Impact of Technology for Maternal and Child Health intervention on health services utilization and continuum of care in Northern Ghana: a quasi-experimental study

Abstract

Maternal and child mortality are of public health concern. Most of these deaths occur in rural communities of developing countries. Technology for maternal and child health (T4MCH) is an intervention introduced to increase Maternal and Child Health (MCH) services utilization and continuum of care in some health facilities across Ghana. The objective of this study was to assess the impact of T4MCH intervention on MCH services utilization and continuum of care in the Sawla-Tuna-Kalba District in the Savannah Region of Ghana. A quasi-experimental study with a retrospective review of records of MCH services of women who attended antenatal services in some selected health centers in the Bole (comparison district) and Sawla-Tuna-Kalba (intervention district) of the Savannah region, Ghana. In total 469 records were reviewed, 263 in Bole and 206 in Sawla-Tuna-Kalba. A multivariable modified Poisson and logistic regression with augmented inverse-probability weighted regression adjustment based on propensity scores were used to quantify the impact of the intervention on service utilization and continuum of care. The implementation of T4MCH intervention increased antenatal care attendance, facility delivery, postnatal care and continuum of care by 18 percentage points (ppts) [95% CI: -17.0; 52.0], 14ppts [95% CI: 6.0%; 21.0%], 27ppts [95% CI: 15.0; 26.0] and 15.0ppts [95% CI: 8.0; 23.0] respectively compared to the control districts. The study showed that T4MCH intervention improved antenatal care, skilled delivery, postnatal services utilization, and continuum of care in health facilities in the intervention district. The intervention is recommended for a scale-up in other rural areas of Northern Ghana and the West-African sub-region.

Mapping the Role of Digital Health Interventions to Enhance Effective Coverage of Antenatal Care: A Scoping Review

“…Out of 27 studies that were included, 15 (56%) of them were conducted in Africa, [23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] nine were from Asia, 33,[38][39][40][41][42][43][44][45] two were from South America, 46,47 and one Australia/Oceania. 48 The other six studies were from six countries, Zanzibar, Nigeria, Samoa, Guinea, Bangladesh, and Myanmar, each contributing one.…”

“…Of the 27 studies, 22 (81%) addressed client education and behavior change communication. 23,[26][27][28][29][31][32][33][34][35][36][37][38][41][42][43][44][45][46][47][48]50 Most of the studies were assigned to more than one category: Registries/vital event tracking (n=11), [24][25][26][27]30,35,[39][40][41]43,51 data collection and reporting (n=6), 24,27,28,32,38,40 Provider to provider communication (n=2), 34,35 electronic decision support (information, protocols, algorithms, checklists) (n=5), 24,27,[39][40][41] provider work planning and scheduling (n = 2). 26,40 The results of the classification are illustrat...…”

“…Short message service (n=16), 23,[27][28][29]31,32,35,37,38,[41][42][43][44]47,51 mobile midwife technology (n=1), 33 mHealth intervention (voice message (n=1)) 50 and Mobile phone voucher component, 34 RapidSMS system 32 were among the digital interventions used for client education and behavior change communication. Some studies used multifaceted interventions.…”

“…A total of 23 studies assessed the effectiveness of digital health interventions on the number of antenatal care visits. Fifteen studies 23,[27][28][29]31,32,34,37,38,[41][42][43][44][45]47,51 treated the topic of antenatal follow-up reminders in improving ANC attendance. Based on the World Health Organization guideline, 6 the reviewed studies are summarized in the following core packages of ANC interventions.…”

“…Most studies [27][28][29][31][32][33][34][35]37,38,[41][42][43][44][45]47,51 reported that digital interventions had a role in improved client education and behavior change communication.…”