mHealth for mothers and babies seems still not proven
Between 1990 and 2010, globally the under-five mortality rate fell by 28% instead of 67% target. Neonatal mortality accounts for 41% of the under-five mortality rate and has a drag on its slow reduction.
Improving Africa’s mother and baby mortality remain high priorities. Many programmes to reduce rates from Africa’s averages of about 430 per 100,000 and 70 per 1,000 respectively, often see mHealth as part of the solution. A review of the impact of 19 mHealth services in Low and Middle-Income Countries (LMICs) published in the Journal of Medical Internet Research (JMIR) by a team from the Ghana, Tanzania, The Netherlands and Norway identified potential, and also “A gap in the knowledge whether mHealth interventions directly affect maternal and neonatal outcomes.” It seems these mHealth interventions are not yet proven.
Ten mHealth interventions and nine descriptive studies comprised the review. mHealth interventions were used as communication, data collection, or educational tool by healthcare providers, mainly at in community services for antenatal, delivery, and postnatal care. Interventions were used to track pregnant women to improve antenatal and delivery care and facilitate referrals. None of the studies directly assessed the effect of mHealth on maternal and neonatal mortality. The lack of evidence points to the need for more research with experimental designs with relevant outcome measures that plug the gap.
Several technical problems were included in the individual reviews. They include limited connectivity and electricity supplies and mobile phone maintenance services.
mHealth was found to be much more efficient when it’s used for communication compared to traditional methods. It also improves community health services’ effectiveness in logistics, reporting events and responding to emergencies. It also enables integration of health workers to expedite emergency referrals and communicate with skilled providers like midwives.
Limitations included over-simplified SMSs, so needing more detailed information. Educational information on web-sites is often limited due to remoteness and either no or poor Internet access.
mHealth interventions that depend on existing information systems are not interoperable, and can’t link to other settings and data structures.
The findings don’t mean that Africa’s health systems should stop or abandon their mHealth services for mothers and babies. It does mean that they should scrutinise them rigorously to focus them to their planned health outcomes and develop rigorous business cases for new mHealth projects.