Entry to high quality maternity care is essential to decreasing maternal mortality and morbidity and assembly the Sustainable Improvement Objectives, however boundaries to entry stay in lots of contexts, together with rural communities in Nigeria. On this weblog submit, an creator new paper inside BMC Pregnancy and Birth Discusses the event and implications of Text4Life, a cellular phone-based intervention to extend entry to expert maternity look after pregnant girls in rural Nigeria.
Text4Life design and operation
Motive
In sub-Saharan Africa, maternal and little one well being initiatives are adopting using digital or cellular know-how to enhance entry to and entry to high quality obstetric care, notably amongst marginalized and weak populations. These initiatives have been proven to achieve success in rising using healthcare services by pregnant girls, enhancing two-way communication between healthcare professionals and pregnant girls, and rising girls’s self-efficacy by means of the dissemination of related well being info.
The analysis workforce on the Girls’s Well being and Motion Analysis Middle in Nigeria (WHARC), led by Professor Friday Okonofua, began formatively in collaboration with nationwide and worldwide companions and with funding from the Worldwide Improvement Analysis Middle (IDRC) and the West African Well being Group. Intervention and apply analysis in 2017 to establish improvements and proof for enhancing girls’s entry to high quality maternity care in rural Major Care Facilities (PHCs). Throughout formative work, we decided that transportation was a serious barrier for pregnant girls to entry accessible ASMs.
Quite a few qualitative research of girls, males, and neighborhood leaders have revealed that ladies resort to conventional strategies of being pregnant care because of lack of transportation to succeed in healthcare services, particularly when labor or problems start at night time. This has been probably the most necessary the reason why pregnant girls favor to make use of the unskilled conventional obstetricians (TBAs) closest to them.
The Text4Life intervention was carried out for about 24 months and produced spectacular outcomes with no documented maternal dying.
In response to this problem, the workforce designed a variety of interventions to beat this hurdle, utilizing community-based participatory analysis methods, in collaboration with girls, neighborhood leaders and policymakers. Text4Life, a RapidSMS system, was developed to answer the difficulties confronted by girls with being pregnant problems in accessing ASMs.
How does it work
Text4Life is designed to supply two-way communication between girls, main care suppliers and transport homeowners. A pregnant girl could expertise bleeding, regular or irregular supply, extreme stomach ache, and so on. When it experiences problems and there’s no entry, it prompts the warning system by sending a code from the pre-registered telephone quantity to a central server linked to it. to all Nigerian telecommunications networks. It initiates the alert itself or is assisted by another person.
When the alarm goes off, the Chairman of the Ward Improvement Committee (WDC), established to register pregnant girls locally the place the girl resides, picks up the alarm and locates it. WDC is an initiative of the Nigerian Federal Ministry of Well being to strengthen neighborhood ties and partnerships for the administration of ASMs. On the similar time, the closest well being employee to the ASM receives the warning and begins preparations to obtain the girl. The WDC chair will then contact one of many licensed and pre-registered movers (taxi homeowners) locally who will go to the girl’s dwelling and take her to the well being middle. Text4Life features a reverse billing approach that sends a free warning message.
Text4Life runs on a steady energy provide with a central server and an internet site linked to the web. The system helps to watch pregnancies through the prenatal, supply and postpartum levels in addition to a platform for registering new pregnancies.
A collection of capability constructing workshops had been held on the mission websites for WDCs, main care suppliers, pregnant girls (and their spouses or caregivers) and feminine volunteers to construct capability amongst neighborhood stakeholders to handle the system. The coaching included a proof of attainable being pregnant problems for which girls would require emergency transplant. It was additionally demonstrated how you can ahead messages and interpret responses from the central server.
This intervention holds sturdy promise for enhancing entry to expert maternity care, decreasing delays because of lack of transport, and decreasing maternal mortality.
Well being professionals had been instructed on particular actions to soak up response to emergencies similar to main care, triage and referral to secondary care hospitals as wanted, in addition to getting ready to just accept girls. Following the completion of the coaching, cell phones got to main well being care suppliers and WDC presidents. Throughout prenatal care visits, main care suppliers additionally confirmed girls how you can use the Text4Life app.
Text4Life’s outcomes and different purposes
as reported in our information new paperThe Text4Life intervention was carried out for about 24 months and produced spectacular outcomes with no documented maternal deaths in rural communities. The United Nations Inhabitants Motion Fund (UNFPA) Nigeria workplace is at the moment operating a response to 320 communities in 9 Nigerian states and the Abuja Federal Capital Territory to report circumstances of gender-based violence (GBV) by girls, utilizing the Text4Life strategy. , COVID-19, household planning wants and undesirable pregnancies.
Girls experiencing GBV and different problems can write a code to a central server by way of their cell phones. Messages are then forwarded to close by skilled healthcare suppliers and civil society officers who’re anticipated to supply healthcare and social administration to distressed callers. The findings present that the server obtained a complete of three,200 studies over a 22-month interval, and the information is at the moment being analyzed to find out administration’s outcomes.
Resolution
The event of the Text4Life app demonstrates the potential of a fast textual content message despatched from a cell phone to a central server and linked with neighborhood managers, transport suppliers and healthcare suppliers to extend entry to expert emergency obstetrics providers for pregnant girls in rural Nigeria. The findings recommend that the intervention is possible and sustainable, particularly when carried out with the energetic participation and possession of neighborhood members. We imagine this intervention holds sturdy promise for enhancing entry to high quality maternity care, decreasing delays because of lack of transport, and decreasing maternal mortality in rural Nigeria and different sub-Saharan African international locations.
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