Midline research reveals promising results for mLabour health application

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April 1st, 2018 marked seven months since the launch of mLabour — a comprehensive labour management tool built on CommCare — in three private health facilities in Tanzania. With this experience in hand, Dimagi and FHI 360 are conducting an ongoing evaluation of the mLabour mobile application to assess its impact on clinical adherence, usability and patient satisfaction.

The midline results are now in, and we’re excited to share that the data indicates an overall improvement in adherence to clinical protocols, as well as an exceptionally high uptake of the tool.

Moving from indicators of facility coverage and use toward capability to reduce maternal mortality

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A primary indicator that tracked progress toward reducing maternal mortality prior to the Sustainable Development Goals (SDGs) was the percentage of women delivering with a skilled birth attendant. The assumption was that skilled attendants would ensure women receive quality, evidence-based services. It is true that more women are delivering with skilled attendants now than in 1990, and that more deliveries are taking place in health care facilities; it is also true that ratios of maternal mortality have decreased. Yet, the relationship between increased facility deliveries and reduced mortality within countries is mixed. Why is that? One explanation could be that a quality gap remains.

To understand this better, we need to move away from relying on one-dimensional indicators of coverage and use toward indicators that more adequately capture the complexity of facility capability and quality. This will help the maternal health community better track changes at health facilities and support national and subnational entities to identify and target needed interventions. Together with Oona Campbell of the London School of Hygiene and Tropical Medicine (LSHTM) and colleagues, our team analyzed data from 50 countries in an article in The Lancet Maternal Health Series to characterize the availability of critical infrastructure and services where women deliver. Here I present some of those findings that are also included in my lecture that is part of a free online Maternal Health Series course developed by LSHTM.