An mHealth strategy to reduce preeclampsia-eclampsia and maternal and infact death in Tanzania
Background: Mobile phones now exist in more than 90% of Tanzanian households and have become the mainstay of day-to-day life and empower people economically (small scale banking, small business, agriculture and utilization in health care). mHealth can provide a means whereby health care workers and patients can receive education, facilitate follow-up. There is huge potential for mobile technologies to improve health care and public health service delivery, especially in resource-poor settings. Mobile phones are cheap and ubiquitous, with massive growth globally, especially in sub-Saharan Africa. Mobile-phone–based health applications are proliferating rapidly and there are persuasive reasons why mobile technologies offer such potential. They can be used at low cost to deliver scalable interventions, to tailor and personalize care, and importantly, to support direct communication between frontline workers, programme managers, patients, and communities. Death from childbirth is one of the greatest challenges facing African women today, particularly in rural communities. The United Nations’ fifth Millennium Development Goal addressed this concern with the aim to improve maternal health and reduce by two- thirds by 2015 the high numbers of women dying while giving birth. Although, several African countries have made some progress toward this goal, thousands of women continue to die each year in childbirth. Tanzania has a maternal mortality ratio of 454 per 100,000, which equates simplistically to one woman dying in childbirth almost hourly. Pre-eclampsia (PE) is associated with an unacceptable burden of death (maternal, fetal and neonatal), disability and poor health outcomes for women and children worldwide. However, it is in low and middle income countries where women, their families and communities bear an unacceptable burden of risk for developing disabling and deadly complications
Maternal Health Problems: Many of these complications arise in women who never access the formal health care system or are moribund when they do gain access. The disparity in outcomes between women in high-income countries compared to low-income countries is a social equity issues that deserves further reflection and effective research. Detection and management of pre-eclampsia-eclampsia is not expensive but requires appropriate health system resources such as skilled (and properly trained birth attendants) as well as equipment to detect high blood pressure and proteinuria. A system of management and referral for appropriate care and delivery is essential but cannot be appropriately utilized if the condition goes undetected or its severity unrecognized by health care providers even when a woman seeks appropriate care. The research program proposed here will be embedded within the strengths of the EMPOWER network in Tanzania and will build on the body of evidence that currently exists regarding effective interventions to reduce PE. EMPOWER was established in 2012 to improve linkages and education to mid-level providers who assist with births at health facilities in Tanzania (nurses, midwives and assistant medical officers).
Our previous efforts: EMPOWER applies the implementation science and research approach to demonstrate how best the scientifically proven interventions for maternal, newborn and child health (MNCH) can be effectively implemented in real district health system setting while considering their scalability. EMPOWER has implemented educational tools and is building an mHealth platform for access to urgent medical advice through a closed user group of mobile phones. The WHO has recognized that task shifting needs to occur in maternal and child health in order to optimize care and that nurses and midwives will play a key role in improving antenatal care and maternal outcomes. We plan to utilize and train nurses and midwives as the backbone of our proposed interventions. We will incorporate innovative mHealth strategies to facilitate education as well as detection and tracking of women with PE. We will also involve pregnant women as key players in the intervention so that when they are informed of risks, they can play a key role in their care by obtaining appropriate follow up. There are many challenges that a pregnant woman faces everyday. There stretches from basic house work all the way to financing the house wholebeing. This statement is even more so for a woman in the village. It is so much so that at times, a pregnant mother does not get the time to visit a health facility for her regular visits. A number of interventions have tried to address the issue of bring the maternal care to the pregnant woman and the amount of live saved and health babies born is worth it all. With all this done there is still room for improvements. And here is where mHealth comes in.
About this project: The mHealth project add the automated vital monitoring. By making use of a a mobile app, a communicate worker can logs the vitals of a pregnant woman during their routinely visits. These logs are then sent to a server where they are quickly put to through an algorithm that will determine the health status of a pregnant woman. In addition to that there are is also a maternal health care that also reviews the results that are given but the algorithm. These results are then used to advise the pregnant woman on the correct course of actions especially if there is a need for immediate medical attention. In addition to that to also the get the health facilities ready to deal with the incoming patient.