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Safe Motherhood: Mobile healthcare in the Philippines

In today’s installment of our special Digital Diversity series, Irma F. Saligumba – Health Research and Projects Coordinator at Molave Development Foundation – talks about a project in the Philippines which aims to reduce mother and infant mortality rates, and provide education and support to expectant mothers, all through their mobile phones.

Digital Diversity is a series of blog posts about how mobile phones are being used throughout the world to improve, enrich, and empower billions of lives.

The Mobile e-health System for Safe Motherhood Program is a research project of Molave Development Foundation, Inc. (MDFI), a not-for-profit organization based in the Philippines. The program aims to reduce maternal mortality by using text messaging to inform and educate pregnant mothers.

It is funded by International Development Research Center (IDRC) Canada under Pan-Asian Collaboration for e-Health Adoption and Application (PANACeA) Network Research Initiative. Irma F. Saligumba is MDFI’s Health Research and Projects Coordinator and PANACeA Network Lead Researcher.

By Irma F. Saligumba

“Ma’am, I already gave birth. Thank you for the messages you sent”. This was the SMS message I received from Meriam. She is one of the 100 pregnant women who registered in November 2010 for the pilot implementation of the Mobile e-health System for Safe Motherhood Program, run by Molave Development Foundation Inc.

This program aims to support the Philippine Government in reaching towards the United Nation’s Millennium Development Goals to reduce maternal mortality ratio by three quarters by 2015.

One of the participants in the "Mobile e-Health System for Safe Motherhood Project". Photo credit: MDFI

As the Health Research and Projects Coordinator of Molave Development Foundation, Inc., I spearheaded a study on the effectiveness of using mobile phones to reach out to pregnant women to improve their maternal health.

We chose the town of Roxas, located on Mindoro Island about 400 kilometers south of Manila, for the research. Its population is about 50,000 spread across 20 villages; its Health Center has 2 physicians, 1 nurse and 8 midwives. To supplement the lack of health staff, there are 140 village health volunteers (VHV) who are trained to do most of the legwork for the midwives, and disseminate information on primary health care, maternal and child health, family planning and nutrition.

I was introduced to Meriam during a visit to her upland village. Like most of the mothers in our program, Meriam is in her mid-20′s, has some years of high school education, is unemployed, and her husband doesn’t have a regular job. Subsistence farming provides additional income, and their average monthly salary is about $150. The only means of telecommunication in their area is through mobile phones. She shares one with her husband.

In the Philippines, where nearly 40% of the population lives below the poverty line, the equity gap is stark and wide. However, the ownership of a mobile phone is one of the few things that has crossed the income divide, making telecommunication relatively affordable and more accessible in this country of 7,100 islands. There are 70 million Filipinos who have mobile phones, compared to only 7 million installed fixed phone lines.

This is the basis for developing a program that uses text messaging to inform and educate pregnant mothers on safe motherhood. Aside from its mass appeal, mobile phones provide the advantage of two-way communication. Mothers are not just passive participants receiving information, but can also ask questions or communicate their concerns if they need to.

We are using FrontlineSMS as our communications platform because it is easy to use for health workers’ with low technical know-how, it works without an Internet connection and provides a way to send SMS through pre-paid SIM cards, thus making it a low cost option. It is also vitally important that the software allows for data storage, and we have created a database of the mothers and the health workers on our on-site computer.

 

 

 

Prior to implementing our pilot project, we conducted various training sessions for the Health Center staff. First we provided a Basic PC Literacy Course which covered use of mouse and keyboard, familiarization with computer symbols and commands, basic computing using word processing and spreadsheets, and how to use the Internet. When they gained sufficient confidence, we then moved on to training basic FrontlineSMS skills (for the PC and mobile phone) to show staff how to use key functionality. Five health personnel were also trained on advanced FrontlineSMS, including administration, management and troubleshooting.

 

 

 

 

 

 

 

 

 

 

Rural Health Midwives getting trained in advanced FrontlineSMS administration. Photo credit: MDFI

 

 

 

 

 

 

 

 

 

 

Meanwhile, village health volunteers were trained on how to use the mobile phone for data entry of pre- and post-natal registration, in order to register pregnant women and new mothers in the program.

With the system in place, we started sending out the messages to participants who had already registered during pre-natal checkups at the Health Center. We also worked to reach out to new pregnant women. Posters and brochures were distributed giving instructions on how to register, by sending in an SMS.

Every day for three months, these women received messages on introduction to safe pregnancy and delivery, baby’s phases of development, tips on preparing for labor, common pregnancy problems, benefits of facility-based childbirth, breastfeeding, neonatal care, and child immunization. Through this program we sent a total number of 11,100 text messages or 111 for each of the 100 women registered.

As we hoped, we received messages back from the mothers. Some expressed appreciation for the messages. Others raised serious questions regarding their pregnancy. An expectant mother named Jane inquired if using the computer is bad for the baby. Jocelyn asked what she should be feeling if the baby is due for birth. At 7-months pregnant, Rebecca wanted to know if it is normal to have swollen and painful vagina.

These questions were forwarded to their respective midwives for advice because they were better aware of their patients’ pregnancy status. The midwife’s response was sent by the system to the mother. In the case of Rebecca, she was advised to go to the hospital for evaluation. She even went as far as Manila to have better care, and she ended up staying there until she gave birth because her condition was too serious for traveling.

We are now looking into expanding the Safe Motherhood Program in other parts of the country. Our initial assessment shows that the program has influenced the parent’s decision to use a health facility instead of their home for childbirth. The system also facilitated the prompt recording of new pregnant women and post-natal reporting. This data helps midwives prepare and plan for the pre- and post-natal care activities in the village. This more efficient and interactive information management system can ultimately contribute to improved maternal care, and thus decreased mortality levels.

Mothers involved say they will recommend the Safe Motherhood Program to others. They feel assured that someone is concerned about their welfare and that there is someone they can go to if they have questions. This gives them a feeling that they are important because someone cares, and that feeling of being important strengthens their desire to take care of not only their health, but also their babies.

Irma F. Saligumba has been the Health Research and Projects Coordinator of Molave Development Foundation, Inc. since 2007, and is Lead Researcher of Pan-Asian Collaboration for evidence-based e-Health Adoption and Application (PANACeA) Network with member countries in Central, South and Southeast Asia.

 

Prior to her involvement at MDFI, she spent 4 years in Attapeu, Laos as provincial health trainer of Health Unlimited. She also served as Training Specialist for 4 years at Philippine Rural Reconstruction Movement focusing on leadership-building, gender and development, and advocacy. She is a registered nurse and earned her masters in Public Health at the University of the Philippines.

Digital Diversity is produced by Ken Banks, innovator, anthropologist, National Geographic Emerging Explorer and Founder of kiwanja.net / FrontlineSMS. He shares exciting stories in Mobile Message about how mobile phones – and technology more broadly – is being used throughout the world to improve, enrich, and empower billions of lives. You can read all the posts in this series, visit his website, or follow him on Twitter.

Comments

  1. denverrifiume
    Croatia
    February 23, 2012, 11:38 am

    I’m newbie and a new user in this forum, but I hope to help and be helped by others. :)

  2. [...] ways, with programs that address public health issues such as malaria outbreaks in Cambodia and maternal health in the Philippines. Medic Mobile has created specific health texting applications from FrontlineSMS software (and [...]

  3. [...] Molave Development Foundation runs the valuable Safe Motherhood project, which was recently featured in our National Geographic blog series Mobile Message.  The project aims to reduce mother and [...]

  4. elnora j. zanoria
    Davao City
    May 16, 2011, 9:33 am

    Congrats bang!!! So proud of you…God bless you always.

  5. riza tan-paches
    Gen. Santos City, Phils.
    May 15, 2011, 11:37 am

    Congratulations! Bangski, continue to excel in your field of expertise. This is a classic example of helping people to help themselves. And people like you help make our world a better place to live in. Go forth and replicate. God be with you always my friend!

  6. Rebecca Q. Sienes
    Dumaguete, Negros Oriental
    May 15, 2011, 12:30 am

    good wisdom…. thanks…… how can you be connected?…. i have a group of women whom I would like to be connected to your group……….

  7. jane bayani
    Abu dhabi
    May 13, 2011, 4:47 pm

    Congratulations, Irms for a job well done. Keep it up and God bless you.

  8. janice mahilum-aller
    general santos city, philippines
    May 13, 2011, 8:29 am

    congrats ate bang =)
    God be with you always..

  9. Francis F. Saligumba
    General Santos City
    May 13, 2011, 3:13 am

    To GOD be the glory! GOD’s grace for the wisdom and knowledge GOD has given you…. We love you ter! We love you! Bra-vo! you’re so amazing! we are so proud of you ter! Good! good! good!
    GOD be with you always ter.
    love you ter. mwaah

  10. Arlene Caparos-Butil
    Fremont,California
    May 12, 2011, 1:22 pm

    Congratulations Irma , for doing a very good and awesome job! Your nickname really give a big Bang!! , to Mom / Baby’s health. Keep up the good works and may your groups continue to prosper in all your humble projects you are doing. You deserve a Nightingale Award for this! God bless you always….

  11. Carter Pat
    Australia
    May 12, 2011, 5:38 am

    Our big cheers of Congratulations to the collective effort of Irma and her team for using the strength of telecommunications for a very productive and much-needed dissemination of information, to an otherwise desperate and helpless young mothers-to-be! We wish you further success in making our healthcare a lot better–God knows we need it much in the Philippines. Goodluck and God be with you all!

  12. Cynthia Catubig
    Illinois
    May 12, 2011, 4:39 am

    Congratulations for a job well done and thank you for your dedication in helping our countrymen.you sure made us proud.

  13. Diana Guipo-Peria BSN RN
    Tampa, Florida USA
    May 12, 2011, 2:41 am

    Congratulations !
    Keep up the good work.
    God bless you & your project in the Philippines.
    Am proud of you…

  14. Shiela Fernandez- Sabulao
    General Santos City
    May 11, 2011, 9:01 pm

    Congrats Bang! You and your team are such a blessing! You’re so inspiring amidst the current population issues!

  15. Ma. Antonietta V. Edris
    Lagao, General Santos City, Philippines
    May 11, 2011, 6:49 pm

    Congratulations Bang!May you continue working for the betterment of the Filipino people. How I wish your efforts will be replicated in all of the remote places in the country. You are truly worth emulating. Goodluck and God bless…

  16. Bojol
    Los Angeles
    May 11, 2011, 3:58 pm

    The collective’s strong work ethic and perseverance has faith that your hard work and creativity will have some reward in the end. Good job well done Bang!!! We are so proud of you!!! Yan ang taga GENSAN…

  17. Lodar Dagoy-Escobillo
    Glan, Sarangani Province
    May 11, 2011, 11:15 am

    Way to go Bang! Maristelles ’91 is so proud of you. Maybe you can consider extending your target recipients to some impoverished barangays down here in Sarangani Province which will qualify with your necessary criteria? :-) Just a suggestion Bang.. More power classmate!

  18. marisol f. saligumba
    Gen.Santos City
    May 11, 2011, 8:56 am

    To God be the glory!!!God’s grace for the knowledge and the wisdom God has given you…we are so proud of you ter…Keep on and go on..God bless you,,love you..

  19. Dennis Santos
    Guam
    May 11, 2011, 6:38 am

    Congratulations Bang, the work you’re doing is crucial in promoting, educating, and maintaining the health of expectant mothers, and their new born children. You have accomplished something that is truly extraordinary. Keep up the awesome work you’re doing. God Bless……..

  20. Scott Carter
    Gold Coast, Australia
    May 11, 2011, 5:11 am

    Well done to Irma and her team for tackling the need to support pregnant women in the Philippines, keeping them well-informed and safe and connected with an authority with the help of mobile phones! My wife is from the Philippines and having been there for a few times, I could see that most people don’t have access to good health facilities, and the efforts of such program as these, are really a big help. Well done Irma and MDFI!!! Keep going and I’m sure your countrymen are grateful for having people like you!
    Godspeed!

  21. Aj Tugano
    Philippines
    May 11, 2011, 4:56 am

    Kudos to people like Irma who has undisputable commitment to help our fellow Filipinos who are isolated and uninformed. You’re a hero Bang! We need more people like you!

  22. Senfuka Samuel
    Uganda
    May 11, 2011, 4:47 am

    This clearly shows to us the relationship between ICTs and development and that appropriate community information systems can greatly contribute to reduction of maternal and newborn health especially in developing countries. Am gonna use this as a point of reference in our community health information system.

  23. [...] Article Ken Banks, NewsWatch, 10 May 2011 [...]

  24. Elvie Eullaran Albano
    General Santos City
    May 11, 2011, 2:02 am

    Wow! Bang…nice to hear about this project…congratulations……

  25. Joy Cabreros Sumayang
    San Francisco, California USA
    May 11, 2011, 1:12 am

    Congratulations Bang! You’ve done a wonderful job! We’re so proud of you. More Power.

  26. Joy Cabreros Sumayang
    San Francisco, California
    May 11, 2011, 1:07 am

    Congratulations Bang! Continue your good deeds! We’re so proud of you! More power.

  27. Fely O. Lim
    General Santos City
    May 10, 2011, 9:38 pm

    Congrats Bang! A long-time dream realized. Wish this program will also reach here in our place, in Sarangani Province. Especially in the remote barangays of Kiamba. More mothers will be reached out with this project. Again, congratulations for a job well done.