Mhealth: Utilizing mobile phones to improve quality of community-based maternal and child health services in Mozambique

Purpose: To determine if mobile phones can improve the quality of services delivered by CHVs in Mozambique by enabling them to 1) diagnose pregnancy complications and make timely referrals as necessary; 2) communicate with facility-based staff to facilitate access to care of pregnant women. Methods: From June 2011 to October 2012, study assessed feasibility of CHVs using mobile phone pregnancy and postpartum module to manage routine perinatal and newborn care. CHVs covered 750 pregnant women. Mobile data was collected through CommCare through the pregnancy and postpartum module and analyzed. Results: The use of mobile technology by CHVs resulted in 20% recognition of danger signs during pregnancy and postpartum periods significantly higher than the global average of expected maternal complication of 15% according to WHO. The prevalence of birth preparedness (64%) in association to danger sign recognition was higher than what was reported previously by studies in Uganda (35%), Kenya (7%),two different studies in Ethiopia (20%, 22%), and India 48%). CHVs reported enhanced communication with health facility personnel through the use of the mobile phone and an expedited referral process (91.3%) benefited both women with significant complications as well as those with minor complications who did not need to be transported to the facility. Recommendation: Initial results conclude that the use of the mobile phone pregnancy and postpartum module improves the quality of and access to services delivered by CHVs as demonstrated by danger sign identification and referral rates.