The Maternal and Child Health Integrated Program (MCHIP) is the USAID Bureau for Global Health’s flagship maternal, neonatal and child health (MNCH) program. Awarded in September 2008, MCHIP focuses on reducing maternal, neonatal and child mortality in 30 priority countries, contributing to Millennium Development Goals (MDGs) 4 and 5.

Designed by USAID as a “Leader with Associate Cooperative Agreement” (LWA), MCHIP can be funded by USAID Missions and Regional Bureaus through traditional field support and other mechanisms. In addition, MCHIP can accept Associate Awards that Missions, Regional Bureaus or Global Offices develop with the Leader organization and oversee directly.

MCHIP takes “what works” to scale by working with USAID Missions, national and local governments, nongovernmental organizations, communities and partner agencies. Based on country context and identified gaps in providing services at the household,community and referral levels, MCHIP designs program strategies to ensure that services reach women and their families.

What MCHIP Is Doing Using Mobile Technology

Nearly half of all births in developing countries occur in facilities, yet the quality of care provided is often unknown. Reported clinical practice may differ greatly from observed practice. MCHIP has developed a Maternal and Newborn Quality of Care (MNH QoC)Toolkit consisting of five mobile, electronic data-entry tools for assessing the quality of services provided in hospitals and health facilities. These are primarily checklist tools for observing health worker performance related to services provided for labor and delivery and essential newborn care. The tools are designed to capture health worker responses to spontaneous complications, such as pre-eclampsia/eclampsia (PE/E) or postpartum hemorrhage (PPH), two of the leading causes of maternal death.

As of November 2010, MCHIP MNH QoC assessments have been conducted in five African countries, providing baseline data for quality improvement activities for maternal and newborn care at facility, regional and national levels.

Maternal and Newborn Health QoC Mobile Toolkit

• Obstetricians and nurse-midwives are trained to use mobile phones for capturing observational health worker performance data at hospitals and health facilities;
• Data is entered on Windows Smart Phone forms with Range, Logic, Skip and other data quality controls;
• Data includes clinical observation checklists on labor and delivery services, antenatal care, facility inventories, health worker maternal and neonatal knowledge tests, register, maternity chart and partograph review;
• Quantitative and qualitative data is captured via interviews, simulations and observation checklists including audio noted and pictures of partograph;
• Data is backed up to internal SD card and then transmitted via GPRS to in-country servers; and
• Results are uploaded to the Web in predefined table, graph and map templates.

A Tool for Improving Quality of Care

The overall goal for MCHIP is to contribute to the reduction of frequent, preventable maternal and newborn deaths through increased quality of known life-saving interventions in countries facing the highest disease burden. Mobile phones have improved the quality of data and expedited the timeliness of results reporting. Specific needs for effective interventions for screening, prevention and treatment of obstetric and newborn complications are being identified as results come in from the MNH QoC Assessments.

Data collected and analyzed provides an opportunity to guide development of program interventions to improve the quality of facility-based maternal and newborn care services. By providing a baseline and end line measures in countries where the survey is part of an evaluation of interventions being implemented, data also provides an opportunity to inform policy change and resource allocation. These indicators and data collection tools can be used in multiple countries to provide information on key screening, prevention and management of interventions of the most frequent direct maternal complications.

Click here to view the poster presented by USAID at the mHealth Summit 2010. Also check out this Youtube Video of MCHIP’s own David Cantor speak as part of the panel discussion at the Summit.