In maternal health care, there are three known delays that contribute to poor maternal health outcomes. These delays include; (i) delay to make decision to seek care, (ii) delay to reach health care and (iii) delay to access health services at the health facility.
DELAY TO SEEK CARE
The proposed solution will address delay number one. The first delay occurs within the household/family level and refers to the limited ability of the woman and or her family members to make a decision to seek skilled health care. This is closely linked to the inability to appreciate danger signs of pregnancy, delivery and postpartum due to inadequate knowledge. In addition, some cultural practices restrict women from seeking health care, while poverty at the household level also limits decision making to seek health care.
Our solution aims at strengthening the community follow up system with a particular focus on the most-at- risk pregnant girls who are less likely to seek health care if no deliberate follow up system is in place. Our solution works in such a way that pregnant girls will be identified through a pregnancy mapping tool at village level which will be used by the community health worker who conducts the pregnancy mapping by visiting individual households.
Health workers are trained on adolescent friendly service provision to ensure that during the visits they appeal to the pregnant girls. The SMS on health related topics shared with the girls is translated in the local language using adolescent/youth oriented terminologies. SMS messages will also be shared with the power holders for the pregnant girls as a way of increasing their knowledge on health related issues and ultimately offer more support to the girls to be able to access health care during and after pregnancy.
Once data is captured, it will be stored in a database in the cloud. When the pregnant girl visits the facility, the health worker will enter their information using the mobile app which information will be sent to the database for storage. When a young girl is expected to return for a service and she does not return- which will be confirmed by the health worker not entering any data on that girl, then the app will generate an SMS which will be sent to the telephone number of the community health worker member, the health facility health workers and to the telephone number for the girls which will have been captured during the mapping. The community health worker member will use the notification alerts and follow up on the young pregnant girls by visiting the girl’s home. Identification component of the mobile app is very critical for reaching out to very vulnerable girls since they are less likely to self-identify by way of visiting health facility.
VHTs demonstrate how to use the GetIN App after a training before the launch of the system in Kanungu District.