The following is part of a series of project updates from the Ifakara Health Institute (IHI). MHTF is supporting their project, Using Cell Phones for Obstetric Emergencies. More information on MHTF supported projects can be found here.
To guide the design of the system for using mobile phones in moments of emergencies, IHI with partners in the Districts of Kilombero, Rufiji and Ulanga recently completed formative research. A variety of stakeholders including health workers, district and community leaders and women themselves were asked about the different problems experienced in responding to emergency complications among women who are delivering and newborns. Preliminary results from the research reveal that there are many systems challenges in the moments of emergency obstetric and newborn complications. Informally, some providers in lower level facilities do call their supervisors, but they must make and pay for the calls themselves on their personal phones. Additionally, they report ability to identify obstetric complications, but have less confidence in their ability to provide treatment in these cases. Other results reveal the need for clearer protocols and improved skills in conducting triage among health workers.
More detailed analysis is underway and will be shared with all stakeholders as the basis for designing district-specific emergency referral systems, including the verbal clinical support to be provided by mobile phone for health workers based in the peripheral facilities. The clinical support component will enable their supervisors at other levels of the health system in the districts to either provide advice on how to manage the patient at the facility or to refer the patient to another facility after initial treatment to stabilize their situation. This will be linked to other necessary elements in the emergency referral system, such as strengthening transport options and improving the documentation of referrals and feedback.