Today was a lot of fun. The theme of the conference is about new technologies and it is mind-blowing what the potential is. I must admit that I was a bit of sceptic beforehand. MSI has a pilot project in Kenya to send routine data through text messaging and I just wasn’t convinced that it would work – or else that it would be too much work.
Now I realise that I have been stuck in the dinosaur age. Take these crazy facts and statistics:
- it is now easier and cheaper to get connected through a mobile phone in Africa and Asia then in Europe and North America;
- there are 4 billion mobile phones in the world – this represents the most sustainable infrastructure for information transfer; and
- 20-30 million texts are sent a day in South Africa. HIV behaviour change messages are now included on one network, leading to 1.5 million people a day receiving health information and advice.
The public health community has started to realise the potential of using mobile phones to improve operational information systems – i.e. to make our current systems work better so that we can deliver services more efficiently. This is great and I am all for improving our data collection systems. However, the really exciting and unexplored territory is how mobile phones can be used to reach people directly with health-related information and services.
Essentially this represents a seismic shift in how healthcare is provided and places power in the hands of the individual rather than the healthcare provider.
This isn’t all just theory but is already happening – for example, people often don’t want to go for HIV testing in South Africa because they fear being seen in the queue for the VCT clinic. In fact, 78% of men would prefer to take the test at home. However, pre- and post-test counselling is an essential part of HIV testing and so people can’t just administer the tests themselves. The answer is to provide the counselling services over the phone. This ensures confidentiality and allows the person to decide where and when to take the test.
Anyway, I could go on and on but need to also tell you very briefly about the exciting research that is taking place in saving newborn lives and why MSI should be doing more in postnatal care. Some distressing facts:
- more than 4 million newborn babies die within in their first month of life;
- 99% of these deaths are in low-income countries; and
- most of these deaths are preventable.
The good news is that there is now very strong evidence based on a cluster randomised controlled trial with over 400,000 women in Bangladesh which shows that there are simple and cheap strategies to prevent these deaths. The study examined a range of strategies such as community education, home versus clinic antenatal and postnatal visits and counselling.
All of these interventions had some impact but the thing that made the most difference was a single home visit to the mother and newborn within 48 hours of birth (the postnatal visit). This alone contributed to a 30-40 % decrease in newborn deaths. Just having a trained community health worker come and check the baby’s weight and check for signs of infection or other ill-health made an incredible difference.
MSI delivers tens of thousands of babies in our clinics every year. We also have strong networks of community-health workers. We could make a real difference in saving newborn lives.