How Icts improve quality of maternal/newborn care in low/middle-income countries
The Evidence for Action (E4A/MamaYe) programme has released a structured literature review of how information and communications technologies (ICTs) /mobile technology have been used in low and middle-income countries for monitoring and improving the quality of maternal and newborn health care in general, as well as in the context of vital event registration and/or maternal death reviews.
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This is the first in the Evidence for Action Literature Review Series that are peer-reviewed by experts in maternal and newborn health.
The review examined a total of 24 projects.
The findings from these projects have been presented in four thematic areas: Data management, point of care support, training and dissemination of knowledge to healthcare workers (e.g. latest research and guidelines), and communication and networking.
With the rapidly rising use of ICTs globally, particularly mobile phones, there has been growing momentum to use these technologies for the improvement of maternal and newborn health.
Studies by the World Health Organisation (WHO) and Lancet have indicated that every year, an estimated 289,000 women die globally from pregnancy- related causes, 2.6 million babies are stillborn and 2.9 million babies die within one month of birth.
Most of these deaths take place in low and middle-income countries (LMICS).
For those who access a health facility, one of the key determinants of death is the poor quality of maternal and newborn health care. Nevertheless, in most LMICs, the focus has been on quantity rather than quality of services.
There has been growing momentum to use ICTs for the improvement of women and children’s health.
The Commission on Information and Accountability for Women and Children’s Health (CoIA) is championing the integration of ICTs into health information systems and health infrastructure.
Moreover, CoIA’s 2014 progress report indicates that in all the countries with strategies on eHealth (the use of ICT for health), half of the initiatives are in the area of women and children’s health.
With the rise in use of mobile phones in developing countries - mobile cellular penetration rates in developing countries was expected to reach 90 per cent by the end of 2019 - it is no wonder that there is a drive to using ICT or mobile technologies for health.
Thus this study sought to bring together both the call for quality maternal and newborn health care and the use of ICTs for health by mapping out how ICTs have been deployed to improve the quality of maternal and newborn health care in LMICS.
In doing so, the mapping focused on the use of ICT/mobile technology for the monitoring and improvement of the quality of care in general, as well as more specifically the use of ICT/mobile technology in the context of vital event registration and/or maternal death reviews.
Data collection and management
ICT has been used for a variety of purposes in the context of maternal and newborn health care.
Literature reviews published by the mHealth Alliance and the Maternal and Child Health Journal have found that ICT, specifically mobile technologies such as mobile phones and other wireless technologies, have been used for data collection and management, appointment reminders, point of care support, the dissemination of education, and emergency obstetric referrals .
The study highlighted the potential in using ICT to improve and monitor the quality of maternal and newborn health care in LMICs, notably in the areas of data management, that is the collection, transmission, and analysis of information to help facilitate the monitoring of services and/or patients, logistics, vital event registration, and conducting verbal autopsies, point of care support to improve clinical performance of health workers by assisting decision making and diagnosis, training and dissemination of knowledge, that is improving the practice of health workers by providing them with training and disseminating latest research and guidelines on best practices and communication and networking, that is improving the communication between healthcare workers and health facilities, patients or other healthcare workers.
Monitoring
The study found that technology could have greater impact in improving and monitoring the quality of maternal and newborn care if healthcare policy makers can ensure the deployment of technology that can be installed and maintained locally; deploy low-cost devices and infrastructure that can be integrated within the health system; and finally, ensure the buy-in and commitment of key stakeholders including private sector players such as telecommunication and pharmaceutical companies.
It indicates that the future for ICT for quality of care is promising; however it must be complemented by other inputs such as adequate infrastructure and equipment and human resources.
(The full report can be assessed on www.mamaye.org.gh)
