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Using Mobile Technology to Address the ‘Three Delays' to Reduce Maternal Mortality in Zanzibar
Abstract
The hallmark article by Thaddeus and Maine (1994) presented a framework to reducing maternal mortality by addressing the delays: (1) deciding to seek care; (2) reaching care; and (3) receiving adequate care. This project developed a phone-based system used by traditional birth attendants to address the three delays in two districts in rural Zanzibar. Mobile phones provided: clinical algorithms to screen pregnant mothers for danger signs; phone numbers and mobile banking to arrange and pay for transportation; and contacts for health facility staff to alert them of referrals. 938 mothers participated in the “mHealth for Safer Deliveries” project. The intervention achieved a 71.0% facility delivery rate in the project zone, compared to the regional average of 32.0% (NBS and ICF Macro, 2011). This project demonstrated the effectiveness of mobile technology in addressing childbirth's three delays and its potential to impact maternal mortality in low-income countries.
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