The use of cell phone for maternal health: the Abiye project

Abstract

Background: Maternal health is a public health concern worldwide, especially in the sub-Saharan African countries, where the burden of maternal death is the highest in the world. A woman dies of pregnancy or childbirth related complications about every 90 seconds every day, and more than 95 per cent of these deaths occur in the sub-Saharan Africa and South Asia. The rapidly growing presence of cell phones in sub-Saharan Africa may offer a paradigm shift and a unique opportunity to make a significant difference in maternal health services. Set against this backdrop was the Abiye pilot project in the Ifedore Local Government Area (LGA) of Ondo-State of Nigeria, aimed at improving maternal health through the use of cell phones. This research work was designed to explore the project. Method: A quantitative case-control method was used in this study with retrospective data from January 1, 2011 to December 31, 2011 collated from the hospitals’ records and patients’ casefiles. Semi-structured questionnaires were also used to generate supplemental data. 2 LGAs (i.e. one LGA where cell phones were distributed and one without such distribution) were compared to detect any differences in the facility utilization of pregnant women and the odds ratios of causes of maternal death were calculated in the two areas. Findings: The primary healthcare and the total (primary and secondary) healthcare facility utilization rates were significantly higher in the LGA where cell phones were in use. The primary healthcare facility utilization in Ifedore LGA was 54.4 per cent while that of Idanre was 30.5 per cent (p < 0.001). Total facility utilization in Ifedore LGA was 43.4 per cent and Idanre was 36.7 per cent (p = 0.0001). The odds ratio of the occurrence of the measured causes of maternal death in the 2 LGAs was 1 (i.e. no difference). Conclusion: The study showed statistical indications that cell phone use increased the facility utilization of the pregnant women. The utilization was found to have increased mainly because of the raise in the primary healthcare utilization in the LGA where cell phones were in use. This means that cell phone usage may be a strengthening factor in the primary healthcare system. The odds of causes of maternal death were still the same in the 2 LGAs. This may be due to the relatively recent implementation of the programme. It is possible that changes in maternal death rates will occur as the programme develops, and this should be examined in further studies.