ACCRA, Ghana — On the porch of a small clinic at the end of a dusty road, a group of women are gathered and waiting for their individual appointments. Some are pregnant, others are nursing babies, but all have been reminded about their visits by a mobile phone service called Mobile Midwife.
In sub-Saharan Africa, maternal health has long been a serious issue and risky undertaking. While one in 8,000 mothers in the U.K. dies in childbirth, about one in 22 women dies during pregnancy or childbirth in this region. According to the World Health Organization (WHO), childbirth and pregnancy in central African countries kill more women than in any other region in the world.
While many factors contribute to poor maternal health in Africa, it can be largely attributed to lack of access to proper health care and a delay in receiving treatment.
Rural areas in particular often experience greater difficulties with access to maternal health care, often due to a lack of transportation, expense, limited staff and supplies in health centers and inability to recognize an emergency. Due to these complications, getting women into health centers for health care appointments is often difficult.
Many women only receive one prenatal appointment throughout their pregnancy, and have superstitions about certain aspects of pregnancy, including the “Evil Eye.” In many cases, women have the date written down for their appointment, and then easily forget about it because they are illiterate, explains community health officer Alice Grant-Yamoah.
Mobile Midwife is a collaborative project between the Grameen Foundation and the Ghana Health service and part of the Ghana mobile technology for community health Initiative (Motech Ghana) that aims to provide tips for healthy pregnancies.
The project began in 2009. The application delivers customized information on a variety of pregnancy tips, such as healthy eating, treatment, vaccinations and labor services. Mothers and their families can choose to receive weekly, time accurate information in the form of voice messages or SMS alerts.
For many women, Mobile Midwife provides information that they would not otherwise have access to. Cynthia Larbie, pregnant with her second child, explained in an interview with BBC that the application taught her valuable information that she had not learned in her first pregnancy.
“When I was pregnant for the first time, I would have enemas, which are supposed to be good for you and your baby,” Larbie said. “But listening to messages from Mobile Midwife, I learned that they can cause your baby to be aborted.”
In Ghana, there are more mobile phone lines than there are people. Thus, using cellphone technology to connect women to health care facilities has been an effective approach. Each woman is assigned a unique number when she signs up for the service. She is then sent updates from a nurse or community health officer following each appointment.
As health centers release the data to women who sign up for the service, they are able to gather a group of maternal data for the region and look at those who are due for care.
In recent years, maternal health has improved dramatically, and in many ways, Mobile Midwife has helped to spur that effort. The maternal mortality rate in Ghana declined by 49 percent between 1990 and 2013, marking a significant improvement.
Still, reaching rural communities and areas without good service remains an obstacle for certain regions, but Mobile Midwife is used in seven districts across Ghana. A desktop application is available for health care providers to enter large amounts of data, and an app has been developed for use on Android Smartphones.
“Mobile Midwife is a great help to me,” said Regina, a pregnant woman in a small village in Ghana after listening to her first message from Mobile Midwife. “I can’t wait to listen to more messages and share them with my husband.”
– Julia Thomas