Thursday, January 12, 2012

mhealth: Mobile Phones to expand demand for, and use of ANC/PMTCT services in rural Uganda

Any development agenda in Uganda must look beyond the city and for a simple reason, over 80% of the total population lives in rural areas.
Almost 70% of the world’s mobile phone subscribers are in the developing world. As an affordable and accessible means of communication, both men and women are realizing the potential of this technology to create economic opportunities and strengthen social networks in rural areas. The mobile phone is no longer just a communication tool but one that`s capable of providing additional integrated functions.
Today, mobile telephony is being used to provide information on health, Agriculture, Education and entrepreneurship to rural communities through Short Message Service (SMS) and multi-media supported systems in many parts of Uganda and Africa at large. This has been made possible through public, private and NGO sector initiatives.
According to the 2010 MDG progress report for Uganda, maternal health indicators for Uganda have generally remained poor in the last two decades. Over the period of 1995-2000 maternal mortality stagnated about 505 deaths per 100,000 live births. The Uganda demographic and health survey of 2006 estimated Maternal Mortality Ratio (MMR) at 435 deaths per 100,000 live births, making a total reduction of only 70 deaths per 100,000 live births in half a decade.
The 2007 ministry of health expenditure survey in Uganda clearly indicates that the main causes of maternal morbidity and mortality in Uganda have overtime been considered preventable and or treatable. These common causes include but are not limited to; abortion, haemorrhage, sepsis and obstructed labour.
As a result of this, The Netherlands National committee for UNICEF in partnership with UNICEF Kampala, the Ministry of Health, Text to Change, The Association of Volunteers in International Service (AVSI), and Catholic Relief Services (CRS) are implementing an intervention to increase ANC and PMTCT attendance by educating communities about Antenatal care (ANC) /Prevention of mother to child Transmission(PMTCT) services and HIV/AIDS prevention in western and Northern Uganda.  
The project will use available technology, mainly the mobile phones to educate and mobilize mothers, families and community members to demand for ANC and PMTCT services. Through the short Message service (SMS), mothers will be reminded about ANC appointments, PMTCT services and their importance as well as provide information about HIV/AID and Malaria prevention.
Mobile telephony is the most preferred technology for this health intervention because it effectively reduces the “distance” between individuals and institutions making sharing of information and knowledge easier and more effective. The benefits of mobile phones are amplified by the fact that the spread of mobile technology in some rural areas has occurred much faster than with other information & communication technologies (ICTs). In a country like Uganda, mobile technology has quickly become much more cost effective for telecommunication provision.
Despite these benefits of the mobile phone, challenges like high costs of handsets, limited network coverage and limited usage capacity still exist but these are being solved by the potential of new models of phones that combine text, audio and video to be used in a more systematic manner that enables sharing of user generated multimedia content.
The chances of success and sustainability of rural health services that are based on mobile telephony are greater when they do not duplicate services provided by existing information sources such as the kiosks, telecentres , digital doorways and information centres.