Use of mobile health: awareness of pregnancy danger signs among women in Bagamoyo district, Pwani region Tanzania

Abstract

Introduction: In Tanzania, the maternal mortality ratio is estimated at454 deaths per 100,000 live births (TDHS 2010). In Sub-Saharan Africa 33% of maternal deaths are due to failure or delay in recognition of danger signs (Galjaart, 2008). Women usually learn about potential danger signs through counseling during antenatal visits through the traditional way, either one to one or in groups. D-Tree International working in collaboration with the Ministry of Health, Jhpiego and UNICEF developed and piloted a phone-based electronic tool (mHealth) to assist health workers to deliver a set of very specific maternal guidelines using electronic decision- support running on mobile phones. Objective: The main objective of this study was to assess whether the use of mobile phone application (mHealth) during antenatal visits that emphasizes a complete maternal assessment and counseling about potential danger signs improves the mothers’ awareness of pregnancy danger signs. Methodology: An electronic questionnaire running on the mobile phone was used to assess women's awareness of danger signs from two groups of women in two separate geographical locations in Bagamoyo district, one of the having been exposed to mHealth services. Each group consisted of 164 women attending antenatal or postnatal clinics. Results: All women who received counseling via mHealth were able to mention at least one pregnancy danger sign compared to 149 (90.9%) of women who were not exposed to the intervention. This difference was statistically significant, both in the univariate analysis (Chi-square 16.235, p–value 0.003) as well as in the independent-samples t-test (M=3.74, SD=1.612) and (M=3.35, SD=1.882) for mHealth and control group; t (326) =2.017, p = 0.045. Conclusion and recommendations: Using mHealth increases awareness of pregnancy danger signs and therefore it is recommended that such intervention be scaled up. Further research using larger groups is also recommended in order to explore the potential of mobile phones that have highly penetrated Tanzania, which can be used to deliver health messages.