Mobile App Improves Prenatal Care in Nigeria.
A mobile phone app that records client information, recommends treatment approaches, and provides health counseling messages improves the quality of prenatal care provided by community health workers, according to a new study conducted in Nigeria.
The study, published online in the journal PLOS ONE and led by a doctoral student at the School of Public Health who is also a technical advisor for Pathfinder International, found that the use of the app improved both technical care and client health counseling to pregnant women in Nigeria, many of whom receive either no prenatal care or limited care.
Nigeria’s maternal mortality rate is the 10th highest in the world, with low-skilled Community Health Extension Workers (CHEWs) increasingly filling gaps in care at primary health centers.
The app, developed by Pathfinder Nigeria using a platform known as CommCare, allowed health workers to register and retrieve records of clients while also prompting workers to provide services based on prior visits. It contained decision support algorithms covering the main areas of patient services, including screening for pre-eclampsia and management of obstetric danger signs. In cases where blood or other test results were out of normal range, the app generated recommendations for a course of treatment, referral, and follow-up.
The app also provided a series of audio-recorded health counseling messages that were played for clients during visits. Health counseling recordings included topics such as nutrition during pregnancy, use of iron/folic acid, maintaining hygienic practices, birth planning, prevention against malaria, information about immunizations, danger signs during pregnancy, postpartum contraception, HIV, and newborn care.
The use of the app was introduced in 20 primary health centers in northern Nigeria. It prompted improvements in care in a number of areas, including an increase in the provision of HIV tests and blood pressure monitoring, the study says. The highest-quality improvement was in health education, with clients receiving counseling on “key health topics.”
Lead author Marion McNabb, a senior technical advisor at Pathfinder International who is a doctoral student in global health, said that while the study did not assess impacts on health outcomes, such as reductions in maternal mortality, the findings suggest that mobile technology can assist community health extension workers who lack adequate training.
“With a dearth of skilled personnel at the primary health care level, mobile apps can be a help to community health extension workers who might be unable to comprehensively identify and address complications among high-risk women,” she said. “This is a problem not only for Nigeria, but for other countries as well. Mobile technology is increasingly a way to help fill some of the gaps.”
Christopher Gill, an associate professor of global health, was a co-author on the study.
Submitted by: Lisa Chedekel