Presenter: Anna Cecilia Frellsen, Maternity Foundation
Quality assurance of Basic Emergency Obstetric and Neonatal Care (BEmONC) in low income countries is challenged by an outreach gap as most health facility deliveries take place peripherally and are difficult to reach. Promotion of health services via mobile phones or other mobile media (mHealth), has been suggested as a means to bridge the outreach gap. The Safe Delivery Application (SDA) has been developed since 2012 in collaboration between Maternity Foundation and researchers from University of Southern Denmark and University of Copenhagen as a mHealth tool for assuring the quality of BEmONC in peripheral parts of the health system in low income countries. The final version launched in Spring 2015 has animated instruction videos on the seven BEmONC signal functions as well as newborn management, prevention of post-partum bleeding and infection prevention. Furthermore the app has Action Cards for quick reference, an essential Drug List and suggested Practical Procedures. To increase the use, push messages are sent as sms-reminders every day. A randomized controlled trial was performed across 78 health facilities in five districts in West Wollega, Oromiya Region in Ethiopia from August 2013 to November 2014. Primary outcomes were total scores in validated tests for skills and knowledge for two selected signal functions; post-partum hemorrhage and neonatal resuscitation that were assessed at base-line and after 6 and 12 months. The final results will be published in peer-reviewed journals in Summer 2015. However, the data show a remarkable increase in the skills and knowledge level of the health workers: The ability of health workers to handle postnatal bleeding and to resuscitate a newborn more than doubled after 12 months of using the app. Furthermore, their skills continued to improve throughout the 12-month period, indicating that the app is able to continuously maintain and improve the level of skills.