I N F O C U S

The Potential of m-Health in Maternal and Child Healthcare Delivery

Adequate access to quality maternal and child healthcare services is a challenge for the majority of people living in developing countries. Consequently, over eight million children under the age of five die worldwide, mostly in sub-Saharan Africa. About two thirds of these deaths are preventable and occur from conditions for which effective and affordable treatments and interventions exist. Without increases in the number of qualified health workers and improved access to quality care for patients, reaching the health-related Millennium Development Goals (MDGs) by 2015 will be a difficult task. In June 2011, CEDA-SL and GrACED-SL conducted a consultation with tradicional authorities, community groups, the District Councils and the Ministry of Health/District Health medical Health Teams of both Pujehun and Bonthe Districts. This participatory process helped identified the following specific problems: Reduce access to Basic maternal and child health care services and Weak referral systems for prompt delivery and distribution of free health care drugs and medical equipments to hospitals and peripherals health units (PHUs) as well as timely and appropriate referrals of obstetric cases.

The proposed action is to contribute towards improving the maternal and child health care services for women and children under five years of age in marginalised communities in Pujehun and Bonthe districts in the Southern region of Sierra Leone. The core results of this action will contribute to improving / increasing the availability, utilization and quality of Maternal and Child Health services by using Information and Communication technolgies (ICTs) through Mobile phone-based teleconsultations which helps to improve access to quality health care services at the primary level for patients in PHUs and communities in ten Chiefdoms in Pujehun and Bonthe Districts.

Mobile health, or mHealth, is a sub-segment of the broader field of electronic health (eHealth) that uses mobile phones to enhance the efficiency of service delivery and improve the quality of health care. mHealth tools have shown important promise in addressing a number of current healthcare challenges including: addressing the shortage of skilled health workers, strengthening health information systems; improving timely data collection, diagnosis and disease surveillance; increasing treatment adherence and compliance; better administration of drug inventories and drug supply chain management; and improving case-management among health workers.

Project overview

Country/Regions

Nongoba Bulum, Kwamebai Krim, Setie, Jong and Benducha Chiefdoms in the Bonthe District, and, Yakemo Kpukumo, Kpanga Kabonde, Kpanga Krim, Barri and Mano Sakrim chiefdoms in the Pujehun District. Southern Sierra Leone.

Project objective

Increase access to maternal and child healthcare services by enhancing the referral system in 10 chiefdoms to reduce un- necessary transportation through the use of mobile phone-based telemedicine.

Target groups

26,896 children under five years and 5,844 pregnant women in Pujehun district; 13,820 chldren under five years of age and 2,908 pregnant women in Bonthe district. Also involve are health care providers from 10 PHUs and 2 district hospitals in Pujehun and Bonthe Districts.

Partners

Grassroots Action for Community Empowerment and Development – Sierra Leone, District Health Medical Health Team, Pujehun District, District Health Medical Health Team, Bonthe District

Project support

European Union

Project start Project end

July 2012 June 2015

Maternal and Child Initiative project in Southern Sierra Leone

In an effort to improve access to maternal and child healthcare services for women and children under five years of age in marginalised communities in Pujehun and Bonthe districts in the Southern region of Sierra Leone, the Community Empowerment and Development Agency – Sierra Leone (CEDA-SL), in partnership with the Grassroots Action for Community Empowerment and Development – Sierra Leone (GrACED-SL), the District Health Medical Teams of Pujehun and Bonthe Districts of the Ministry of Health and Sanitation in Sierra Leone, initiated a Maternal and Child Health Initiative Project in Southern Sierra Leone. The objective of the project is to improve access to primary healthcare by using mobile phone-based information and communication technologies (ICTs) to overcome geographical barriers.

During the initial phase of the project:

Stakeholder Meetings: These meetings took place at the Community hall (for Bonthe) and District Council Conference Hall (for Pujehun) with 19 participants (in each district) (Paramount Chiefs – 5 (1 from each chiefdom), DHMT staff -3, District Council staff- 2, Voice of Women/Radio Wanjei-1, Police forces-1, Military forces-1 and CEDA-SL- 4 and GrACED project staff- 2) in August and September, 2012. The key stakeholders meetings in the 2 operational districts were also conducted twice; firstly, to inform them about the success in approval of the award and disbursement of the first tranche of funds from the EU for the implementation of the project, as well as, exposing them to the full content of the envisioned goals and objectives plus the methodologies of the implementation process. The second visit targeted the actual operational chiefdoms, 5 in each district, with similar above objectives and in addition to identify key stakeholders/ participants at that level for the ultimate implementation process for a category of program intervention, i.e. workshops, community mobilizers, health workers etc. The attendees appreciated the meetings.

Recruitment and Orientation of Project Staff: This activity was completed. The following staff were recruited – Programme Coordinators -2 (CEDA-SL-1, GrACED-1), Programme Officer -2 (CEDA-SL-1, GrACED-1), Telemedicine Consultant -1, IEC/BCC Consultant -1, IEC/BCC Assistant- 2, Finance/Admin Manager -1 (CEDA-SL), Assistant Finance Adim/Manager-1 (GrACED-1), M&E Manager -1 (CEDA-SL-1), M&E Officer -2 (CEDA-SL-1, GrACED-1), Assistant M&E Officer -1 (GrACED), and IT Officer -1 (CEDA-SL), Procurement Officer- 1(CEDA-SL), and Driver -6 (CEDA-SL-4, GrACED-2).

Procurement of project equipment: Following the prescribed EU procurement procedure, the following items were procured, 4- 4x4 vehicles, 2-stand by generators, 16-motorbikes, 110-bicycles, 16 desktop computers and accessories, 5-laptops, 2-projectors and screen, 4-digital cameras, 2-photocopiers, 12-solar fixtures and 200 chargers. These items had already been distributed. The procurement of the boat ambulance was delayed pending approval from the EU for two boats (one for each district) instead of one boat as originally indicated in the project document.

Conduction of baseline survey: This was done in August 2012 and the findings are used in the implementation of the project.

WHAT NEXT?

The project’s second phase will begin in January 2013. This phase will involve:

- Launching of project
- Distribution and installation of solar equipment and computers
-Development and distribution of IEC/BCC materials
- Meetings – Steering community
- Training- Computer by Community health officers
- Development of telemedicine software and database
- Training – Health care providers and strengthening of the referral system

I N F O C U S

Launching of the Maternal and Child Health Initiative Project

Following the stakeholders’ meetings, the project implementation started with the Launching of the project on the 6^th and 13^th February, 2013 in Bonthe and Pujehun districts, respectively.

Official handing over of logistic items for project implementation

After the official launching the project, handing over of all logistic items to the DHMT was done through the District Councils of Both Pujehun and Bonthe Districts.

Distribution and installation of solar equipment and computers

Having done the procurement of hardware components in the form of desktop computers and accessories, mobile phones, solar fixtures and chargers to support the implementation of the project in the first six months of the implementation, distribution and installations in the five telemedicine sites in Pujehun district was done from the 18 to 27^th February 2013. For Bonthe district, the same activity was done from the 4^th to 7^th March 2013.

This activity was done with the assistance of technicians from the District Councils and DHMTs of both Districts.

The distribution of other equipment, motorbikes, bicycles etc were also completed.

Information Education and Communication/Behavioural Change Communication activities