Toll free mobile communication: overcoming barriers in maternal and neonatal emergencies in Rural Bangladesh

Abstract

BackgroundToll free mobile telephone intervention to support mothers in pregnancy and delivery period was tested in one sub district of Bangladesh. Qualitative research was conducted to measure the changes of mobile phone use in increasing communication for maternal and neonatal complications.MethodsIn-depth interviews were conducted among twelve Community Skilled Birth Attendants and fourteen mothers along with their husbands prior to intervention. At intervention end, six Community Skilled Birth Attendants were purposively selected for in-depth interview. Semi structured interviews were conducted among all 27 Community Skilled Birth Attendants engaged in the intervention. One Focus Group Discussion was conducted with 10 recently delivered mothers. Thematic analysis and triangulation of different responses were conducted.ResultsPrior to intervention, Community Skilled Birth Attendants reported that mobile communication was not a norm. It was also revealed that poor mothers had poor accessibility to mobile services. Mothers, who communicated through mobile phone with providers noted irritability from Community Skilled Birth Attendants and sometimes found phones switched off. At the end of the project, 85% of mothers who had attended orientation sessions of the intervention communicated with Community Skilled Birth Attendants through mobile phones during maternal health complications. Once a complication is reported or anticipated over phone, Community Skilled Birth Attendants either made a prompt visit to mothers or advised for direct referral. More than 80% Community Skilled Birth Attendants communicated with Solution Linked Group for guidance on maternal health management. Prior to intervention, Solution Linked Group was not used to receive phone call from Community Skilled Birth Attendants. Community Skilled Birth Attendants were valued by the mothers. Mothers viewed that Community Skilled Birth Attendants are becoming confident in managing complication due to communication with Solution Linked Group.ConclusionsThe use of mobile technology in this intervention took a leap from simply rendering information to providing more rapid services. Active participation of service providers along with mothers’ accessibility motivated both the service providers and mothers to communicate through mobile phone for maternal health issues. These altogether made the shift towards adoption of an innovation.

Health Worker mHealth Utilization

“…Seven articles studied communication between a health worker and patients, with the emphasis on improving health worker efficiency by saving travel time and gaining work time 11,12,22,25–28 . Texts focused on increasing access to skilled attendants at birth 26 , patient medication adherence 22,25 , appointment reminders 22,26 , and tracking patients 11,12 .…”

“…Twelve articles studied communication between health workers 12,22–24,28–35 . Communication by mobile phone was highly acceptable to health workers 30–32 .…”

“…In addition to improving patient health outcomes, text message reminders facilitated an adherence to protocols, which had not been previously followed 29,35 . Another found Traditional Birth Attendants increased their skills and confidence using mobile phones to access information via mobile phone on managing birth complications 28 .…”

Mobile Health Application in Implementation of Maternity Nursing Care: Literature Review

“…Almost all of the study show that mobile health application help mother and father to enhance health status on her pregnancy especially for working mom (Chaves et al, 2017;Premji, 2014;Jennings et al, 2016;Obasola, Mabawonku, & Lagunju, 2015;Felicie et al, 2016;Ledford et al, 2016;Mcnabb et al, 2015, Waring et al, 2014Spiby et al, 2014, Asiodu et al, 2015Rhyne & Borawski, 2014;Guerra-reyes et al, 2017;Smith) . Inline with previous study from Western countries, the 7 studies from non-Western countries including Africa, India, Bangladesh, Australia found that mobile health can give positive impact for pregnant mom Balakrishnan et al, 2016;Forti, Stapleton, & Kildea, 2013;Huq, Azmi, Quaiyum, & Hossain, 2014;Khatun et al, 2015;Lupton & Pedersen, 2016;Khatun et al, 2017). In Indonesia, several studies have been conducted about this topic and its show that utilizitation of mobile health as health promotion media still in progress (Santoso, 2017;Probandari, Arcita, Kothijah, & Pamungkasari, 2017 …”

“…The use of mobile health as one of the effective solutions recommended by the WHO in the healthcare process continues to grow (Balakrishnan et al, 2016;Forti, Stapleton, & Kildea, 2013;Huq, Azmi, Quaiyum, & Hossain, 2014;Santoso et al 2017). The process of health care includes the exchange of information, communication and consultation using smart phones owned by the majority of the population in various countries (Ayiasi et al, 2016;Khatun et al, 2015;Vital Wave Consulting, 2010).…”