Sav­ing ba­bies through text mes­sages

Lesotho Times - - Africa -

NYARUKOMBE — Us­ing an old mo­bile phone, health worker Floride Uwinke­sha logs the lat­est lo­cal preg­nancy, part of ef­forts in Rwanda to boost ma­ter­nal health through a mon­i­tor­ing pro­gramme in iso­lated ru­ral ar­eas.

The scheme has al­ready helped slash in­fant and ma­ter­nal mor­tal­ity rates.

Marce­line Mwuba­hamana, three months preg­nant at 31, doesn’t even have to leave home to have her de­tails logged into a na­tional data­base at the health min­istry.

Uwinke­sha, the com­mu­nity of­fi­cer in charge of ma­ter­nal health in the ru­ral Nyarukombe district of eastern Rwanda, sends through sim­ple codes on a ba­sic mo­bile phone.

The data­base known as Rapidsms, was set up in 2009 with the back­ing of the UN chil­dren’s agency Unicef and un­der­pins a med­i­cal mon­i­tor­ing pro­gram for preg­nan­cies and ba­bies aged up to two years.

Uwinke­sha is one of 45,000 com­mu­nity vol­un­teers help­ing track health across the re­motest parts of the rolling hills of Rwanda. They are elected by the peo­ple of their vil­lage and given ba­sic training by the gov­ern­ment.

“PRE,” she taps, giv­ing a code that means that the preg­nancy was con­firmed by a health cen­tre. “NP,” she adds, mean­ing “no prob­lem”.

Once Mwuba­hamana’s de­tails are recorded in the data­base, the soft­ware au­to­mat­i­cally gen­er­ates a date for her next pre­na­tal visit.

‘Red alert’

“I also send ba­sic in­for­ma­tion, such as their iden­tity num­ber, if this is her first preg­nancy or not and if there are any prob­lems,” Uwinke­sha said. She will re­ceive a re­minder text mes­sage ahead of the next ap­point­ment.

This preg­nancy is go­ing well, but should there be health con­cerns or an emer­gency, the health worker can no­tify the near­est med­i­cal fa­cil­ity via a “red alert” text mes­sage.

Once logged into the sys­tem, alerts help to flag up women who may be in dan­ger.

“We can eas­ily find the names of women who have high-risk preg­nan­cies, like those who have had re­peated mis­car­riages or have had gy­nae­co­log­i­cal surgery,” said Fran­cois Hak­iz­imana, who runs the Mu­rambi med­i­cal cen­tre, a short drive out­side the cap­i­tal Ki­gali.

Typ­ing on his com­puter, Hak­iz­imana demon­strates how the sys­tem works, scrolling down the screen to show dozens of names of preg­nant women liv­ing in vil­lages.

“We can tell them to go to the near­est health fa­cil­ity as soon as we see that there is any prob­lem,” Hak­iz­imana said.

Those in­volved in the text mes­sage pro­gramme say it has helped save many lives since its launch, but no ex­act fig­ures are avail­able since mea­sur­ing the pre­cise im­pact is tough.

In any event, Rwanda has reg­is­tered huge progress in ma­ter­nal health, ac­cord­ing to World Bank data.the in­fant mor­tal­ity ra­tio for ba­bies aged un­der one year was 31 deaths per thou­sand births in 2015, just be­low the world av­er­age of 31.7 — a sig­nif­i­cant ad­vance from 2009, when the rate stood at 47 per thou­sand.

Death rates cut

Over the same pe­riod, the ma­ter­nal mor­tal­ity rate was cut by al­most a third, from 411 to 290 deaths per 100,000 births.

Uwinke­sha will keep check­ing on Mwuba­hamana and her baby for up to 28 days af­ter birth. Af­ter that, a health worker spe­cialised in in­fant care will take over.

Two car­ers are trained per vil­lage, of­ten one man and a woman, who will per­form at least three home vis­its in two years to ver­ify the health of the child and record data such as its weight and nor­mal breath­ing rate.

“The main risks at birth are in­fec­tions, mal­nu­tri­tion, diar­rhoea and res­pi­ra­tory dis­eases,” said Joseph Nk­inzingabo, who co­or­di­nates 1 422 health work­ers spread over an area com­pris­ing 14 health cen­tres.

Nk­inzingabo just re­ceived a “red alert”: a woman who is about to give birth at home.

Call­ing the mo­bile phone of her health worker, he checks that all is well. The mother was able to reach a health cen­tre and de­liv­ered safely. “No need to send an am­bu­lance,” he said. — AFP

the ma­ter­nal mor­tal­ity rate in Rwanda was cut by al­most a third, from 411 to 290 deaths per 100,000 births.

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