community workers adopt mobile technology to improve maternal-child health - so
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Community Workers Adopt MobileTechnology to Improve Maternal-Child Health
Stefano Montanari 2015/06/04
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As world leaders get ready to meet in New York in September to set a new developmentagenda for the next 15 years, their discussions will likely focus on maternal and childhealth. A report published by the World Health Organization (WHO) last May 13, in fact,highlights that progress has been insufficient to improve mothers’ health and reduce childmortality.
800 women still die every day in the world from preventable causes related to pregnancyand childbirth, while less than one third of all countries have achieved or will meet thetarget of reducing child-death rate by two-thirds.
Although the Millennium Development Goals have helped address many important publichealth challenges, there is still the need to ensure the “world’s most vulnerable peoplehave access to health services,” said Dr Margaret Chan, Director-General of WHO, in astatement presenting the report.
Local solutions to a global problem
South Africa is a good illustration of these public health emergencies – and of possiblesolutions. In a country where 30 percent of pregnant women do not access prenatal care,
more than 12 percent of the population live with HIV and around 40% of maternal deathsare HIV/AIDS-related, a number of initiatives show encouraging results.
A study published last October by the Philani Maternal, Child Health and Nutrition Trusttogether with the University of California, Los Angeles, and Stellenbosch University inSouth Africa found that repeated home visits by trained community health workers toneighborhood mothers led to significant health improvements both for mothers andchildren, including in the prevention of mother-to-child HIV transmission.
Trained and recruited by the Philani, these health workers – known as mentor mothers –provide a lifeline for families otherwise excluded from the reach of many public healthservices. In the past 7 years, they have brought healthcare interventions into the homesof tens of thousands of pregnant women and new mothers. They taught them how torehabilitate underweight children and improve their chances of giving birth to healthybabies, helped obtain state welfare allowances and assisted in the prevention ofpreventable illnesses.
Tablets for health workers
Mentor mothers’ work has now caught the attention of some professors at StanfordUniversity (California) who have started a project in February to support them with sturdytablets pre-loaded with education videos. These videos explain basic health and nutritionfacts in a simple and intuitive way, with the aim of helping mentor mothers in their work ofexpanding access to health knowledge and improving health conditions.
Nomfusi Nquru, one of the twelve mentor mothers testing the project, cannot conceal herexcitement about using these tablets. “It is something new and a chance to usetechnology that I do not get to use,” she said in an interview. “Mothers react excitedly tothe videos and seem to pay careful attention to what is being said. Hearing lessons in adifferent way is something that catches the mothers’ attention and afterwards they askquestions on how to feed their children well and look after themselves in theirpregnancies.”
The tablet project is the brainchild of Dr Maya Adam, a lecturer at Stanford School ofMedicine with years of experience in developing digital educational content. After runninga successful online course on child nutrition followed by thousands of people around theworld, she has now decided to use her experience to help mothers in the developingworld. “When we first introduced the teaching tablets, it was quite amazing to see howquickly these mothers picked up the new technology” she says. “In a way we arebypassing the blockage in access to education at least in the short term and providingthese women with the opportunity to access knowledge using the technology we havetoday.”
According to Adam, who has spent years as a volunteer at Philani during her medicalschool and undergraduate studies, recruiting successful mothers and training them tobecome community health workers “is a powerful model for passing on good healthpractices in a way that is sustainable because women are counseling within their owncommunities. They are not going anywhere and they are not coming in from somewhereelse with a solution that will then disappear when they leave.”
Adam hopes that the tablets will facilitate the learning and accelerate the training of newmentor mothers. Initial feedback from the twelve mentor mothers seems to confirm herintuition: responding to a questionnaire prepared by Stanford University, they all reactedenthusiastically to the introduction of the tablets in their work.
“Community health workers can help bridge the gap, in the short term, between what weneed in access to healthcare providers and what we have,” says Adam. “If we wait foraccess to education and healthcare in South Africa to catch up with the need for it inthese under-resourced communities, we are going to wait for a long time. By usingtechnology like the tablets we can accelerate that process in communities otherwise cutoff from main infrastructures.”
Adam intends to start an evaluation of the project next year, but is already working on amore ambitious goal of creating an open access health promotion library for communityoutreach workers.
“That’s my dream,” she says. “We are now raising funds for additional tablets, eachcosting around $170 U.S. dollars, and preparing translations of the videos into Spanishand other languages to extend the reach of this project. The videos are all picture-based,so they can easily be translated and used in other countries. We have the technology, wehave the equipment. If we can get support, we can really put our heads down and startcreating a comprehensive, multilingual, open access library to promote the health ofmothers and children everywhere.”
A promising tool
Stanford University’s is the latest of a number of projects providing health workers withmobile technology. OpenSRP, for example, is a tablet-based open source platform thatallows health workers to register and track the health of their entire clients.
“The use of mobile health technologies is a promising mechanism to ensure that we canbetter measure health outcomes in order to inform processes intended to improve healthalong the continuum of care,” says Dr Lale Say, coordinator of the adolescents and at-risk populations team at the Department of Reproductive Health and Research of theWHO. “Digital technologies like those used in this project have proven valuable for bothcommunity members as well as the health workforce to gain access to quality informationthat can help make timely and well informed health decisions that can impact on the livesof mothers and their children.”
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Tagged with: AIDS, child health, child mortality, HIV, Lale Say, Margaret Chan, maternalhealth, Maya Adam, mentor mothers, Millennium Development Goals, Nomfusi Nquru,OpenSRP, Philani, pregnancy, South Africa, Stanford University, Stellenboch University,tablets, University of California, WHO, World Health Organisation
About Author
Stefano Montanari
Stefano Montanari is an Italian freelance journalist specialised in human rights. Graduated in
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Humanities, with a focus on History and International Relations, he obtained an M.A. inInternational Co-operation and Project Design, after which he has been working forinternational organisations promoting human development and human rights. He currentlyworks as head of communications for the Council of Europe Commissioner for HumanRights. The views expressed here are his own and do not necessarily reflect the officialpolicy of the Council of Europe. View all posts by Stefano Montanari →
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