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How Mobile Health Is Saving Moms’ and Babies’ Lives

Jul 26, 2017 4 MIN. READ

Though maternal mortality is decreasing in many nations, a handful — including South Africa and the United States — are experiencing an increase. mHealth initiatives like MomConnect, though, could help turn that around.

Over the course of just 20 years, everything had changed.

In 1996, South Africa had one of the lowest maternal mortality rates (MMR) in the world. By 2010, less than 20 years later, a potent HIV epidemic had caused that rate to more than double. Like the United States, South Africa was one of a handful of nations whose maternal mortality rates skyrocketed at a time when even many developing nations were seeing theirs decline.

Where is MMR Increasing?

Though the epidemic has since diminished, Amnesty International reports that nearly 30 percent of the nation’s 1.2 million pregnant women and girls are living with HIV. With that in mind, the South African National Department of Health needed an effective means of providing vital healthcare information to pregnant women and their families. The answer? MomConnect, launched in 2014, uses mHealth to reach pregnant women across the country.

Percent Increase in MMR Between 1990 and 2015

Country

Increase

Democratic People's Republic of Korea

9.3%

Jamaica

12.7%

Saint Lucia

12.7%

United States

16.7%

Serbia

21.4%

Suriname

22%

South Africa

27.8%

Guyana

33.9%

Tonga

65.3%

Bahamas

73.9%

Trends in Maternal Mortality: 1990 to 2015. World Health Organization, 2016. Accessed June 13, 2017

The Right Care at the Right Time

Joy Kamunyori is a project manager and health informatics advisor who supports MomConnect and other initiatives under the USAID-funded MEASURE Evaluation Strategic Information for South Africa (MEval-SIFSA) project.

Typically, a woman registers for MomConnect during a visit to a healthcare clinic, but she also can self-register using her mobile phone or be registered elsewhere by a certified community health worker. The method was particularly well-suited to South Africa, where more than 90 percent of the population owns a cell phone.1

“When a pregnant woman goes for her first antenatal care visit,” Kamunyori explains, “a nurse confirms her expected delivery date and tells her about MomConnect. If the woman wants to sign up, the nurse registers her in the system.”

Once a user is registered, she’ll receive two messages tailored to the stage of her pregnancy or her child’s age. This continues throughout her pregnancy and until their child turns one. The messages, which are available in the 11 South African official languages, encourage healthy behaviors and provide check-up reminders. They also offer information on broader health topics related to women and children’s health.

The Importance of a Two-Way Street in Mobile Healthcare

Kamunyori and her team knew that in order for MomConnect to serve its purpose, they would need to understand the user experience in qualitative as well as quantitative terms. When an expectant mother registers for MomConnect at a clinic, she is invited to take a survey to rate her experience. This survey, which aligns with the South African National Core Standards for Health, asks users to rate cleanliness, friendliness, professionalism, perceived waiting time, and actual waiting time at their clinic. MomConnect then sends that data to the District Health Information System and records the woman’s pregnancy in the National Pregnancy Register.2

The service can also glean important information about sensitive concerns or issues women encounter during or after their pregnancy. For instance, MomConnect includes a helpline feature that allows women to ask questions anonymously — ones that they may feel uncomfortable asking their provider or family – and get real answers from experts. “There’s been quite a bit of interaction with women using MomConnect,” Kamunyori says. “While South African telemedicine laws don’t allow diagnoses to be made over the phone, we can respond to questions and offer referrals.”

Every month, the app — which complies with South African ehealth standards3 — sends user feedback to local health administrators who use it to detect problems and improve services at healthcare facilities. For example, when users reported that iron tablets were widely out of stock in a northern province, members of the local department of health met with clinic staff to review ordering procedures.4

Measuring Impact and Looking Ahead

“Capturing user comments has made a big difference,” Kamunyori says. “Monitoring is having a positive impact on services. Based on our review of anecdotal feedback, we believe MomConnect is helping to improve the quality of antenatal healthcare services.”

To date, more than 700,000 unique users have registered with MomConnect—an adoption rate of more than 50 percent and a reach that encompasses more than 95 percent of the country’s clinics.5 The help desk has answered more than 180,000 questions,6 and the system has recorded nearly 80,000 service ratings.7 

With support from MEval-SIFSA and other partners, MomConnect is advancing South Africa’s health information system and generating momentum for additional digital health services and policies. In the future, the program could add mobile channels, integrate with the national health insurance system, and generate data and monitor performance at other points in the continuum of care.8 Its reach in the country makes it an ideal platform for additional health-related services—for moms, children, and all South Africans.

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