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Facilitating theImplementation ofMNCH Protocols throughmHealth: Tanzania

Dunstan Bishanga, MD,MSc

Chief of Party-MAISHA,Jhpiego/Tanzania

05 October 2013

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MAISHA: Mothers and Infants, Safe, Healthy,Alive

Duration: October 2008

May 2014 Scope: National program, > 250 health facilities

Funding: USAID

Partners: Save the Children, D-Tree

Program objectives: Reduce maternal mortality due to major direct causes

Reduce newborn mortality through timely newborncare

Eliminate mother to child transmission

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A phone-based tool for Maternal Care

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mHealth for Quality MNCH Services

Jhpiego is working withthe MoHSW in

collaboration with D-

tree International to

implement the use of aphone based tool for

maternal care in

communities andfacilities in:

Morogoro

Zanzibar

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mHealth for Antenatal and Postnatal

Care: continuum of care Goal: To ensure delivery of high-quality care

to pregnant mothers following MOH

guidelines in a format that is easy to

understand and use.

To strengthen facility/community linkages

To serve as job aids for service providers andcommunity health workers

To track individual client records for individualizedcare

To consolidate monthly records and streamlinereporting

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Scope of the Project

The project includes both Facility and

Community based tools that focus on:

Electronic registration

ANC, PNC, PMTCT and PPFP

Follow-up for appropriate visits.

Referral linkage between

community and facility.

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The Application

The application includes:

Identification of risk factors

Screening for danger signsand complications

Monitoring lab results toensure all tests are done(BP, Hb, protein in urine,

etc.)

Encouragement for facilitydelivery

Comprehensive counseling

including individual birthplanning, nutrition andfamily planning.

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Use of the Application: examination

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Results to date

28 health facility workers from 5 facilitiestrained in mobile application (from July

2012)

3,429 women registered from July 2012 to present

12 community health workers trained in

mobile application (from February 2013)

436 women registered and visited by CHWs inMafiga and Gairo catchment areas fromFebruary 2013 to present

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Early Data from ANC:

Cases reported at the

Baseline 2012

Cases reported with use of mHealth

Application in 2013

January 0 6

February 0 4

March 0 5

April 0 4

May 0 1

June 0 1

July 4 1

Increase in Anaemia Detection/Recording

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Early Data from ANC:

Increase in High BP Detection/RecordingCases reported atthe Baseline in

2012

Cases reported with use of mHealth

Application in 2013

January 0 5

February 0 12

March 0 16

April 1 13

May 1 7

June 0 7

July 4 8

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Data generated using the mobile phoneapplication is more complete than paper forms.

Danger signs are more frequently recognized

resulting in higher number of referrals to higher

level facility Nurses report that while using the mobile tool takes

more time they believe they are giving more

thorough care.

Mothers report they have come to the clinicbecause they have heard about the phone and

believe they get better care.

Lessons Learned

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CHWs and mobile phones

Success story from Gairo Health Center

We received a client who was referred by one ofthe CHWs who is using a phoneshe detected

that the client was not feeling fetal movement,so referred client to the facility. The facilitynurse confirmed the fetal distress and thenreferred the client to hospital. The client was

operated and they managed to save the livesof baby and mother.(reported by GraceNgallya, CHW supervisor)

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PARTNERS

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Ahsanteni

Sana!