Research Brief: mHealth Interventions in Sub-Saharan Africa

Krista Brooks, ABSN Student, Johns Hopkins University School of Nursing

Our past blog posts have featured: using advocacy as a tool to prevent maternal and child deaths; using films to train nurses and midwives in rural Somalia; improving access to health hygiene for women and girls with the use of social entrepreneurship and impact investing; maternal and child health in the time of Ebola; integrating indigenous health knowledge to health systems specifically food safety; the importance of establishing public-private partnerships to help create sustainable programs as described in the Water Ecuador program; and the role of nutrition in non-communicable diseases. All of these posts touched on different facets of addressing how to improve maternal and child health from various angles.

Recent studies have shown the use of new technologies in conjunction with forming public-private partnerships can be an effective way to improve outcomes in maternal and child health. Specifically, the use of mHealth or mobile technology programs have shown promising results in terms of improving both health knowledge, medication adherence, and overall health outcomes in both urban and remote areas (Gazmararian et al., 2014).

The article in focus for this brief is a systematic review by Obasola et al. 2015. The review examined 18 articles that focused on mHealth related interventions in sub-Saharan Africa from 2002-2013. Inclusion criteria consisted of interventions showing evidence of positive outcomes in maternal and child health in sub-Saharan Africa. The mHealth interventions ranged from appointment reminders and vaccine schedules to the dissemination of general nutritional information and data collection, as well as an enhanced decision support systems for healthcare workers. The findings showed that mHealth programs: increased women’s awareness about health issues; improved feelings of empowerment among health care workers; provided supplementary information for patient management in the field; and increased patient satisfaction with overall care. Additionally, some interventions were able to reach women who might not otherwise interact with the health system because of poor access.

While these mHealth interventions offer low-cost solutions in low resourced and rural areas, the study mentioned challenges associated with these interventions. The review found that training on the use of technology and associated programs is needed for programs to be effective as well as the need for high proliferation of mobile phone usage and coverage. Additionally, they found confidentiality to be a common issue as mobile phones can be stolen or left out allowing others to view private health information. Costs of mobile phones and associated usage fees were also limitations to these programs. This is where the formation of public-private partnerships can be seen as imperative to the success of these programs. Obasola et al. 2015 highlighted several programs that formed strong public-private partnerships to bolster their success. For example, in one intervention, the government provided human resources for telecommunication companies so they could expand services and mobile phone coverage. In another intervention cost sharing was achieved by pairing mobile health interventions with currently existing services to help lower the direct costs of the health intervention.

While these interventions prove promising, Obasola et al. 2015 emphasized that holistic care is extremely important in offering any kind of maternal and child health care; that is interventions should provide a continuum of support from antenatal care through childhood. The authors noted that many of the programs reviewed only targeted one stage of care. Additionally, they found that many of these studies would be considered pilot studies and need to be scaled up to regional levels with the help of partnerships and stakeholders for greater impact.

It is promising that advances in information technology programs such as mHealth, as well as the formation of public private partnerships could help drive effective maternal and child health programs, thereby helping to reduce maternal mortality rates and improve both mother and child’s access to quality care.

For further reading please review the article below:

Obasola, O. I., Mabawonku, I., & Lagunju, I. (2015). A review of e-health interventions for maternal and child health in Sub-Saharan Africa. Maternal and Child Health Journal. Doi: 10.1007/s10995-015-1695-0

Other References:

Gazmararian, J., Elon, L., Yang, B., Graham, M., & Parker, R. (2014). Text4baby program: an opportunity to reach underserved pregnant and postpartum women? Maternal & Child Health Journal, 18(1), 223-232. doi:10.1007/s10995-013-1258-1

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