Ugandan Organisation Combats Child Mortality with Text Messages

The messages have so far been sent to 339 mothers and mothers-to-be in the Uganda’s Jinja District. The messages contain information about how women can protect themselves and their unborn children against diseases and the importance of going to health clinics for check-ups during pregnancy. The messages are also sent to the pregnant mothers to remind them about their scheduled antenatal appointment with eight health centres collaborating with Health Child which has led to increased number of women attending antenatal care in time. 

Targeted messages to increase health centre visits

Health Child identifies pregnant women through their community health workers. These health workers visit households and keep a database of pregnant women and women who have delivered. 

Contacting pregnant women postpartum women is important in the Jinja District as child mortality is very high there. In the Eastern region of Jinja, which the text messaging programme targets,  the child mortality rate is 147 children per 1,000 live births. This is because among others most women are not aware of the importance of regular check-ups during pregnancy and often do not visit health centres for safe delivery. 

In order to reduce maternal mortality, the government of Uganda through the Guidelines of sexual reproductive health and rights, recommended (among other things) the delivery of goal oriented antenatal care where each woman is required to make at least four visits during pregnancy to a health centre, deliver under skilled care and is accorded post natal care 24 hours after delivery and after six weeks. “With the reminder messages that women receive, we hope that pregnant women attain the recommended four visits to health centres,” says Betty Walakira, executive director of Health Child.

Increasing HIV-AIDS awareness

Another health risk is HIV-AIDS. Jinja District is located close to Lake Victoria, a place where many fishermen operate.  Research has shown that many people involved in the fishing business tend to have multiple sexual partners. Some women therefore are infected and require education on how to prevent transmission of the disease to their unborn and born children. Pregnant women receive text messages on how to prevent this transmission so they are able to deliver healthy children.

Getting husbands more involved

The text message programme also recognises the importance of also involving men during pregnancy and post pregnancy stages. Not all the 339 women in the District own a phone, but their husbands often do. It is therefore crucial to also make them aware of health risks for their children. Health information about the wives is also sent to the husband since he can convey the message to the wife. So far, the fathers-to-be have responded very well to the text messages, says Health Child director Betty Walakira.

Part of a larger health text messaging programme

The Health Child text messaging programme for pregnant women is part of a larger e-health programme, supported by IICD, Cordaid and Text to Change. In this programme, a resource centre has been established. In this centre, community representatives are trained and counselled, improving their ability to access the relevant health information via Information and Communication Technology (ICT) including the internet, CD-Roms, a newsletter, digital stories from the field and television. 

From the centre, bulk text messages are sent to 694 people in the region. These messages are often health quizzes that are meant to educate people on certain health risks, such as ANC services, post-partum, family planning, early infant HIV diagnosis and immunization of children. These quizzes get high response rates and so far we have received 1711 responses for the 4 questions that have been sent out. 

Results from the quiz show that there is generally high levels of knowledge about Family Planning topics and lesser knowledge about pregnancy and HIV/AIDS including transmission of HIV from mother to child. When asked about the ways a mother can transmit HIV to her baby, 48% of the respondents did not know that this can take place during pregnancy, at delivery and during breastfeeding. This kind of information is vital for Health child in deciding what messages need to be spreaded. 

Health Child also systematically collects evidence based health data for the pregnant mothers and community members to inform interventions and for sharing with other partners.