February 11, 2011
Ellen Yiadom is Grameen Foundation’s Africa Legal Fellow. She graduated from the University of Virginia School of Law in May 2010 and is a recipient of Dewey & LeBoeuf’s Community Service Fellowship.
Last November, I visited Grameen Foundation’s Mobile Technology for Community Health project (MOTECH) in Ghana. The project covers 15 health facilities in Kassena-Nankana, a district in the Upper East Region that is only a few miles from Ghana’s northern border with Burkina Faso. I was there to observe the operations of the project and help the field staff update patient care information.
We flew into Tamale, the capital of the Northern Region of Ghana, and drove two hours to Navrongo, which became my base for this trip. As we drove from Tamale to Navrongo, I was impressed by the lushness and serenity of the natural landscape, which was a contrast to the bustle of Accra, Ghana’s capital, where I was born.
Although there was very little human activity along the road, small towns would spring up along the way and the road would quickly become populated with people on bicycles, motorbikes and even an occasional donkey. These small vehicles often included several passengers. I even saw very small children riding behind or in front of their parents seemingly without fear.
Upon arriving in Navrongo, I visited a health facility in Kurugu, a sub-district in Kassena-Nankana, to help update patient care information in the MOTECH system that provides customized health information to pregnant women through mobile phones.
One key service is Mobile Midwife, which provides weekly phone calls and text messages to women about prenatal and postnatal care. After registering for the service, pregnant women receive information tailored to their stage of pregnancy, while women with newborns receive vital information during the baby’s first year of life. For example, if a woman is six weeks pregnant, she would receive information about what to expect during her first trimester. Additionally, the messages encourage the women to visit the nearest health facility throughout their pregnancy and give them tips on staying healthy during their pregnancy. Because Mobile Midwife is run through an Interactive Voice Response Server, women can call in to listen to any messages they may have missed. There’s also a call center where women can ask questions about technical issues such as the alerts and messages they are receiving; staff in the field also go out to meet with women who are more comfortable speaking in person than over the phone.
As the women come in for their health check-ups and their immunizations, the nurses keep records of this information by entering it into the mobile phones they received as part of the MOTECH project. This enables women who are registered with MOTECH to receive automatic notifications about any immunizations they need. The nurses can also enter information about upcoming appointments and the server will send automatic reminders to pregnant and new mothers. Of course, if the patient care information is not entered, or entered incorrectly, then the women will receive inaccurate alerts and reminders, so it’s very important for the nurses to update in a timely, accurate way.
During my time in Navrongo I visited other health facilities and was able to meet some of the participants in Mobile Midwife. One of them was Cecelia Ayebe, who had given birth the week before we arrived. She showed us her beautiful baby girl, who looked quite big and healthy for a one-week-old. When asked about the main difference between this pregnancy (her second) and her first, she explained that she became more informed and proactive about her care after listening to the Mobile Midwife messages. For example, she learned that she had to visit the nearest health facility when she experienced certain pains. Consequently after experiencing pains in her womb she visited the nearest health facility and learned that her baby was not positioned well. In her local culture, women are often discouraged from visiting a health facility when they are experiencing pain during their pregnancy. Without the information from Mobile Midwife, she might have ignored the pain, and possibly hurt her baby.
Despite having almost no formal education, the other women I met during my time in Navrongo were dedicated to improving the health of their families – just like Cecilia. MOTECH offers them the information they need to have a healthy pregnancy and baby.