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Reducing Maternal Mortality:
mHealth for Safer Deliveries in
          Zanzibar
Problem
• Low rates of in- facility deliveries and
  access to post-partum care
• More than 1,000 women die every day in
  the developing world as a result of
  complications in childbirth.
• While women are encouraged to deliver in
  a health facility, in Zanzibar half of all
  births still take place at home, far from
  skilled care.. Source: Tanzania
  demographic health survey 2010
Main obstacles to in-facility
            deliveries are
• An insufficient understanding of the
  benefits of delivering in the facility
• Delays in decision-making to get there in
  time; and
• Lack of available finances for transport.
• Further, only one-third of Zanzibari mothers
  and newborns receive post-natal check-
  ups within 42 days after birth,
• locking them out of opportunities to access
  post-partum care, family planning, infant
  vaccinations and other services that will
  ensure their healthy future
• Through a generous grant from the Bill and
  Melinda Gates Foundation, D-tree
  International is addressing this problem in
  Zanzibar together with Etisalat, JHPIEGO
  and the Ministry of Health and Social
  Welfare.
Solution
• mHealth tool for community-based birth
  attendants (TBA)
• D-tree has developed an mhealth tool for
  traditional birth attendants (TBAs), who are
  well-respected in their communities and
  have considerable influence and access
  over the mothers that are most likely to
  give birth at home.
• Using an open source, java-enabled
  application, the protocol follows the
  Zanzibar Ministry of Health guidelines and
  allows TBAs
TO
• Screen pregnant mothers to: identify
  risks or danger signs, discuss birth plans,
  secure permissions, and promote the
  community-based referral system
TO
• Establish community-based referral
  systems to transport laboring mothers to
  health facilities in time by calling reliable
  drivers and alerting on-call facility staff
• Using mobile banking, coordinate
  mother’s transport to health facilities
  and hospitals
• Within 2-3 days after delivery, follow-up
  with the family to ensure a continuum of
  care, including post-partum and post-natal
  care
• Focused on prevention and
  integrated with the health system,
  the tool harnesses community
  actors to help mothers with high-
  risk health conditions access the
  right care at the right time.
In	
  summary
•  D-tree’s mHealth application for safer deliveries aims to:
Ø  Improve identification of `pregnant mothers’ risks
Ø  Improve decision-making for critical referrals during labor
Ø  Improve coordination of community and health facility
   actors
Ø Increase percentage of high-risk deliveries to be
   assisted by skilled caregivers in facilities
Ø Increase percentage of mothers and newborns attending
   postpartum care within the first 7 days after delivery
RESULTS
• High demand for integrated mHealth
  tool
• Traditional birth attendants, community
  health workers, and primary health care
  staff are using D-tree’s mHealth application
  for safer deliveries in the North A District of
  Unguja, Zanzibar.
• Based on high community demand for use
  of D-tree’s mHealth application, strong
  partner commitment, and promising initial
  results, the project has potential to extend
  across Zanzibar.
JOIN	
  US
• h1p://www.globalgiving.org/projects/
  safedelivery/

• Watch	
  video	
  at	
  
  h1p://www.youtube.com/v/DZl7z_oItro

• Website	
  	
  www.d-­‐tree.org	
  

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Peter Lubambi: Reducing Maternal Mortality with mHealth, MobileMonday Dar es Salaam, April 2nd 2012

  • 1. Reducing Maternal Mortality: mHealth for Safer Deliveries in Zanzibar
  • 2. Problem • Low rates of in- facility deliveries and access to post-partum care
  • 3. • More than 1,000 women die every day in the developing world as a result of complications in childbirth.
  • 4. • While women are encouraged to deliver in a health facility, in Zanzibar half of all births still take place at home, far from skilled care.. Source: Tanzania demographic health survey 2010
  • 5. Main obstacles to in-facility deliveries are • An insufficient understanding of the benefits of delivering in the facility • Delays in decision-making to get there in time; and • Lack of available finances for transport.
  • 6. • Further, only one-third of Zanzibari mothers and newborns receive post-natal check- ups within 42 days after birth,
  • 7. • locking them out of opportunities to access post-partum care, family planning, infant vaccinations and other services that will ensure their healthy future
  • 8. • Through a generous grant from the Bill and Melinda Gates Foundation, D-tree International is addressing this problem in Zanzibar together with Etisalat, JHPIEGO and the Ministry of Health and Social Welfare.
  • 9. Solution • mHealth tool for community-based birth attendants (TBA)
  • 10. • D-tree has developed an mhealth tool for traditional birth attendants (TBAs), who are well-respected in their communities and have considerable influence and access over the mothers that are most likely to give birth at home.
  • 11. • Using an open source, java-enabled application, the protocol follows the Zanzibar Ministry of Health guidelines and allows TBAs
  • 12. TO • Screen pregnant mothers to: identify risks or danger signs, discuss birth plans, secure permissions, and promote the community-based referral system
  • 13. TO • Establish community-based referral systems to transport laboring mothers to health facilities in time by calling reliable drivers and alerting on-call facility staff
  • 14. • Using mobile banking, coordinate mother’s transport to health facilities and hospitals
  • 15. • Within 2-3 days after delivery, follow-up with the family to ensure a continuum of care, including post-partum and post-natal care
  • 16. • Focused on prevention and integrated with the health system, the tool harnesses community actors to help mothers with high- risk health conditions access the right care at the right time.
  • 17. In  summary • D-tree’s mHealth application for safer deliveries aims to: Ø Improve identification of `pregnant mothers’ risks Ø Improve decision-making for critical referrals during labor Ø Improve coordination of community and health facility actors Ø Increase percentage of high-risk deliveries to be assisted by skilled caregivers in facilities Ø Increase percentage of mothers and newborns attending postpartum care within the first 7 days after delivery
  • 18. RESULTS • High demand for integrated mHealth tool
  • 19. • Traditional birth attendants, community health workers, and primary health care staff are using D-tree’s mHealth application for safer deliveries in the North A District of Unguja, Zanzibar.
  • 20. • Based on high community demand for use of D-tree’s mHealth application, strong partner commitment, and promising initial results, the project has potential to extend across Zanzibar.
  • 21. JOIN  US • h1p://www.globalgiving.org/projects/ safedelivery/ • Watch  video  at   h1p://www.youtube.com/v/DZl7z_oItro • Website    www.d-­‐tree.org