New innovation case on THINK!: MOTECH

Can information delivered over a mobile phone improve someone’s health? Can it improve the quality of care received in a rural clinic? The Mobile Technology for Community Health (MOTECH) initiative in Ghana is a partnership between Ghana Health Service, Grameen Foundation and Columbia University’s Mailman School of Public Health. Funded by a grant from the Bill & Melinda Gates Foundation, the project aims to determine how to use mobile phones to increase the quantity and quality of prenatal and neonatal care in rural Ghana, with a goal of improving health outcomes for mothers and their newborns. The MOTECH system was launched in July 2010 in the Upper East Region; a replication in Awutu Senya district in Central Region will happen in April 2011. Further opportunities for scale across Ghana will be assessed in the second half of 2011. If successful, it is intended that MOTECH will be launched nationally in Ghana, and that this will become a showcase for replications throughout Africa and the world. The software system used in Ghana is available via OpenSource license and can be used for implementing a wide range of mobile health applications.

MoTeCH seeks to alter this dynamic by enabling the delivery of relevant and actionable information over mobile phones. Pregnant women will register by providing their phone number, the name of the area in which they live, their estimated due date, and their language preference. They will then begin receiving SMS and/or voice messages that provide information about their pregnancy (e.g., milestones in fetal development), the location of the closest health facility, and specific treatments that they should receive during their pregnancy (e.g., tetanus vaccination). Some of the messages the woman receives will be specifically relevant to her history of receiving antenatal care. For example, someone who has not received a tetanus vaccination will receive a message specifically about the importance of tetanus immunization. Services will also be created that allow an expectant mother to send health related questions via SMS and receive an automated response that is relevant to their question. Once her child is born, the mother will receive messages and information about essential vaccinations for her child and how to manage critical childhood illnesses. Specific tools will also be created for Community Health Workers.

A huge amount of energy and effort is currently invested tracking patients and services in a wide range of forms and registers. In close consultation with the Ghana Health Service, a simplified patient register will be established. Information from this register will be entered into MOTECH via the health workers' mobile phone. This will simplify daily record keeping as well as vastly reducing the amount of time currently spent aggregating data for monthly reports. Since antenatal interventions will be recorded using this system, MOTECH will be able to send messages to expectant mothers if they have missed critical antenatal care, health care workers can receive feedback about the number of women in their area who have received proper antenatal care, and administrators in the health system can track the delivery of services across specific geographies.

The MOTECH system helps community health workers to record and track the care delivered to women and newborns in their area. Each rural health facility is equipped with low-end mobile phones on which the MOTECH Java application for health workers is installed. Nurses enter data about patients’ clinic visits into forms on the mobile phone and send this to the MOTECH servers. The MOTECH system then checks patients’ healthcare information against the schedule of treatment recommended by Ghana Health Service for that care event. If the system sees that a patient has missed care that is part of the advised schedule, the Mobile Midwife service sends a message to remind the patient to go to the clinic for that particular service. Meanwhile, the healthcare worker is informed when the patient becomes overdue for treatment so that they can follow up with them and reduce the number of clients defaulting for recommended healthcare. Using the data nurses have submitted to the server, MOTECH also generates many of the monthly reports that facilities are required to submit to their district and regional management offices. Previously these reports had to be compiled by hand; a process that took three to four days. Healthcare workers can also use the MOTECH Nurses’ Application to query the database , enabling them to retrieve lists of patients overdue for care, women due to deliver in the next week, or details about individual clients.

source: http://www.thinkinnovation.org