Harnessing mHealth for Improved Fistula Awareness and Referral
MLC Voyager | Created by Comprehensive Community-Based Rehabiliiation in Tanzania
Elimika is a free, interactive voice response (IVR) platform raising awareness about obstetric fistula, its causes, and treatment options to increase community health education, reduce stigma, and encourage all women to seek treatment earlier.
597,176 Lives Impacted
CCBRT's mission is to become a healthcare social enterprise serving the community and the most vulnerable with accessible, specialised services and development programmes. Elimika is a step forward in providing that level and accessibiltiy of care to women with obstetric fistula.
As a result of health inequalities created by poverty, up to 21,400 Tanzanian women currently live with obstetric fistula(1), with an estimated 3,000 more developing the condition each year(2). More than 85% of these women lose their baby in childbirth(3). Due to social stigma, limited knowledge of available treatment and the condition itself, affected women are often rejected by their communities and live in isolation, making their identification and referral for treatment a major challenge.
The early data has provided the following insights: - 1 in 4 callers to Viamo’s mobile messages platform have selected to listen to Health messages (other options are Education, Agriculture and Weather). - Among the 16 fistula messages those focussed on fistula identification were listened to the most, followed by fistula prevention and treatment. Messages focussed on the right to treatment and life after fistula treatment had significantly less listeners.
The Innovation
Through the application of mHealth Interactive Voice Response technology, CCBRT is using this innovation to heighten awareness, strengthen its ambassador network capacity and increase referrals for treatment. Adding free, accessible content to Viamo's national infoline ‘3-2-1’ to address the knowledge barrier to treatment on a national scale, ultimately reducing the years women suffer from fistula by improving access to care.
Women with fistula often suffer social stigma, shunned by their communities and unable to work. Due to their physical symptoms and myths about fistula, women may be forced into isolation and abandoned by their husbands, losing sources of income. Isolation, poverty, poor education (almost a third of women treated at CCBRT had not attended school; 28% defined themselves as illiterate) and limited decision-making power due to traditional gender roles, mean that women living with fistula are among the most marginalised in Tanzanian society. By placing accessible audio information at their disposal through 3-2-1, CCBRT is bridging the gap to treatment, increasing the flow of women seeking treatment. On 18th February 2019 Tanzania’s first nationally-available range of fistula audio content on a mobile infoline available on-demand and free of charge to Vodacom subscribers of any literacy level wentlive. The sixteen messages cover the prevention, detection and treatment of fistula and direct listeners to CCBRT’s free fistula hotline for further information and advice. The Vice PResident of Tanzania is also featured in one of the messages. Over 3-5 years, national awareness of fistula should increase, particularly in conjunction with CCBRT’s advocacy and government engagement. The amount of active ambassadors, and therefore referrals, will also increase as IVR surveys strengthen skills and highlight ambassador support needs.
About Comprehensive Community-Based Rehabiliiation in Tanzania
From its roots in small-scale community-based rehabilitation for people with disabilities, CCBRT has grown to become Tanzania’s largest provider of disability and rehabilitation services. Through advocacy, training, and clinical service, we strive to empower people with disabilities and their families, improve their quality of life, and ensure access to medical and rehabilitative treatment. Recognising the critical relationship between quality accessible healthcare at birth and disability prevention, we also provide maternal and newborn healthcare services.
