mCare Data flow, quality and use assessment in Bangladesh
Despite marked progress in reducing under 5 mortality over the past decade, neonatal mortality continues to contribute over 55% of the under- 5 child deaths in Bangladesh. In the rural northwest of this country, around 26% pregnant women receive the WHO recommended 4 complete antenatal care visits, over 90% births occur at home and merely, 18% of home deliveries are attended by a skilled attendant at birth. Nationally, only 27% of all women receive a postnatal care check-up by a trained medical practitioner within 2 days of childbirth, a practice considered essential to the health of the mother and the vulnerable neonate. More than 20% of these infants are born preterm, and nearly half are low birth weight, unprepared to encounter the many challenges home-based deliveries present.
In an effort to address high mortality rates and poor access to health services, mCARE was developed to connect rural frontline health workers with pregnant women and their families through a cloud-based server, currently maintained at the Directorate General of Health (Management Information System Division) with the Ministry of Health and Family Welfare, Government of Bangladesh. The system is designed to systematize and standardize the way frontline health workers engage with their client populations for the key functions of population enumeration, pregnancy surveillance, pregnancy registration and the accountability service delivery. To improve coverage of key antenatal and postpartum interventions, the mCARE system is designed to remind frontline health workers (via phone based alert and day to day scheduling systems) and pregnant women (via text messages on their phones) about antenatal and postnatal care visits, while also aiding in referral mobilization during emergency events. Unlike most other mHealth frontline health worker systems, mCARE also allows clients (pregnant women and their families) to contribute information directly to the system, by sending simple, structured messages that alert responsible health workers to the onset of labor, the occurrence of a birth or when a family in need of support during a crisis or emergency event.