Authors: Marion McNabb, Emeka Chukwu, Oluwayemisi Ojo, Navendu Shekhar, Christopher J. Gill, Habeeb Salami, Farouk Jega
Nigeria’s maternal mortality ratio is the tenth highest in the world, with an estimated 630 maternal deaths per 100,000 live births, and 40,000 maternal deaths annually. There is now a critical need to support Nigeria’s efforts to make significant progress in achieving the Millennium Development Goal 5 target of reducing maternal mortality by 2015 through the government’s recently launched Saving One Million Lives (SOML) initiative. With a dearth of skilled personnel at the primary health care level, Community Health Extension Workers (CHEWs) have increasingly filled the gap at primary health centers (PHCs). CHEWs have not received adequate technical support and most are unable to comprehensively address complications among high-risk women who present at the facility. The low skill level of CHEWs and lack of adequate supervision adversely affects the quality of ANC. In larger PHCs, other health care workers (HCWs) including nurses and midwives, provide ANC services, in addition to the CHEWs.
In the last decade, mobile phone ownership and use has grown significantly in sub-Saharan Africa. With this growth has come the emergence of programs globally that use mobile technology to support health programs, otherwise known as mHealth. Mobile applications providing decision support and facilitating case management for health workers are one common application of mHealth programming.
Studies in Africa and Asia have shown that mobile phone decision support applications for community health workers (CHWs) are acceptable and feasible and can improve clinician adherence to treatment protocols and national guidelines. CommCare, an open source mobile phone decision support and case management platform developed by Dimagi Inc., allows users to develop custom applications that run on Java-enabled or Android-based phones or tablets. CommCare applications, or “apps,” are currently being implemented by over 50 organizations across 30 countries, mostly supporting CHWs in Asia and Africa, for a variety of health and development focus areas.
To the authors knowledge, no study has been conducted in Nigeria assessing the effect of implementing mobile phone decision support applications on the quality of ANC services offered by community health workers. In this paper, the authors present data regarding the effect of an mHealth decision support application used by CHEWs and other HCWs in 10 PHCs in Nigeria. They assessed two main outcomes: 1) the quality of services rendered, as reported by their clients and measured by 25 technical and counseling indicators; and 2) the level of satisfaction with ANC services received as reported by clients.
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Resource Topic: Behavior Change and Communication, Community Health Workers/Volunteers, Community Involvement, Human Resources Management/Workforce Development, Maternal, Newborn and Child Health, Midwives, Performance management, Sustainability, mHealth and Technology
Resource Type: Research
Year: 2015
Region: Sub-Saharan Africa (SSA)
Country: Nigeria
Publisher May Restrict Access: No