Tele Safemotherhood Pilot Project in Rolpa District of Nepal

Background: Rolpa district is one of the remote districts of Nepal, with a high maternal mortality rate (MMR) of 352 per 100,000 livebirths  (The national MMR being 240 per 100,000 livebirths) . Although 54% of pregnant women attend hospitals for the first antenatal check-up, only 19% of the total number of pregnancies complete the 4th antenatal check-up.  Institutional delivery is only 5%.  Low antenatal care (ANC) during 3rd triemester and low institutional delivery are responsible for high maternal mortality in the district. As it is with other remote districts, the main reason behind the low institutional deliveries in Rolpa seems to be remoteness of health facilities and lack of health education among women.

Objective: Reduce maternal mortality by giving access of pregnant women to obstetric care using mobile technology.

Methodology: Female community health volunteers (FCHVs) use their cellphone to send information about pregnant women to the district hospital, and use template written in their own language to send information. The district hospital collects all the data and act to encourage pregnant women to have the last 4 ANC visits and institutional delivery. The district hospital sends health workers to pregnant women for antenatal check-up if she is not willing to come to hospital.  The hospital  divides pregnancies into normal and high-risk pregnancies. High-risk pregnancies are followed accordingly and, if necessary, are referred to maternity-care centre for better management.

Results: Over  90% of pregnant women get 4 ANC visits. Institutional delivery is increase to 25% for adoption of the mobile-phone technology.

Conclusion: Incorporation of modern technology into health service-delivery system is highly recommended, especially in remote areas, to achieve the  universal goal ‘Healthcare for All’.

Keywords: Antenatal care; Maternal mortality; Mobile phone technology; Safe motherhood; Nepal