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CareGiver Solution for Midwives

The solution could help midwives/HCW monitor expecting mothers, identify risk pregnancies and involve a doctor when required. I suggest a hybrid between Nokia Data Gathering tool or similar, like MoTeCH, and Medica Application from Nokia. Nokia Data Gathering tool allows creating of questionnaires and sending them to the midwives/HCW. Midwives gather data from the expecting moms they visit. Medica Application provides reminders, alerts, plays recorded messages, etc on the mobile phones of the midwives. I introduce a user profile: Asha, a midwife.
Potential list of features of the CareGiver Solution for Midwives:
- Capture and store important data when she visits an expecting mom via a questionnaire (name, age, location, pregnancy stage, previous child deaths, # of children, birth intervals, blood pressure measures, etc.). Ask multiple-choice questions would make it easier and faster to capture the answers.
- Take pictures and store them as part of the data gathering process.
- The questionnaire takes her no more than 30 mins per household. Thus she can cover more households per day.
- The data Asha captures is submitted real time (if possible) to the server database
- An online community of doctors identifies risk pregnancies based on the data received. (similar concept to tickets that service agents pick up and work on)
- The solution will automatically generate alerts for risk pregnancies based on the analyzed by the doctors data (i.e. 6th pregnancy at age 43, swollen feet) that will appear as phone alert or sms on Asha’s mobile phone. - (see visual 1)
- Asha encourages the expecting mom to deliver in a hopsital based on the sms she has received- (see visual 2)
- The solution could automatically make entries in Asha’s calendar on her mobile who to visit (i.e. based on a schema- 1 visit per month from week 4 to 28 of pregnancy, weeky visits after week 36, etc.). This will allow her to plan her day and not miss a visit.
- Asha can call/text message with other midwives in the vicinity using a free number
- Asha can call an emergency number at the base hospital
- Play videos with visual instructions and/or voice over (preloaded content of 7-8 visual guides/videos of 1 mins length on some procedures that demonstrate what needs to be done in the most common cases i.e. where the baby comes the wrong way or how to stop/slow bleeding, which techniques to use, how to avoid sepsis, etc.)
- Receive ring tone reminders (special ring tone) for deliveries that are due within i.e. 72h
- Asha distributes vouchers for hopsital deliveries + transportation once the doctor indicates risk pregnancy.
COSTS:
Technology-related costs:
- Nokia phones for the midwives data gathering platform that is integrated with server side software
- Training costs for the midwives
- Accessible e-record system in the hospitals; training costs and maintenance costs
- Costs for the data transmission
Health care-related costs: Delivery costs and transportation costs to the hospital and back home; Salaries for the midwives and incentives payouts
ECOSYSTEM:
- A large network of trained midwives linked to obstetricians in hospitals (possible partnership model with i.e. LifeSpring Hospitals).
- Network of taxies/buses that accept transportation vouchers that Asha distributes.
ADVANTAGES:
Possibility to identify expecting mothers in remote rural areas and bring maternal care to them instead of waiting for the moms to seek care.
- For the expecting mothers: the "health care" comes to them; they receive vouchers for institutional delivery + transportation costs
- For the doctors: can concentrate on the risk pregnancies, as the midwives take care of the normal deliveries and provide consultation via mobile
- For the community: midwives are often seen as “members of the family” as they are part of the community
- For the midwives: “Just-in-time” communication with a doctor in the hospital when complications arise; knowledge sharing with other midwives via calls/sms


DISADVANTAGES:
Relies on a stable network of midwives and on supporting network of hospitals.


BUILDS (Sarah Bird): MoTeCH could be used as a data gather platform as its current version is centered around pregnancy. MoTeCH runs on much cheaper phones than suggested in the original concept. The current implementation of MoTeCH in Ghana is using Nokia 1680s, which cost about $35 (in Ghana).

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