maternal health

Design and Usability Testing of an mHealth Application for Midwives in Rural Ghana

Posted by EKStallings on Dec 20, 2011
Design and Usability Testing of an mHealth Application for Midwives in Rural Ghana data sheet 100 Views
Vélez, Olivia
Publication Date: 
Jan 2011
Publication Type: 
Report/White paper

Midwives in Ghana provide the majority of rural primary and maternal healthcare services, but have limited access to data for decision making and knowledge work. Few mobile health (mHealth) applications have been designed for midwives. The study's purpose was to design and test an mHealth application (mClinic) that can improve data access and reduce the reporting burden for midwives at the Millennium Villages Project site in Ghana.

From the design science field, the Information Systems Research Framework guided this study through two research cycles: 1) Relevance, and 2) Design. The first phase of the Relevance Cycle took a user-centered approach to assess the people, organizations, and technology of the midwives’ environment through participant observation, contextual inquiry, and interviews. In the second phase, structured requirements specification was used to categorize the data into goals, system qualities, and constraints. From the categorized data, use cases were developed for patient registration, antenatal care, malaria, family planning, and referrals. Use cases then informed the development of functional requirements. In the Design Cycle, we first used functional requirements for patient registration and malaria to develop the mClinic prototype as part of a coded-in-country initiative. Next, we examined usability of the mClinic prototype by conducting field testing, heuristic evaluation, and usability surveys. Additionally, low-fidelity prototyping was used to determine applicability of the other use cases to the midwives’ environment.

Midwives reported inability to access critical data, high patient loads, and extensive reporting requirements. Low technical self-efficacy and inadequate infrastructure were identified as barriers to implementation. Heuristic evaluation noted issues related to hardware selection, workflow, and security. Midwives ranked the tool as useful in the usability survey; however, ease-of-use rankings were neutral. Interviews indicated this was related to low technical self-efficacy. Applicability checks found support for touch-entry prototypes over those that included lengthy forms or text-entry.


Health Information as Health Care: The Role of Mobiles in Unlocking Health Data and Wellness

Posted by EKStallings on Nov 11, 2011
Health Information as Health Care: The Role of Mobiles in Unlocking Health Data and Wellness data sheet 838 Views
Ranck, Jody
Publication Date: 
Feb 2011
Publication Type: 
Report/White paper

Around the world, countless lives are lost due to insufficient access to quality health information. The availability of accurate, timely, and analyzed data is directly relevant to the quality of an individual’s health and the healthcare system in general, the delivery of individual care, and the understanding and management of overall health systems.


This discussion paper:

1) Examines the role ICTs, and mobile technology in particular, can play in improving access to quality health information, review the ecosystem of health information related to patients,

2) Traces the data throughout the continuum of care, examine health information flows from patients in villages to international health organizations and the most important steps in between,

3) Identifies common ground on which technologists and public health professionals can develop innovative strategies and tools to strengthen health care systems by supporting health data flows, working from the premise that better data collection will lead to better health policies and health outcomes,

4) Focuses on three healthcare domains – surveillance systems, supply chain, and human resources – and through the perspectives of experts in these domains, identify critical gaps in health information flows that technology-based solutions could address. In the case of each of these three domains, we use maternal health as an example to show how technology-backed interventions can improve health information flows,

5) Identifies barriers, choke points, and other inefficiencies to guide the discussion of how modern ICTs can improve health information flows and health outcomes in the developing world,

6) Provides recommendations for using modern ICTs to make health information flow more efficiently and perhaps even transform the process of care delivery itself.


Amplifying the Impact: Examining the Intersection of Mobile Health and Mobile Finance

Posted by MarkWeingarten on Feb 21, 2011
Amplifying the Impact: Examining the Intersection of Mobile Health and Mobile Finance data sheet 1628 Views
Gencer, Menekse
Publication Date: 
Jan 2011
Publication Type: 
Report/White paper

Both mHealth and MFS (Mobile Financial Services) are nascent industries and fragmented along multiple dimensions. The aim of this paper is to help reduce some of these uncertainties and reinforce dialogue on how the mobile communications platform can be leveraged to strengthen mutually positive outcomes related to both financial inclusion and health. With user-centric solutions that leverage common technologies, new efficiencies and capabilities can be created that serve to accelerate global scale.

Unlocking this potential will require the following questions to be addressed: 1. What will be the best method to drive awareness and adoption of the self-reinforcing dynamics of “wealth and health”? Who will lead these efforts? 2. How will the integration and interoperability of disparate technologies across multiple industry and public sector domains occur? 3. Who will build and manage the common infrastructure and distribution networks? 4. How will the various points of policy coordination work across sector domains?

Research and Reality: Using Mobile Messages to Promote Maternal Health in Rural India

Posted by MarkWeingarten on Jan 13, 2011
Research and Reality: Using Mobile Messages to Promote Maternal Health in Rural India data sheet 1625 Views
Ramachandran, Divya, Vivek Goswami, and John Canny
Publication Date: 
Dec 2010
Publication Type: 
Report/White paper

Rural health workers in India do not always have the training, credibility or motivation to effectively convince clients to adopt healthy practices. To help build their efficacy, we provided them with messages on mobile phones to present to clients. We present a study which compared three presentations of persuasive health messages by health workers using a phonebased lecture-style message, a phone-based dialogic message that elicits user responses, or no additional aids.

We found that dialogic messages significantly improve the quality of counseling sessions and increase discussion between health workers and clients; however, we did not statistically measure an effect of either phone-based message on health behavioral outcomes. We analyze these results in light of the challenges we faced and compromises we made through the research process due to the interplay of social, cultural and environmental realities, and discuss how these factors affect ICTD projects at large.

Texting with a Purpose: Catholic Relief Services in India

Posted by AnneryanHeatwole on May 19, 2010
Texting with a Purpose: Catholic Relief Services in India data sheet 4613 Views

Catholic Relief Services' maternal and neo-natal health monitoring program in Uttar Pradesh, India is incorporating mobiles into its work. The pilot project, which launched in June 2009, uses mobiles to increase volunteers' ability to share and gather health information.

The program uses SMSs to allow ASHAs (Accredited Social Health Activists who are local volunteers) to report statistics on maternal and neo-natal health metrics. According to O.P. Singh, who gave a presentation on the program as part of the SHOPS/mHealh Alliance online conference, several problems in the current system led to the adoption of mobiles: the existing paper system was difficult to use, workers at village and block levels had limited access to information from headquarters, and the paper system was slow. The organization hoped that incorporating mobile phones would give the volunteers a better sense of the health landscape, since they would have access to real time information and be able to instantly share their results. During the presentation, Singh illustrated the system with the following graph:

Basic Information
Organization involved in the project?: 
Project goals: 

The project's goals were:

  • To increase communication flow and collect data via community health workers
  • To teach local health workers to incorporate technology into their work
  • To more accurately track births and deaths


Brief description of the project: 

Catholic Relief Service's "Texting with a Purpose" gave mobile phones to community health workers (ASHAs) in the Uttar Pradesh region of India in order to track live births and deaths. The ASHAs filled out mobile forms and submitted them via SMS to a central database in order to better monitor maternal and neonatal health in the region. 

Target audience: 

The target audiences are:

  • 36 volunteer accredited social health activists
  • Pregnant women and newborns in Uttar Pradesh, India 


Detailed Information
Length of Project (in months) : 
What worked well? : 

The project has raised the level of reported births to almost 100%. Because the data is compiled instantly, less children are missed than under the old system. The Catholic Relief Service has also seen that the ASHAs view the SMS system as a viable plan for the future or reporting on maternal/neonatal health and that they are working hard to master the system.

What did not work? What were the challenges?: 

So far, 65% of the ASHAs still need support from family members or the Catholic Relief Services staff in order to manage the SMS texting; reasons for this include a lack of familiarity with mobile technology and low literacy. Another challenge is the coded SMS system; it has to be filled out very precisely, which can lead to errors.