Mobile Mothers: SMS for Maternal and Child Health

 Closing the health gap for women and children one cell phone at a time

Where we work: Olengobir, Awita, Olago and Te Okole villages in Lira District, Uganda

Background:

     Sub-Saharan Africa has one of the worst maternal and infant mortality rates of any region in the world. Specifically, each year in Uganda, more than 10,500 mothers die from pregnancy-related complications -- one in every 25 women. Moreover, less than half of Ugandan women receive proper prenatal care or deliver with assistance of a skilled birth attendant (WHO). Infant mortality in the country is no better – a staggering 161,000 babies die soon after birth, with rural mortality especially high. Furthermore, access to paediatric care is poor. Less than half of Ugandan children with pneumonia or dehydration symptoms actually receive treatment, and micronutrient deficiencies and malnutrition still plague millions.

     These problems, however, are less the product of a weak healthcare infrastructure - Uganda's healthcare system rivals that of most developing nations – than a result of underutilization of existing services. There is a gap between service provision and health/healthcare knowledge. Multiple UN agencies report a widespread shortage of access to medical information in the area and low medical literacy rates, which hamper compliance with treatment regimens and care-seeking behaviour. Women often claim feelings of powerlessness in seeking care because of this lack of knowledge of services.

      In sum, it is not really healthcare provision which is lacking, but access to health information. A bridge is needed to link extant services and knowledge to the women and children who need them, when they need them.

Action plan:

Phase 1: Design - First 3 months

• Collect baseline information on women’s knowledge regarding specific maternal and child health issues targeted by our service – 1 month.

• Health message content design & adaptation of Frontline SMS software based on focus group discussions and user surveys- 3 months

•  Design and print pamphlets to advertise within the district – 1 week

Phase 2: Service Set-up - 4 months

• Set up hardware and service- 2 months

• Launch website detailing the work done thus far and the Health2Home Initiative – 1.5 months

• Obtain focus group feedback on model- 3 months, but spread out into three approximately equal-length phases

• Recruit and train female service managers to operate the Frontline SMS service - 1 month

• Refine content & service model based on focus group feedback – 1 month

• Enroll mothers and children onto the Health2Home system – 1 month

Phase 3: Service Deployment - 6 months

• Advertise and demonstrate service in communities with the ministry of health – 1 month.

• Collect community feedback via periodic surveys – 1.5 months.

• Conduct a system-wide process evaluation – 5 months

 Phase 4: Outcome Evaluation - 1 month

• Collect community data on knowledge regarding specific maternal and child health issues targeted by our service – 1 week.

• Analyse final data and compare it with baseline data to quantify changes in knowledge levels and attitude – 2 weeks.

• Partner with the Ministry of Health for service expansion beyond Lira district – 1 week.

For the Duration of the Project:

• Fundraising (months 0-14)

• Establishing partnerships (months 0-14)

Our partners:

            Ministry of Health, Uganda

            Contact: John Opio Nelson

Assistant District Health Officer,

Lira District, Uganda

John Dusabe, Public Health Researcher from Uganda

           Research Assistant, Sexual and Reproductive Health Clinical Group,

           Liverpool School of Tropical Medicine, UK

           http://www.inthec.org/