Ticket to better health

On Thursday 25 July, the Vodafone Foundation and Swiss Re Foundation announced a collaboration to further develop and expand the Mobilising Maternal Health programme in Tanzania.  Tanzania has one of the highest global rates of maternal mortality with 454 deaths per 100,000 live births.  The Mobilising Maternal Health programme aims to contribute to a reduction in maternal death and disability in Tanzania through a combination of innovative mobile technologies and health system improvements.  Mobilising Maternal Health has already seen a considerable uplift in the number of women being treated for obstetric fistula following the introduction of M-PESA money transfer in the patient referral system at Comprehensive Community Based Rehabilitation in Tanzania (CCBRT).  Funds for a woman’s bus journey to hospital are sent to one of the programmes ambassadors who purchase the bus ticket on their behalf. This has enabled many more women to access maternal healthcare with the number of obstetric fistula surgeries increasing from 168 in 2009 before M-PESA was integrated to CCBRT being on track to perform 800 surgeries in 2013.  In addition, over the past seven months close to 100% of all women who have come to the hospital for treatment have arrived via the M-PESA system.  The Swiss Re Foundation, which is focussed on making visible and tangible the social and humanitarian values of Swiss Re has invested CHF 500,000 (approximately £348,000) to expand the Mobilising Maternal Health programme.  This considerable contribution has been made in celebration of the 150th anniversary of Swiss Re and will be spent on the training of Community Healthcare Workers, caring for women in rural regions of the country. This contribution marks an exciting milestone in the Mobilising Maternal Health programme, enabling the project to expand beyond the current centre of implementation in Dar es Salaam to the rural regions of Tanzania.

The Mobilising Maternal Health programme is a multi-partner, multi-million dollar effort led by the Vodafone Foundation with financial contributions from other private sector companies and foundations.  The programme is focussed on improving access to maternal healthcare for women in Tanzania, reducing maternal mortality and focussing on prevention and treatment for maternal health conditions such as obstetric fistula, which affects 3,000 women a year in Tanzania alone.  The contribution from Swiss Re Foundation will be channelled to one of the programmes key implementation partners, Pathfinder International.  Pathfinder will train Community Healthcare Workers (CHWs) in maternal, neonatal and child health using a three week curriculum approved by the government of Tanzania.  This will better connect pregnant women to healthcare and prevent maternal deaths in Tanzania.  CHWs will also receive a bicycle as a mode of transport, enabling each to expand their catchment area and consequently help more women. The contribution from Swiss Re Foundation will play a critical role in getting more women to facilities where they can give birth in safety. Through training CHWs women at risk of complications will be identified and transported to clinics using the innovative 'text to treatment' service.

Implementation of Mobilising Maternal Health is centred in three principal locations. At CCBRT Hospital in Dar es Salaam a significant effort is being made to increase capacity to treat women with obstetric fistula; build an all new maternity hospital and; provide education and improved referral and access to emergency obstetric services. In two rural Districts, the first in the Lake Zone of Tanzania, efforts will be made to improve access to maternal health services.  This will include improved District Hospital referral and maternity services (i.e., increased numbers of qualified staff and improved and expanded obstetric and gynaecology facilities) and a significant complementary rural community programme.

The rural community programme will centre on training and supporting a team of the CHWs. The CHWs will be trained to provide education and information to women and their families about the importance of antenatal care and the danger signs in pregnancy; to identify those at high risk of complications during pregnancy and delivery; and to refer those women to the appropriate level of health facility for care, whether that be the nearest health centre, which will be supported with training and supplied with basic equipment, or referral to the improved District Hospital facility.

The programme is underpinned by Vodafone Foundation’s ‘Text-to-Treatment’ transport programme which seeks to improve referral from the village to District level by employing local private transport providers, paid and incentivised via the company’s MPESA mobile money system, as well as through the provision of tailored SMS and text-based mobile health solutions.

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