MomConnect
MLC Vanguard | Created by Praekelt.org
MomConnect is a South African National Department of Health (NDOH) initiative that uses mobile technology to improve the health of pregnant women, newborns and infants at national scale. Through the platform, every pregnant woman in South Africa can register to receive free, informative, stage-based messaging during pregnancy and for the first two years of her baby’s life via either WhatsApp or SMS.
2,460,000 Lives Impacted
At the time of the development of MomConnect, the National Department of Health felt that sufficient evidence of the advantages of a messaging programme existed to justify the programme. However, integration of programmes such as these into Central Health Information Systems as well as National implementation of such a programme had not yet been achieved. For this reason, MomConnect was not set up with impact evaluation in mind. However, as the programme has matured and proven its practical application, it has become more critical to measure the impact of the programme in order to develop an investment case for continued support or the programme from National Government and funding organisations. For this reason we have secured funding which will take a comprehensive view of Monitoring and Evaluation of the programme, including a Randomised Control Trial based Impact Evaluation. In the absence of an impact evaluation, we can however use the qualitative and quantitative evidence to infer that: Mothers receive messages which have been approved by National Department of Health officials and aim to create demand for quality health services, promote self care and promote the adherence of mothers to critical behaviours such as attendance of antenatal visits and exclusive breastfeeding for 6 months. Mothers value the messages they receive and are highly engaged, with between 24% and 60% of mothers responding to surveys on the platform. Nearly 2000 complaints about service at facilities have been received, processed and resolved. Time to access certain pregnancy information at a national level has been improved from 3-6 months to 24 hours due to the integration of MomConnect with the National Health Information System. Nurses value the service and 97% are likely to recommend this service to a friend or colleague. MomConnect does not yet have in place a mechanism to measure impact, although an impact evaluation has been lined up as part of funding by Grand Challenges Canada.
The programme is now at scale but its clinical impact has never been effectively evaluated. One interim monitoring and evaluation report has been produced (MomConnect Evaluation Team, 2016); and some programme indicators are reported by consortium members to the National Department of Health. A theory-based monitoring and evaluation framework, however, has only recently been developed. Such a framework alongside evidence of the programme’s impact are important to ensure ongoing support and funding for the programme from the South African National Department of Health (NDOH) and other stakeholders. This work is currently being undertaken through a grant from Grand Challenges Canada. 61 quantitative measures are used across the programme for measurement and assessment, ranging from the number of registrations per facility code, to the number of messages sent per month. These are available through online, real-time dashboards. A Rapid Feedback Framework has been developed which leverages the feedback of users to understand the quality of care that they receive at clinics as well as improving the effectiveness of the programme itself.
The Innovation
MomConnect is a South African National Department of Health (NDOH) initiative that uses mobile technology to improve the health of pregnant women, newborns and infants at national scale. Through the platform, every pregnant woman in South Africa can register to receive free, informative, stage-based messaging during pregnancy and for the first two years of her baby’s life via either WhatsApp or SMS. MomConnect also provides access to a text-based helpdesk and the ability for women to rate the service they receive at the clinic. Ratings and questions are sent directly to the NDOH officials who can respond to queries and ensure that a high level of service is available at every clinic. The platform has been able to improve service delivery through integrating with the national health information systems.
Any woman who attends her first antenatal visit at a public clinic in South Africa will be consulted by a health care worker who will offer to sign her up for the MomConnect programme. The health worker/nurse signs her up to MomConnect via a reverse-billed USSD (Unstructured Supplementary Service Data) line, providing her National Identification Number, the code for the facility at which she is registering, contact number, preferred language, expected due date, and noting whether the mother is HIV+. This information is delivered into the national registry and her registration to the service activated. The mother then receives messages from MomConnect on her preferred channel (either SMS or WhatsApp) for the duration of her pregnancy, twice a week, and up to the second birthday of her child. During this time, the mother can ask questions, register complaints or submit compliments about her care, simply by responding to any of the messages which she receives. These are routed through to a helpdesk at the National Department of Health. The Helpdesk staff have a library of Frequently Asked Questions which they are able to use for quick replies to mothers. They are also able to compile free-form answers where a suitable response is not available. The helpdesk operators include a midwife, available to respond to more technical or challenging queries. All complaints about the service at facilities are opened as cases and district point people are engaged so as to resolve the case within 10 working days. Nurses, on the frontline of delivery of services to women, are also supported by the programme. Through the service, branded NurseConnect, nurses receive psychosocial support and clinical training messages. They are also kept up to date with any news from the National Department of Health or any changes in protocols or outbreaks of disease.
About Praekelt.org
Praekelt.org is an African non-profit dedicated to using mobile technology to improve the lives of people living in poverty. It is a mission-driven organisation, deeply invested in developing the best possible solutions to the projects we develop with our partners. Rather than implementing technologies in response to a brief, they work with partners to interrogate the problems, getting involved in projects from the very start so that the right technologies, channels and methodologies are put into play.
