This article was originally published by IPP Media (Tanzania) here.
By Felister Peter
The use of digital health system in Lake Zone’s Geita region is posed to immensely contribute into reduction of neonatal and maternal mortality, thanks to USAID BoreshaAfya project for increased access to health services, information and improved patient connectivity with skilled health care professionals. The digital health technology is said to transform the way the entire maternal and newborn health services were previously offered following introduction of toll-free mobile phones that have been given to key healthcare providers at all levels.
The phones play a crucial role in linking expectant mothers with skilled health care providers through community health workers (CHW). The CHWs conduct home visits as a complementary strategy to facility based postnatal care (PNC) to increase coverage of care and maternal and newborn survival. Community health workers offer support, education, counseling and process referrals for woman during critical hours of labour pains and days after birth.
A beneficiary of the newly introduced digital health technology, Grace Jeremiah (27) said: “I would have lost my baby and even my life without the help from a community health worker who through the toll-free mobile phone codes managed to make arrangements for transport and treatment at the regional referral hospital. I safely gave birth to my three months son after a successfully surgery”.
Jeremiah from Buchundwankende village in Nyamkumbo ward commended community health workers for the support, maternal education and regular visits to ensure a healthy lifestyle for the benefit of herself and the baby. She said the CHWs had from earlier insisted on her to attend antenatal services at a nearby health center to help doctors to treat and prevent potential health problems.
“I followed all the instructions and attended to antenatal care to ensure that I don’t lose my baby since I have struggled for over five years to conceive. I immediately called the community health workers at early stages of labour pains to put myself in self hands in case of birth complications”, narrated Jeremiah whose plans are to have four children.
Athanas Mbali is the community health workers at Buchundwankende village, said the digital health system is saving the lives of mothers and babies since they can easily request for ambulance and arrange for treatment and process referrals before patient reaches the hospital.
“We are saving lives of expectant mothers and their newborns. We can process referrals and make follow-up on patient development while at the village”, said Mbali as he commends USAID BoreshaAfya project for facilitating communications as well as capacity building trainings.
He said Jeremiah was directly referred to Geita regional hospital as her condition was deteriorating and she had started to develop pregnancy complications including signs of eclampsia, posing threat to her health and that of the baby. Eclampsia is a condition characterized by high blood pressure which may result into unconsciousness.
According to Mbali pregnant women were previously dying or losing their babies due to communications difficulties. He said that there were no prior communications for treatment arrangement before a pregnant woman is referred to the regional referral hospital hence delayed services which posed risk to both, mother and child.
“We were at times forced to make calls at our own cost”, he noted adding most of the villagers in Nyamkumbo ward are now aware of the importance of attending antenatal care as well as giving birth at health centers and hospitals.
Agnes Ndonde is the Assistant In-charge of the Antenatal Labour Ward at Geita referral hospital, commended the digital health system saying it has improved efficiency and contributed to reduction of maternal and infant deaths which were caused by various factors including over bleeding—postpartum hemorrhage (PPH) and Eclampsia. She said the hospital receives between two and five cases of the above mentioned diseases per month.
“With the phones, we can communicate and assist during delivery process to mothers admitted at ward and district level. The service also helps us to do prior treatment arrangement for referred patients before they arrive”, said Ndonde noting the hospital was provided with four mobile phones distributed to various departments.
She linked the decrease in maternal and infant deaths to the trainings provided by USAID BoreshaAfya project to six mentors who are sharing the knowledge to other health care providers through on job trainings.
Ndonde said that in between January and June 2019, there was only one death caused by PPH compared to eight deaths recorded in the same period in the previous year. She said that one pregnant woman died of Eclampsia between January and June this year, compared to three deaths recorded in 2018.
By 2020, the government, through the Health Sector Strategic Plan III 2016-2020 (HSSP IV)) aims to cut down maternal mortality ratio to 292 per 100,000 live births from the current 556 deaths per 100,000 live births.
In the same plan, the government seeks to reduce neonatal mortality rate from 21 to 16 per 1,000 live births and under-five mortality from 54 to 40 per 1,000 live births in the next two years.
Acting Regional Reproductive Health Coordinator, Felister Kimaro said the USAID BoreshaAfya project has enabled the Geita referral hospital to cut down maternal and infant mortality ratio. She said the health facility has also benefited with renovation of its wards as well as various medical equipment including the mobile phones.
“We are grateful to the project since we can comfortably do consultations to ensure safe delivery of babies”, said Kimaro noting the training of trainers in each of the districts has sharpened the skills of many health care providers, hence improved services.
Geita regional acting medical officer, Dr Michael Mashala said the various interventions by the government and USAID BoreshaAfya project have increased community awareness on the importance of antenatal care as a good number of women give birth at hospital and health centers. He said maternal and newborn deaths is no longer a challenge at the hospital as they have managed to reduce maternal mortality rates to less than five per month compared to 30 deaths in the previous years. He said infant deaths have been reduce to three per month from 80 deaths per months in past years.
“The digital health system facilitates communications between skilled health care providers, community health workers and patients. It is now more easy to process referrals and follow-up on patient development”, said Dr Mashala.
USAID BoreshaAfya project coordinator, Dr Venance Frederick outlined some achievements as procurement of various medical equipment for the referral hospital, training of trainers where a good number of mentors had their skills sharpened to train health care providers in all the districts. He said the introduction of on job trainings has helped to improve provision of services to expectant mothers as well as reduction of maternal and newborn mortality rates.
The USAID BoreshaAfya project which is jointly implemented by Jhpiego, Path International and EngenderHealth in western and Lake Zone regions works to improve enabling environment for health service provision, increase access to health services at community level and improving community linkages with the health system.
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