyses. The estimated intervention effect is reported as the difference between the intervention and the control group in scores from baseline to 6 and 12 months and between 6 and 12 months. The differences are presented as mean difference in score with a 95% confidence interval as percentages of maximum score achieved, hence both knowledge and skills tests have a range of 0–100%. A significant difference in mean score was considered if the 95% confidence interval was above zero. We used the CONSORT checklist when writing our report [