eHealth Nigeria was selected to present a poster on a project that we did in conjunction with the Population Council and the Population and Reproductive Health Initiative (based out of the Ahmadu Bello University Teaching Hospital).

The poster was entitled “The use of RapidSMS to facilitate community-based surveillance for maternal and newborn health in rural communities in Northern Nigeria”.

Abstract:
In rural communities of Northern Nigeria maternal, newborn, and child health (MNCH) is hindered due to the lack of timely and accurate health reports, a lack of coordination amongst public health stakeholders, and lack of urgent and follow-up care. The mobile Community Based Surveillance (mCBS) project introduced a means of capturing maternal newborn child health (MNCH) data in Northern Nigeria through the use of coded SMS messages that transmitted the observations of traditional birth attendants (TBAs), a community nurse midwife (CNMW), and skilled community health workers (CHW) to a centralized information system. Four TBAs received a week-long training on cell phone literacy and vital event reporting via SMS. They also received “refresher” trainings on how to recognize 10 different MNCH vital events which included eclampsia, post-partum hemorrhage, miscarriage, and others. For three months TBAs reported vital events via SMS as well as a low-literate manual-count method for comparison. The CNMW then forwarded weekly summaries of vital events via SMS. For urgent events, the CHWs were immediately alerted to respond at the community level, and sent an SMS detailing the outcome. Preliminary analysis of process and outcome data indicated that non-skilled, illiterate TBAs could be trained to effectively send SMS messages to report MNCH vital events. Accuracy and timeliness of rural public health reporting and response improved.  As the program is expanded, it is expected that the use of the SMS reports will continue to reduce the time it takes to receive urgent care, improve follow-ups on deliveries, and thus improve MNCH outcomes. The project demonstrates that non- and semi-skilled health workers can be incorporated into in a real-time, community-based, data collection scheme.  Furthermore, the project offers a pathway to engage TBAs as productive members of health reporting and referral systems in a severely resource deprived setting.

Poster:

As we began to build our data center in Nigeria, we looked for equipment that was durable, low-power, powerful, and would meet all of our needs. After working with ICC, we decided on using AMD equipment.

Read the whole case study here:

In order to fix an episiotomy or a perineal tear, good visualization and light is needed so that a health care professional can clearly see the tissue and muscle that needs to be sewn back together. If a episiotomy or tear is not repaired properly, it could lead to a woman’s inability to control her bladder or a fistula.

When a facility does not have adequate lighting to perform an episiotomy of perineal tear, this is what happens:

If subtitles do not immediately show up, hover your mouse over the arrow on the bottom right of the video and click on “CC” to turn it red.

Also in Northern Nigerian health facilities, it is common for a woman to not receive any form of pain killer when undergoing an suturing.

For the position of “Community Mobilization Program Officer”, we are looking for a skilled project manager with experience in health program management. Speaking Hausa is a requirement, experience in PMTCT is very helpful, Public Health experience is greatly desired, candidate will need to possess excellent written and oral communication skills, also familiarity with computers is necessary.

Salary range will be =N= 130,000 to =N= 190,000 monthly depending on experience.

Please contact info@ehealthnigeria.org with you inquiries.

A detailed job description is available here: Job Description: Community Mobilization Program Officer

If subtitles do not immediately show up, hover your mouse over the arrow on the bottom right of the video and click on “CC” to turn it red.

If subtitles do not immediately show up, hover your mouse over the arrow on the bottom right of the video and click on “CC” to turn it red.

If subtitles do not immediately show up, hover your mouse over the arrow on the bottom right of the video and click on “CC” to turn it red.

One of our current projects entitled “Safe Delivery: Portable Solar Suitcases to Support Emergency Obstetric Care,” which we are implementing with WE CARE Solar, is working to give women the ability to deliver their babies safely in the night by bringing solar systems to the maternity wards at primary health care centers and general hospitals in Kano and Kaduna states.

We will kick off with a story written by one of our Project Coordinators, Hussaina Martha. Please feel free to leave comments in the box below. Names of health facilities have been ommitted and names have been changed for privacy.

Stories from the Field: Aug 16, 2011

On the afternoon of August 16, a seizing woman was carried into a near-by PHC in Kano. She already had 2 seizures while at home and began to have her third on the way to the health facility. Two men, her husband and a friend, carried the woman through the door to the maternity ward where the waiting CHEWs instructed them to put her on the floor. The head CHEW, Maryam, quickly administered 1 dose (10 ml) of Magnesium Sulphate and the woman’s seizing stopped, although she was left barely conscience. Using a standard blood pressure cuff, the woman’s blood pressure was found to be 200/150. Since the PHC is not equipped to handle eclamptic patients, Maryam told the husband that he would need to take his wife to a General Hospital and that she would need to administer a second dose of MgSO₄ to ensure that his wife would arrive there safely. MgSO₄ is difficult to find in Kano and is therefore quite expensive at a cost of N1,500 ($10) per dose. Initially, the husband began to protest over the cost of the drug, however, the friend who was with them asked the husband “What is N1,500 compared to life?”, and the husband agreed to pay. The second dose of MgSO₄ was administered as the woman continued to lay lifeless on the entrance floor.

In order to send the woman to the General Hospital, a referral card had to be filled out which contained the woman’s date of birth, religion, address, blood pressure, and the drug and dose she was given. A copy was given to the woman’s husband to take with them to the General Hospital while another copy was kept for the Population Council (the NGO responsible for providing the MgSO₄ to the PHC). With the referral card in hand, a wheelchair was used to transport the woman to the local kekenapep (little yellow buggy) that was waiting outside the facility to take them on the 30 min ride to the General Hospital.

Although this man said he would take his wife to the General Hospital, Maryam said there are some cases when patients refuse to go to the referred facility. One particular case she narrated happened on the August 5^th, 2011. A woman was brought to the PHC with a seizure. After giving her MgSO₄, her bp was taken and she was referred to the General Hospital for further treatment. At the General Hospital, the doctors made a list of the drugs the woman would need during labour and delivery and told the family to go out and purchase those drugs for the woman. Her family decided instead to take the woman back home to deliver the baby. During delivery, she developed 3rd- degree lacerations to the vagina and anus and experienced a great amount of pain. For the next three days, her family treated her by bathing her with hot water. On the third day, her family finally took the woman back to the primary health center to seek treatment. Unfortunately, the family waited too long to bring the woman to the health facility and after only 20 minutes of being at the PHC, the woman passed away.

Maryam explained that the woman’s husband was not willing to pay the hospital bills and that is why he took her home to deliver. Maryam was the head nurse when the woman was brought back to the PHC and was still very upset over the situation that happened only a few days before we spoke with her. She told us that after the woman died, the family wanted to sit in the health facility to mourn and cry over her death. However, Maryam refused to let them stay in the health facility because she said it was their ignorance and selfishness that caused this woman to die.

Check out this short video that gives an overview of the project and how RapidSMS is being used to collect vital maternal and child health events.