Description of Session
Objective: To determine the role of an mHealth intervention, Nighedaasht, in empowering Community Midwives (CMWs) and improving Maternal and Neonatal Child Health (MNCH) outcomes in rural settings. Methodology: The Nighedaasht mHealth application has been implemented in the following districts in northern Pakistan: Chitral (20 CMWs); Gilgit (8 CMWs); Hunza (3 CMWs); Nagar (5 CMWs); Ghizer (7 CMWs) and Astore (6 CMWs), in efforts to digitize processes of the services provided by CMWs in inaccessible, rural areas. It aims to strengthen referral systems and improve communication between CMWs and physicians. The app allows CMWs to register mothers and births; track pregnant women and deliver ANC services; refer cases electronically to specialists; and seek case specific expert advice from physicians directly from the field. Nighedaasht empowers CMWs through its social franchising model, allowing them to earn an additional income through deliveries and distribution of family planning products. Training videos build capacity of health workers and raise awareness among community members. Results: Between January 2018 and May 2019, 1316 patients have been registered; 1194 patients have received antenatal care (88% compared to national average of 73%); 608 skilled health worker-assisted deliveries and 162 referrals have taken place while specialists have been asked for expert opinion on 53 instances in the field. Nighedaasht has been successfully integrated in the routine CMW processes in implementation areas. Conclusion: Nighedaasht addresses health worker isolation in remote areas, as a result of inadequate skill sets; insufficient training; inefficient paper-based systems; and a lack of communication between CMWs and physicians. Employing short-messaging-services, the application provides a novel solution to address communication and coordination barriers. Nighedaasht aims to inform policymakers about the role mHealth can play in enhancing provider-to-provider communication and remote client-to-provider communication in low-resource settings, and improve MNCH outcomes.
