This document summarizes the first year results of monitoring and evaluation of MomConnect, a South African mHealth program that aims to improve maternal and child health outcomes. Key results include:
- Over 50,000 pregnant women registered for the program, though registration rates varied significantly between provinces.
- Under 10% of subscribers to the program's text messages converted to registered users.
- Most registrations (over 75%) occurred before or at 20 weeks of gestation.
- Client satisfaction with health services was high, though only a small percentage provided ratings.
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ICT4Health 2015 -Peter delobelle
1. Addressing maternal & child health
using mHealth: First year of
MomConnect monitoring &
evaluation
P Delobelle, T Esterhuizen, L Dudley, A Parsons
A Fernandes, Y Pillay, P Barron
2. Table of Contents
Rationale
Aims & objectives
Overview & set-up
Logical framework
Study design
Output indicators
First year results
Discussion
Conclusion
3. MomConnect : Rationale
High rate of avoidable maternal mortality (140 /
100,000 live births) associated with late uptake of
antenatal care
Barriers include lack of privacy and confidentiality
related to HIV/AIDS counselling and testing, lack of
knowledge and information about SRH and rights
and problems related to the availability and cost of
transport
NDoH strongly committed to achieving MDG 4-5
targets related to decreasing maternal and child
mortality
Mobile phone penetration in South Africa stands at
115%
Benefits of text messaging include its low cost and
4. Aim : To contribute to decreased maternal and child
mortality in line with MDG 4-5 by using cell phone based
SMS technology
Objectives :
To register all pregnant women in the public health sector
in South Africa on a national database;
To send stage-based health messages to their mobile
phones during pregnancy, childbirth and up to the first
year of age;
To provide a platform for feedback and strengthen the
demand and accountability of MCH services to improve
the access, coverage and quality of care
To improve competency of nurses and midwives
delivering MCH services (end of 2015)
MomConnect: Aim & Objectives
6. Logical framework based
on a Theory of Change
approach with specific
indicators for each
component of the
framework including input,
process, output and
outcome indicators with
respective sources of
verification and underlying
assumptions
MomConnect M&E : Logical Framework
8. Indicator Data Source
a % client registrations / (target) ANC 1st visits
(previous fin. year)
MomConnect /DHIS 2
database
b % client opt-outs from MomConnect and
reasons for opting-out
MomConnect /DHIS 2
database
c % client service ratings (response rate) MomConnect /DHIS 2
database
d % client ratings of privacy, staff attitudes,
cleanliness and waiting times
MomConnect /DHIS 2
database
e % clients using the help-desk and categories
of messages sent
MomConnect /DHIS 2
database (if available)
f % clients logging complaints / compliments MomConnect /DHIS 2
database (if available)
MomConnect M&E: Output Indicators
12. MomConnect Registrations by Age Group
0%
5%
10%
15%
20%
25%
30%
35%
40%
< 20 years 20y - 24y 25y - 29y ≥ 30 years
0%
5%
10%
15%
20%
25%
30%
35%
40%
13. MomConnect: Opt-outs by Reg Category
0
2
4
6
8
10
12
14
Percentage
Registration CHW subscription Public subscription
14. MomConnect: Opt-out Rates by Reason
0
10
20
30
40
50
60
70
80
90
100
Percentage
Baby loss
Miscarriage
Not useful
Other
Stillborn
Unkown
15. MomConnect: Opt-out rates by Province
0
2
4
6
8
10
12
14
16
18
20
Percentage
Kwazulu-Natal
Gauteng
Western Cape
Free State
Northern Cape
Limpopo
Mpumalanga
Eastern Cape
North West
16. MomConnect: Satisfaction with Services
0
10
20
30
40
50
60
70
80
90
100
Percentage
Cleanliness
Friendliness
Privacy
Waiting times (felt)
Waiting times
(length)
Regs submit
service ratings
17. MomConnect M&E: Discussion
Data quality issues
Data script errors / missing values (e.g. divergence
between early booking and registration rates)
Data processing issues and time lag between integration
and reporting
Issues to be explored
Significant variation in target registration achievement
between Provinces and (sub)-Districts
Reasons for low conversion rate (<10%) among
subscriptions
Opt-out among registered clients for unknown / other
reasons
Relatively low service ratings coverage
18. Uptake of MomConnect as measured by target
registration achievement varies widely between
Provinces and Districts
Conversion rates of MomConnect subscriptions remain
low
Registrations before 20 weeks of gestation approximate
the rate of first ANC visits
Registrations among women younger than 20 years
increased slightly overall and was higher in rural districts
in EC / KZN
Opt-out among registered clients showed variation over
time albeit at a low rate
Service ratings are highest for satisfaction with
MomConnect M&E: Conclusion