maternal health – Integra LLC

Tag Archive for: maternal health

Agriculture, Family Planning, Health, Health, Maternal & Child Health, Originally posted on the GBI Portal, Women in Development

mHealth for Women: A Diverse Set of Applications

Photo Credit: Anupam Nath / AP

In an ode to International Women’s Day, we wanted to review a few of the mobile health projects and programs directly focused on women’s health issues. mHealth has a great variance in the type of applications used to promote and assist in women’s health. This ranges from sending health information about pregnancy via basic text messaging to more advanced tools that allow community health workers to collect data, diagnosis diseases, and refer patients. As the need and ability to extend health information to women in developing countries increases, here is a diverse set of examples that have been used or are in current use.

MOTECH

Launched in Ghana, the Grameen Foundation’s Mobile Technology for Community Health (MoTECH) initiative has a duel focus – providing health information to pregnant women and arming community health workers with applications to track the services provide to women and children. This project was funded by the Gates Foundation and has worked in partnership with Columbia University’s Mailman School of Public Health and the Ghana Health Service. The “Mobile Midwife” application provides pregnant women with time-specific information about their pregnancy via text or voice messages. This includes reminders about seeking care, advice on how to deal with specific challenges during pregnancy, and knowledge about best practices and child development. The Nurses’ Application allows community health workers to register and track the care provided to patients in the region. By recording patient data in the MOTECH Java application and sending it to the MOTECH database, the system captures the data and can send automatic reminders to nurses for when and what type of follow up care to provide. For more information about the MOTECH as well as the lessons learned, read the report from March 2011, “Mobile Technology for Community Health in Ghana: What It Is and What Grameen Foundation Has Learned So Far.”

MAMA

Launch in May 2011, MAMA (Mobile Alliance for Maternal Action) is a public-private partnership focused leveraging mobile connectivity to improve information and access to health care for pregnant and new mothers in developing countries. USAID and Johnson & Johnson are the founding partners, and the United Nations Foundation, the mHealth Alliance, and BabyCenter are supporting partners. This initial 3-year, $10 million investment from USAID and J&J is being used to build and expand global capacity of new and current mHelath programs in three countries – Bangladesh, South Africa, and India. The beauty of the MAMA Partnership is the focus on country ownership through these partners. And each country has a separate focus based on the specific needs and problems of the maternal health. In Bangladesh, the focus is to decrease maternal morbidity and mortality through stage-based health messages via mobile phones to low-income and at-risk mothers. The public-private partnership network in Bangladesh has already been established. Lead by D.Net, it includes technology developers (InSTEDD, SSD-Tech), corporate sponsors (BEXIMCO), outreach NGOs (Save the Children, BRAC), mobile operators (Airtel, Grameenphone, Banglalink), content providers (MCC Ltd), media (Unitrend Limited, Brand Forum), researchers (ICDDR, B), and government agencies (Ministry of Health and Family Welfare). In India, MAMA is completing a landscape analysis to understand the complex cultural environment and see in what areas mobile phones can be utilized to improve maternal health throughout the country. Finally, in South Africa, MAMA has partnered with the Praekelt Foundation (lead partner), Wits Reproductive Health and HIV Institute, and Cell-life to provide messages to pregnant and new mothers about receiving earlier antenatal care, prevention mother-to-child HIV transmission, and exclusively breastfeeding.

CycleTel

Developed by the Institute for Reproductive Health (IRH) at Georgetown University, CycleTel is an innovative solution, combining a previously used family planning technique with mobile phones. In 2001, IRH created the Standard Days Method (SDM) as a low-cost alternative to family planning based on a women’s menstrual cycle. By avoiding intercourse on a woman’s most fertile days during her menstrual cycle, days 8 to 19, there is only a 5% chance of becoming pregnant. Having developed the system, IRH saw a natural fit with mobile phones. In the original set up, women would use Cyclebeads (multiple colored beads used to represent specific days of a menstrual cycle) to keep track of when they are more likely to become pregnant. Using the same idea, the CycleTel replaced the beads with a mobile phone. Each month on the first day of menses, a women text messages the system. Utilizing FrontlineSMS, it then responds by sending a message showing which days she could get pregnant. In 2009, IRH conducted a research study in the region of Uttar Pradesh, India. The pilot showed the need to tweak the system to fit the region context including the local languages and women’s past experience using mobile phones. But it also showed the willingness of women and men to pay for the service in order to avoid unwanted pregnancies. This program is being operated under to the Fertility Awareness-Based Methods (FAM) Project which is funded by USAID.

Dunia Wanita

Dunia Wanita, which means World of Women, was launched in February 2010 by Telkomsel, a MNO in Indonesia. It is a part of the MNO’s value-added services applications and is specifically for women to receive information on a number of different topics, including health. The subscription costs $0.12 per day. By dialing *468#, women have access to a “one stop info service.” By selecting “Cantik Sehat” (Health and Beautiful), women can receive health information and advice from famous Indonesian doctors. The voice messages include information about sexual health, pregnancy, and healthy living.

These are just a few examples of mobile health applications that are available to women in the developing world. The applications vary in information provided, media used, and business models utilized. This is a great illustration of how diverse mobile health can be in order to reach a targeted group within a country, based on infrastructure, location, health knowledge, and mobile usage/connectivity.

March 8, 2012/by actualize

Agriculture, Health, Health, Maternal & Child Health, Originally posted on the GBI Portal

Don’t Miss Raj Shah on 20/20 Tonight!

BY: Raj Shah, U.S. Agency for International Development (USAID) Administrator

This Post originally appeared on ABCNews.

Raj Shah holds up his hads, with the words 1 million moms written on his palms Ensuring the safety of a mother and her newborn is not only one of the greatest development challenges we face, it is also one of the most heartbreaking.

Earlier this year, I visited South Sudan, where I met school children studying in a classroom—some of them for the very first time. Although I was optimistic about their future, I was also concerned, because I knew that for every girl I met, she was statistically more likely to die in childbirth than complete a secondary education.

This reality is simply unacceptable.

There is an incredible need to ensure the safety of mothers and infants in the critical period of 48 hours surrounding birth. To help spur progress in maternal and child health, we launched our first Grand Challenge for Development – Saving Lives at Birth – in partnership with the Government of Norway, the Bill & Melinda Gates Foundation, Grand Challenges Canada and The World Bank.

Saving Lives at Birth calls for groundbreaking prevention and treatment approaches for pregnant women and newborns in rural settings during this perilous time around childbirth. We received more than 600 proposals to our Grand Challenge, more than a quarter of which arrived from the developing world. Last week we announced our three transition-to-scale grant nominees. These nominees have proven that their ideas can deliver real results in local communities and are ready to test them on a much larger scale. While we expect our first round of grants to yield exciting innovations with the potential for significant change, we will encourage our community of innovators to push boundaries and find new ways to shape collective action.

Similarly, the Million Moms Challenge is inspiring American families to help mothers and children around the world. I am proud to accept this Challenge and will continue my commitment to this important cause.

I hope you will too.

December 16, 2011/by actualize

Agriculture, Health, Health, Maternal & Child Health, Originally posted on the GBI Portal

How to Disseminate Maternal Health Information to Rural Women

There are numerous ICT projects that focus on maternal health, many designed to reach women in rural areas where there is a severe lack of healthcare services. Mhealth in particular – the use of mobile phones to improve health – has taken off as a tool for providing critical information to pregnant and new mothers. In USAID’s MAMA project, for example, pregnant women in Bangladesh receive weekly information updates via text or voice message.

Photo credit: Open Ideo

But what is the best method for disseminating health information to rural women? How can the women learn and interpret the information in a way in which they can understand its value, making certain behavior changes if needed? Vikram Parmar, a professor at the Delft University of Technology in the Netherlands, attempted to find this out through research conducted in India with 120 women from seven different rural villages. Parmar wanted to know how to motivate users of a Primary Health Information System (PHIS) to adopt positive health practices through designing and developing a Health Information System that maximized information dissemination.

Parmar wanted to explore how to improve information dissemination where health ICT projects had fallen short in three areas. First, he was concerned with the limited impact of Health Information Systems in educating rural users, as well as ICT-based health interventions such as film showings and radio program broadcasts that had not improved the health practices of rural target audiences. Secondly, the typical content and design of Health Information Systems did not encourage regular use due to the “non-persuasive setting of health interventions,” resulting in an information gap between rural women and primary health information. Finally, HIS deployed to rural users were based on content developed for urban users, resulting in a mismatch between the information given to rural women and the information they actually needed. In particular, maternal health and other personal women’s health issues had not been addressed.

Parmar proposed addressing these problems by employing a user-centered design framework to develop ICT interventions (see framework in full below). He tested this framework in the context of the PHIS. The results of his exploratory research indicated that the rural women’s knowledge had improved after interacting with the PHIS, signifying the importance of understanding user needs, taking into account existing social beliefs and practices related to health issues. Using this framework could improve information dissemination, resulting in positive change in rural women’s health-related practices.

October 14, 2011/by actualize

Agriculture, Health, Health, Maternal & Child Health, Originally posted on the GBI Portal

USAID MAMA initiative leading the way in mobile for maternal health projects

The USAID-initiated MAMA (Mobile Alliance for Maternal Action) project that utilizes cell phones to improve maternal health in developing countries gave an in-depth update at the latest mHealth Working Group meeting.

The pilot initiative, announced in May by Secretary of State Hillary Clinton and co-sponsored by Johnson & Johnson, has begun work in Bangladesh. MAMA seeks to achieve “scale, sustainability and impact” by creating a replicable model of reaching low-income mothers and household decision-makers (husbands, mothers-in-law) through increasing the impact of current mHealth programs, providing technical assistance to new mHealth models, and improving methods of applying mobile technology to improving maternal health.

At the working group meeting, Sandhya Rao of USAID and Pamela Riley of USAID’s SHOPS (Strengthening Health Outcomes through the Private Sector) program discussed the status of Aponjon, the MAMA project in Bangladesh. Aponjon provides vital health information through mobile phones two times a week to expecting and new mothers, reminding them of when to receive checkups and how to stay healthy during the pregnancy. Bangladesh was chosen to pilot the project because the country’s government has been a leader in promoting and expanding access to ICTs and is very active in mHealth.

Photo credit: Council on Foreign Relations

In order to bring it to a national scale, the burgeoning MAMA initiative has established private, public, and NGO partnerships to help implement its activities, and is carefully monitoring its methods and practices to ensure that the project is reaching its target goals. For example, Aponjon is constantly tweaking the content of its phone messages so that mothers and decision-makers understand, retain and relate to the information given.

Photo credit: Highmark Medicare Services

Another aspect of the project that MAMA will be monitoring is its business models to determine which are the most sustainable and effective. Currently, customers pay service providers to retrieve the phone messages. Text messaging is the cheapest method for remitting information in most developing countries, but many of the poorest clients are unable to read the texts. The alternative is interactive voice response (IVR) through which customers can hear recorded messages at a much lower cost than call centers but more than texting. MAMA and its partners are experimenting with different pay schemes, such as subsidizing rates, working with service providers to offer low rates or donate funds to the project, and charging fees based on usage.

It will take the new initiative years before sustainable, reliable, and replicable models are in place. What is clear is that the potential for improving maternal and newborn health through the use of mobile phones is being tapped.

September 29, 2011/by actualize

Agriculture, Family Planning, Health, Health, Maternal & Child Health, Mobile, Originally posted on the GBI Portal

Delivering babies in Ghana just got a little easier

Pregnant woman on phone. Photo Credit: MOTECH

A new mobile phone service was recently launched in Ghana that provides free access to health information in ensuring safe pregnancies. The service, aptly named Mobile Midwife, offers text or voice messaging on maternal health to pregnant women.

Mobile Midwife was developed as part of the U.S. based Grameen Foundation’s MOTECH Ghana initiative, funded by the Bill & Melinda Gates Foundation. It is just one more result of rising donor attention to mHealth services. Its creation continues a trend of mHealth initiatives being churned out in Africa.

Educating women and making them aware of the maternal health risks associated with pregnancies are the cornerstone goals of the service. To make it convenient for the user, the service comes in several different languages, and is presented by text or voice via mobile phones. Additionally, the messages are time specific concurring with the woman’s stage of pregnancy.

When a pregnant woman registers for the service, they are asked to give the expected due date for delivery of the unborn child and their location. Then, periodically, the woman receives messages informing when appointments are due or overdue to remind them to visit the health clinic for check-ups.

The users also get reminders for specific treatments, information about milestones in fetal development, nutrition facts, tips on the benefits of breastfeeding and other pregnancy-related and prenatal health information. It also provides information that demystifies local pregnancy myths and helps users overcome the widespread fear of visiting doctors or health clinics.

MOTECH also rolled out a similar mobile health service earlier in the year that enables nurses in rural Ghanaian health facilities to automate much of their record keeping and reporting, which formerly took 4-6 days per month. The service is in the form of a java–based mobile phone application.

Both Mobile Midwife and the application mentioned above have made life easier for everyone involved in the process of delivering a baby.

One Ghanaian mother said to Grameen, “I would like to advise my pregnant friends to go to the hospital to enroll into MOTECH, to listen to the messages and also to practice what is said because it helps a lot…I used to be scared about pregnancy but now with the messages I am no longer scared and it has taken away my worries and that we feel ok and then the pregnancy is ok.”

This service is extremely pertinent since Africa exhibits some of the worst maternal health records in the world. Fourteen of the fifteen countries with the highest rates of maternal mortality in the world are in Africa. Furthermore, African countries are far behind in meeting Millennium Development Goals set for 2015; especially for those associated with maternal health. Perhaps services like this can lend a helping hand.

July 18, 2011/by actualize

Agriculture, Health, Health, Health Systems, HIV/AIDS, Infectious Diseases, Maternal & Child Health, Mobile, Originally posted on the GBI Portal

Mobile health quizzes get a 2.7 million Euro boost

Text to Change (TTC), an mHealth non-profit organization based in the Netherlands, announced earlier this month that they will receive a €2.7 million grant to expand its services. TTC provides an SMS-based educational service to improve the health of citizens in eight countries in Africa and one in South America.

Already a big contributor in mHealth development, TTC hopes to become a leader in the field with the reception of its multi-million Euro grant from the Dutch Ministry of Foreign Affairs via Connect4Change (C4C), a consortium funded by the Dutch Ministry of Foreign Affairs that develops mobile based solutions on issues of poverty in Africa and Latin America. TTC will partner with C4C to expand its services to 11 more countries in Africa and South America by the end of this year.

Implementing ICT in the 11 countries is a top priority for both TTC and C4C. They are hoping the mutual partnership will make establishing ICT services an easier task as the expansion continues. According to TTC, the game plan calls for TTC to provide “low” technologies like SMS and mobile voice services while C4C provides “high” technologies such as mobile internet and video transfer. Therefore, TTC and C4C will play different roles.

C4C will also invest its time reaching out to local entities on the ground to strengthen ICT networks. TTC will focus on improving health outcomes through their established mobile phone initiatives.

TTC sets up their mobile platform through the recipient country’s mobile service infrastructure already in place. They then subscribe mobile phone users to their programs which use SMS communication to inform people of HIV testing, treatment clinics, and other health related services at no cost to the recipients.

TTC SMS system Photo Credit: TTC

TTC programs offer the information through a free educational quizzing service where participants are quizzed about a specific health topic. As participants answer the questions correctly, they are sent more rounds of questions, again at no cost. If the participant can answer enough questions correctly, he/she receives incentives such as phone credit, t-shirts and health products.

Thus far, TTC has reached thousands of individuals with their programs on HIV/AIDS, malaria, and reproductive health. Furthermore, to assess the impact of ICT in the countries they are currently working in, TTC will even conduct large scale ICT evaluations over the next few years in those countries.

TTC is poised to make an impact in ICT through their mobile services. Their work is just another example of how mobile phones are being used as a medium to educate, inform and save lives. The tag-team partnership with C4C will be expanded to all 11 target countries by the end of this year. However, we will have to wait some time before confirming the outcome of this joint strategic approach.

June 27, 2011/by actualize

Health, Maternal & Child Health, Originally posted on the GBI Portal

Using cell phones to improve pregnancy in Herat

A community health worker shows a visual aid

Photo credit: Dimagi

With funding from USAID, World Vision and Dimagi will conduct operations research to test if the use of CommCare will increase the uptake of healthy actions, improve knowledge of important information points, and improve communications and coordination between community health workers (CHWs) and higher trained workers.

CommCare is a phone-based application to strengthen community health programs. CHWs use software running on a phone during each client visit to improve quality of care and data reporting. When the CHW is within range of a cellular network, data is automatically submitted to a central server for use in program management, monitoring and health surveillance.

World Vision’s study will focus on improving the uptake of a list of identified “Healthy Actions” and knowledge of key “Important Information” points. It will also study the improvement that the phone make between the CHWs for coordination with midwives and other health experts. World Vision expects the following:

Utilization – increased percentage of healthy actions taken by pregnant women
Knowledge Access – increased knowledge by pregnant women of the important information points
Access- increased use of midwives and expert services via phone calls

The primary CommCare module the study will focus on promotes essential care during and immediately after pregnancy. The module reinforces the training the CHWs will have received based on the American College of Nurse-Midwives Home Based Life Saving Skills. The module is designed to quickly bring a CHW through key points of identifying and responding to emergency signs including difficulty breathing, low birth weight, and hypothermia. The module then helps the CHW promote simple but effective hygiene and preventive care to reduce infections such as infected cord stumps, pneumonia, and tetanus.

A key challenge World Vision encountered was that the CHWs in the Herat region are low-literate. CommCare was, therefore, adapted for low-literate users by including audio prompts and images. These multimedia prompts have been found to also help engage the client more, as the CHWs play the audio clips and show images to their clients.

The following video demonstrates how the CommCare application works:

CommCare-Sense House Visit 1 from Derek Treatman on Vimeo.

Click here to learn more about this project.

March 8, 2011/by actualize

Agriculture, Health, Health, Maternal & Child Health, Mobile, Originally posted on the GBI Portal

USAID Maternal and Child Health Integrated Program Uses Mobile Technology to Improve Health Care

The Maternal and Child Health Integrated Program (MCHIP) is the USAID Bureau for Global Health’s flagship maternal, neonatal and child health (MNCH) program. Awarded in September 2008, MCHIP focuses on reducing maternal, neonatal and child mortality in 30 priority countries, contributing to Millennium Development Goals (MDGs) 4 and 5.

Designed by USAID as a “Leader with Associate Cooperative Agreement” (LWA), MCHIP can be funded by USAID Missions and Regional Bureaus through traditional field support and other mechanisms. In addition, MCHIP can accept Associate Awards that Missions, Regional Bureaus or Global Offices develop with the Leader organization and oversee directly.

MCHIP takes “what works” to scale by working with USAID Missions, national and local governments, nongovernmental organizations, communities and partner agencies. Based on country context and identified gaps in providing services at the household,community and referral levels, MCHIP designs program strategies to ensure that services reach women and their families.

What MCHIP Is Doing Using Mobile Technology

Nearly half of all births in developing countries occur in facilities, yet the quality of care provided is often unknown. Reported clinical practice may differ greatly from observed practice. MCHIP has developed a Maternal and Newborn Quality of Care (MNH QoC)Toolkit consisting of five mobile, electronic data-entry tools for assessing the quality of services provided in hospitals and health facilities. These are primarily checklist tools for observing health worker performance related to services provided for labor and delivery and essential newborn care. The tools are designed to capture health worker responses to spontaneous complications, such as pre-eclampsia/eclampsia (PE/E) or postpartum hemorrhage (PPH), two of the leading causes of maternal death.

As of November 2010, MCHIP MNH QoC assessments have been conducted in five African countries, providing baseline data for quality improvement activities for maternal and newborn care at facility, regional and national levels.

Maternal and Newborn Health QoC Mobile Toolkit

Obstetricians and nurse-midwives are trained to use mobile phones for capturing observational health worker performance data at hospitals and health facilities;
Data is entered on Windows Smart Phone forms with Range, Logic, Skip and other data quality controls;
Data includes clinical observation checklists on labor and delivery services, antenatal care, facility inventories, health worker maternal and neonatal knowledge tests, register, maternity chart and partograph review;
Quantitative and qualitative data is captured via interviews, simulations and observation checklists including audio noted and pictures of partograph;
Data is backed up to internal SD card and then transmitted via GPRS to in-country servers; and
Results are uploaded to the Web in predefined table, graph and map templates.

A Tool for Improving Quality of Care

The overall goal for MCHIP is to contribute to the reduction of frequent, preventable maternal and newborn deaths through increased quality of known life-saving interventions in countries facing the highest disease burden. Mobile phones have improved the quality of data and expedited the timeliness of results reporting. Specific needs for effective interventions for screening, prevention and treatment of obstetric and newborn complications are being identified as results come in from the MNH QoC Assessments.

Data collected and analyzed provides an opportunity to guide development of program interventions to improve the quality of facility-based maternal and newborn care services. By providing a baseline and end line measures in countries where the survey is part of an evaluation of interventions being implemented, data also provides an opportunity to inform policy change and resource allocation. These indicators and data collection tools can be used in multiple countries to provide information on key screening, prevention and management of interventions of the most frequent direct maternal complications.

Click here to view the poster presented by USAID at the mHealth Summit 2010. Also check out this Youtube Video of MCHIP’s own David Cantor speak as part of the panel discussion at the Summit.

January 20, 2011/by actualize

Tag Archive for: maternal health

Case Studies

Contact Details

Quick Links

About

Expertise

Impact

Join

Sign up for Updates