mHealth: Tanzania

WV is collaborating with D-tree International and the University of Toronto to deploy and evaluate a mobile phone based application for community health workers (CHWs) in Singida Rural, Iramba, and Kilindi districts. The application is based on Tanzania’s community Maternal, Newborn, and Child Health (MNCH) program for CHWs and helps them to provided targeted information to pregnant women and caregivers of young children. Thirty CHWs in two program areas have been trained and are using the application. Researchers from the University of Toronto are evaluating the impact of the application on the knowledge and behavior of pregnant women around accessing antenatal care and delivering at health facilities.

BackgroundIn March 2013, D-tree International began working with World Vision Tanzania (WVT) to develop a mobile phone-based tool that assists CHWs to deliver a set of very specific maternal protocols that have been developed in Tanzania for use at the community level. The tool aims to assist CHWs to give preventive care and identify problems as they arise and leads the health worker through a step-by-step process to know exactly what to do and say to the client. The phone-based tool is used to register pregnant women when they are identified by CHWs. Once registered, the tool will prompt CHWs to monitor the progress of these women and encourage them to receive antenatal care at a clinic and go to a health facility when they are due to deliver. During the monitoring process, the tool also provides CHWs with a checklist of danger signs for the mother (during pregnancy, labor, and postpartum) and newborn, and gives instructions on how to counsel a

mHealth: Tanzania

CHWs at mHealth training in Singida district

mHealth: Tanzania

woman regarding antenatal clinic visits, facility based deliveries, and postnatal clinic visits.

The guidelines used in the application have been developed in consultation with the Government of Tanzania and other stakeholders in maternal health in Tanzania and has been approved by the Ministry of Health and Social Welfare (MoHSW) division of Reproductive Health. The project has four phases (design, refinement, training, and implementation) with a total duration of 12 months from March 2013 to February 2014. Phases 1 and 2 were completed and 30 CHWs were trained and are utilizing the application in two program areas in Singida Rural and Iramba districts (SUSTAIN). Training in Kilindi district is still pending.

The University of Toronto has developed an evaluation protocol that was reviewed and approved by research ethics boards in Canada and Tanzania. A modified cluster randomized field trial design was proposed involving 60 CHWs. Mobile phones were randomly assigned to 30 CHWs, and the second group is using the standard tool provided by MoHSW. Both groups of CHWs will follow pregnant women up to two months postpartum, providing targeted counseling in keeping with MoHSW CHW guidelines. Once the follow up period is completed, a random sample of mothers will be interviewed to determine their knowledge base and their care seeking practices. Particular attention will be focused on determining whether there are any differences in the knowledge base and care seeking practices of mothers followed up by CHWs with mobile phones and those followed by CHWs using the standard protocol.

Stakeholder Engagement

Key stakeholders, at the international and national level include: University of Toronto D-tree International Ministry of Health and Social Welfare Council Health Management Teams in Singida Rural, Iramba, and

Kilindi districts

Targets

30 CHWs in Singida Rural and Iramba districts (2 ADPs) 30 CHWs in Kilindi district

Contact

mHealth: Tanzania

Project Management Dr. Curtis La FleurProgram Manager, WV Canada GAMEmail: curtis_lafleur@worldvision.ca

Technical LeadDr. Peter NyellaField Project Manager, WVTEmail: Peter_Nyella@wvi.org

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