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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!