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Open Access

Using mHealth to Improve Timeliness and Quality of Maternal and Newborn Health in the Primary Health Care System in Ethiopia

Zeleke Yimechew Nigussie, Nebreed Fesseha Zemicheal, Gizachew Tadele Tiruneh, Yibeltal Tebekaw Bayou, Getnet Alem Teklu, Esubalew Sebsibe Kibret, Kristin Eifler, Sarah E. Hodsdon, Dessalew Emaway Altaye, Leona Rosenblum, Yeshiwork Aklilu Getu, Zinar Nebi, Ephrem Tekle Lemango, Eyob Kebede and Wuleta Aklilu Betemariam
Global Health: Science and Practice September 2021, 9(3):668-681; https://doi.org/10.9745/GHSP-D-20-00685
Zeleke Yimechew Nigussie
aJSI Research and Training Institute, Inc., Addis Ababa, Ethiopia.
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  • For correspondence: zyimechew@gmail.com
Nebreed Fesseha Zemicheal
aJSI Research and Training Institute, Inc., Addis Ababa, Ethiopia.
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Gizachew Tadele Tiruneh
aJSI Research and Training Institute, Inc., Addis Ababa, Ethiopia.
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Yibeltal Tebekaw Bayou
aJSI Research and Training Institute, Inc., Addis Ababa, Ethiopia.
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Getnet Alem Teklu
aJSI Research and Training Institute, Inc., Addis Ababa, Ethiopia.
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Esubalew Sebsibe Kibret
aJSI Research and Training Institute, Inc., Addis Ababa, Ethiopia.
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Kristin Eifler
bJSI Research and Training Institute, Inc., Boston, MA, USA.
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Sarah E. Hodsdon
bJSI Research and Training Institute, Inc., Boston, MA, USA.
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Dessalew Emaway Altaye
aJSI Research and Training Institute, Inc., Addis Ababa, Ethiopia.
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Leona Rosenblum
bJSI Research and Training Institute, Inc., Boston, MA, USA.
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Yeshiwork Aklilu Getu
aJSI Research and Training Institute, Inc., Addis Ababa, Ethiopia.
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Zinar Nebi
aJSI Research and Training Institute, Inc., Addis Ababa, Ethiopia.
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Ephrem Tekle Lemango
cMinistry of Health, Addis Ababa, Ethiopia.
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Eyob Kebede
cMinistry of Health, Addis Ababa, Ethiopia.
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Wuleta Aklilu Betemariam
aJSI Research and Training Institute, Inc., Addis Ababa, Ethiopia.
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Figures

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  • FIGURE 1
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    FIGURE 1

    Proposed Technology Architecture for mHealth Initiative in Ethiopia

    Abbreviations: IVR, interactive voice response; mHealth, mobile health.

  • FIGURE 2
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    FIGURE 2

    Health Extension Workers CommCare-Based mHealth Application in Ethiopia for Client Registration and Tracking, Screenshots

    Abbreviations: HDA, Health Development Army; HEW, Health Extension Worker; mHealth, mobile health; L10K 2020, Last Ten Kilometers 2020 Project.

  • FIGURE 3
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    FIGURE 3

    Sample Screenshots of the Electronic Job Aids Included in the CommCare-Based mHealth Application in Ethiopia

    Abbreviations: HEW, Health Extension Worker; mHealth, mobile health; PLW, pregnant and lactating women.

  • FIGURE 4
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    FIGURE 4

    Health Service Modules Prioritized by the Ethiopia Ministry of Health (Left) and the CommCare Platform (Right)

    Abbreviations: ANC, antenatal care; CBNC, community-based newborn care; ENC, essential newborn care; EPI, Expanded Program for Immunization; GMP, growth monitoring and promotion; HEW, Health Extension Worker; iCCM, integrated community-based case management of common childhood illnesses; IMNCI, integrated management of newborn and childhood illnesses; MDSR, maternal death surveillance and response; PNC, postnatal care; PMTCT, prevention of mother-to-child-transmission (of HIV); PSPI, possible serious bacterial infection.

  • FIGURE 5
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    FIGURE 5

    Health Extension Workers (HEWs) Supervisor/Focal Person mHealth Application Screenshots

    Abbreviations: ANC, antenatal care; HMIS, health management information system; mHealth, mobile health; PNC, postnatal care.

  • FIGURE 6
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    FIGURE 6

    Increased Early Pregnancy Registration as a Result of the App at L10K 2020 mHealth Pilot Project Sites in Ethiopia, July 2017–June 2018

    Abbreviations: mHealth, mobile health; L10K 2020, Last Ten Kilometers 2020 Project.

  • FIGURE 7
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    FIGURE 7

    Trends of Delivery and Postnatal Care in mHealth Pilot Sites in Ethiopia, 2017–2018

    Abbreviations: mHealth, mobile health; PNC, postnatal care.

Tables

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    TABLE 1.

    Summary of Objectives of the mHealth Initiative in Ethiopia With Corresponding Technology Components

    Health ObjectivesTechnology Components
    1.Improve timeliness and coverage of RMNCH services provided by health postsLeverage electronic platform for automated reminders and follow-up notifications and alerts
    2.Improve the quality of RMNCH services provided by health postsLeverage electronic platform for mobile electronic job aids (e.g., checklists) for Health Extension Workers
    3.Improve referral care for RMNCH clients to health centersLeverage electronic platform for improved data and referral workflow
    • Abbreviation: RMNCH, reproductive, maternal, newborn, and child health.

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    TABLE 2.

    Number of mHealth App Users Trained in the Pilot Sites of L10K 2020, Ethiopia, May to December 2017

    RegionHEWs and HWs Trained on mHealth
    Training of TrainersHEWsMidwives and HEP SupervisorsTotal  
    Amhara55840103
    Oromia5473183
    SNNP6352869
    Tigray58840133
    Total21228139388
    • Abbreviations: HEP, Health Extension Program; HEW, Health Extension Worker; HW, health worker; mHealth, mobile health; L10K 2020, Last Ten Kilometers 2020 Project.

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Global Health: Science and Practice: 9 (3)
Global Health: Science and Practice
Vol. 9, No. 3
September 30, 2021
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Using mHealth to Improve Timeliness and Quality of Maternal and Newborn Health in the Primary Health Care System in Ethiopia
Zeleke Yimechew Nigussie, Nebreed Fesseha Zemicheal, Gizachew Tadele Tiruneh, Yibeltal Tebekaw Bayou, Getnet Alem Teklu, Esubalew Sebsibe Kibret, Kristin Eifler, Sarah E. Hodsdon, Dessalew Emaway Altaye, Leona Rosenblum, Yeshiwork Aklilu Getu, Zinar Nebi, Ephrem Tekle Lemango, Eyob Kebede, Wuleta Aklilu Betemariam
Global Health: Science and Practice Sep 2021, 9 (3) 668-681; DOI: 10.9745/GHSP-D-20-00685

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Using mHealth to Improve Timeliness and Quality of Maternal and Newborn Health in the Primary Health Care System in Ethiopia
Zeleke Yimechew Nigussie, Nebreed Fesseha Zemicheal, Gizachew Tadele Tiruneh, Yibeltal Tebekaw Bayou, Getnet Alem Teklu, Esubalew Sebsibe Kibret, Kristin Eifler, Sarah E. Hodsdon, Dessalew Emaway Altaye, Leona Rosenblum, Yeshiwork Aklilu Getu, Zinar Nebi, Ephrem Tekle Lemango, Eyob Kebede, Wuleta Aklilu Betemariam
Global Health: Science and Practice Sep 2021, 9 (3) 668-681; DOI: 10.9745/GHSP-D-20-00685
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  • Article
    • ABSTRACT
    • BACKGROUND
    • MHEALTH SOLUTION DESIGNING PROCESS
    • IMPLEMENTATION
    • USABILITY AND CONTRIBUTION OF MHEALTH INITIATIVE ON RMNCH SERVICE DELIVERY
    • mHealth App used at scale for eCHIS program
    • LESSONS LEARNED
    • Acknowledgments
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    • Maternal, Newborn, and Child Health
US AIDJohns Hopkins Center for Communication ProgramsUniversity of Alberta

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