The role of m-health in providing antenatal care in rural areas

Abstract

INTRODUCTIONGlobally about 800 women die every day of preventable causes related to pregnancy and childbirth and 20 % of such deaths are from India. It is estimated that per year, 55,000 women die due to preventable pregnancy-related causes in India.1 The United Nations' Millennium Development Goal (MDG5) was to reduce maternal mortality rate (MMR) by 75% between 1990 and 2015. 2 In order to achieve these goals and accelerate their progress, newer strategies like m-Health are required. India faces several challenges in meeting the needs of pregnant women, particularly those related to complications of pregnancy and obstetric emergencies. Besides medical causes, other factors that may contribute to maternal deaths are delay in care-seeking due to delay in identifying the complication, deciding to seek care, transportation to a health facility, and delay in receiving appropriate treatment.3 Mobile health (m-Health) denotes using small portable and wireless communication devices like mobile phones, personal digital assistants, based on web applications to facilitate the health needs of health care providers and consumers. The basic idea of m-health application for expectant mothers is that community health workers collect data about pregnant women and send to a specialist. The specialist views the patient information and provides feedback to the mobile of community health worker.4 It works as a good support system and is operated by rural health workers to improve point of care diagnostic support. It is also useful for screening of patients who need specialist care and to provide advice for routine cases. ABSTRACT Background:The maternal mortality rate is high in India and many deaths are due to preventable causes related to pregnancy. Mobile-health is an innovative strategy wherein, mobile phones are used for pregnancy tracking and giving support during the antenatal period. Aims and objectives of the study was to know the role of m-Health in providing antenatal care in rural areas. Methods: This was a prospective, comparative study carried out at Kamineni Hospital, LB Nagar, Hyderabad and the Primary Health Centres (PHC) of Uppal and Narapally, Ranga Reddy district over a period of one year nine months and consisted of 204 registered antenatal cases divided into study and control groups. Both groups received routine antenatal support and the study group, in addition received mobile health support also. Various parameters were compared in both the groups. Results: The study group had more antenatal visits, better correction of anemia, less number of patients who were lost to follow-up, and more number of Caesarean deliveries. Conclusions: Mobile health helps in pregnancy tracking and increasing the antenatal visits. It helps in timely referrals for high-risk pregnancies in remote areas and it has the potential to provide obstetric care and consultations to both low risk and at-risk women in rural areas where specialist care is not always available.

Experiences of midwives and community health workers using mHealth to improve services to pregnant women in rural Burkina Faso, Africa

“…[3,4] Despite the type of mhealth applications such as appointment reminders, client education, provider-to-provider communication, etc., [5] evidence exists that these interventions improve antenatal care (ANC) attendance, increase utilization of oral contraception, [6] promote the choice of delivery by a skilled birth attendant thereby reducing home deliveries, [7][8][9] and permit early detection and timely referral of high-risk pregnancies in remote areas. [10] The majority of mhealth studies tend to report on the reproductive health outcomes or the efficacy of these interventions; [11] however, the experiences of community health workers (CHWs) and midwives using these applications are key to increasing the uptake of mhealth services. Findings have shown that there is high acceptance of mhealth among CHWs as it is perceived as superior to their traditional method of care delivery, in the best interest of their communities, and more aligned with future trends in health systems.…”

A cluster randomized controlled trial of an electronic decision-support system to enhance antenatal care services in pregnancy at primary healthcare level in Telangana, India: trial protocol

“…This paper describes the protocol for a cluster-randomized controlled trial to evaluate the effectiveness of an mHealth intervention (i.e., the mIRA EDSS) in enhancing the quality of ANC and improving the screening and management of PIH, GDM, and anaemia, in rural primary healthcare settings in India. To the best of our knowledge, only a few mHealth interventions in India have been tested for improving maternal and child health outcomes [ 22 – 26 ]. Of these, the two mHealth interventions [ 24 , 25 ] that involved a clinical decision-support system only targeted community health workers who worked primarily at the SC level and were responsible for referring pregnant women to the PHC.…”

Receiving antenatal care via mobile clinic: Lived experiences of Jordanian mothers

“…This type of intervention can effectively refer high-risk pregnancies in remote areas and provide timely recommendations. One significant benefit of mobile clinics is the increased convenience they offer women and their families, as they reduce travel time and distance [ 6 ] . The study suggests that mobile clinics have the potential to offer obstetric care and consultations to both low-risk and at-risk women in rural areas with limited resources, where specialist care may not always be available.…”