SDG: Goal 3 – Good Health and Well-being
Technology: Instant Messaging
155 deaths occur per 100,000 live births in South Africa. The country aims to reduce this maternal mortality ratio to 70 deaths or less per 100,000 live births in 2030. At the same time, the child mortality rate should decrease from 39 to 25 per 1,000 births in 2030 (AHS, 2016). There was an opportunity for South Africa to experiment with mHealth (mobile health) programmes. Since 2010 there is a 100% or more phone penetration in the country (GSMA, Deloitte, 2012). In contrast to other sub-Saharan countries, there is mobile phone ownership parity (GSMA, 2010) and high (94.4%) female literacy rates (UNESCO, 2018).
The minister of health developed with several partners the MomConnect solution. The vision is to use the mobile phones to connect all mothers of the country with the public health sector and provide them with information to improve their health and that of their upcoming babies (Barron et al. 2018). Women who suspect to be pregnant can subscribe to MomConnect via the unstructured supplementary service data (USSD) on their phones with (*134*550#) (AHS, 2016). The women are asked to visit an antenatal clinic for their formal registration and first pregnancy support and introduction to MomConnect. The women will receive SMS-messages twice-weekly throughout the different stages of her pregnancy. The messages are timed based on the gestational age. After birth, the information messages continue up until the first year of the infant (AHS, 2016).
The solution chose for SMS because every woman has access to this service. The subscription mechanism via USSD is available on all mobile phones and familiar to most South Africans through the process of buying and loading mobile airtime (Barron et al. 2018).
Women can send out questions or feedback to the helpdesk. The ability to provide feedback should serve as a social accountability mechanism.
Women can receive the SMS-messages free of charge, but the telecom operators charge the national health department for the operating cost (Barron et al. 2018). To reduce cost and increase the richness of interactions with women a pilot has been launched with the instant messaging app Whatsapp (Shapshak 2017).
In August 2017, MomConnect had cumulatively reached over 1.7 million pregnant women, which represent 63% of all women attending their first pregnancy care appointment. MomConnect has scaled to reach over 95% of public health facilities.
The helpdesk has processed more than 300,000 questions with an average of 600 questions per day needing a response. 9700 compliments have been given versus 1300 complaints. 80% of the complaints have been resolved (LaFevre et al. 2018).
Customer satisfaction is reported to be high. Women appreciate the MomConnect system and the content of the messages sent to them. They feel supported in their pregnancy, the health of themselves and their children (SIFSA ME, 2016).
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Barron, P., Peter, J., LeFevre, A. E., Sebidi, J., Bekker, M., Allen, R., … & Pillay, Y. (2018). Mobile health messaging service and helpdesk for South African mothers (MomConnect): history, successes and challenges. BMJ global health, 3(Suppl 2), e000559.
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Shapshak (2017). South African messaging wonder MomConnect launches on WhatsApp. Retrieved from https://www.forbes.com/sites/tobyshapshak/2017/12/04/african-messaging-wonder-momconnect-launches-on-whatsapp/#35cd73e7c3b2
SIFSA ME (2016). Systemic barriers to MomConnect’s capacity to reach registration targets. A process evaluation. Pretoria: MEASURE Evaluation–Strategic Information for South Africa (MEval-SIFSA) Project.
UNESCO (2018). Adult literacy rate, population 15+ years (both sexes, female, male). 2016. UIS Data Centre. Retrieved from http://data.uis.unesco.org/Index.aspx DataSetCode=EDULIT_DS&popupcustomise=true&lang=en#