Cell a lifeline for women

Major mobile initiatives are being rolled out to help tackle health challenges facing women and mothers in particular.

Carol Goodrich, Johnson & Johnson corporate communications director, says millions of women worldwide have cellphones, offering an opportunity for them to access relevant health information, when and where they need it.

In September, Johnson & Johnson introduced a five-year collaborative programme called Every Mother, Every Child, in an effort to improve the health of women and children in developing countries - and cellphones form a key component.

“Almost 1.1 billion women in low- and middle-income countries own a mobile phone today, making it possible to provide timely, life-saving information and innovative health solutions via text and audio messages to even the most remote locations,” she says.

According to the company, the initiative supports the United Nations' (UN's) call earlier this year to achieve the Millennium Development Goals (MDGs) of reducing both mother and infant mortality by 2015. “The UN itself recognises that mobile health technology has the potential to radically improve health in the most resource-poor settings,” adds Goodrich.

The company says part of the programme's focus is providing health information for pregnant women over mobile phones, as most women only visit a healthcare professional once before they give birth. This means millions of women around the globe lack a basic understanding of how to have safe pregnancies, proper nutrition, recognising warning signs, and preparing to give birth.

Every Mother, Every Child aims to send more than 20 million expectant and new mothers, in six developing countries, free mobile phone messages on prenatal health, reminders of clinic appointments and calls from health mentors, explains Goodrich. Countries include Bangladesh, China, India, Mexico, Nigeria, and SA.

Despite the potential of cellphones to address health issues, disparities still exist which make this a challenge. While optimistic about the future of m-health services for women in developing nations, Goodrich says mobile as a health tool is in its infancy. “It's important to assess these programmes and enhance them over time.”

Issues relating to women and mothers feature in three of the eight MDGs, but recent research by the GSMA reveals a woman living in sub-Saharan Africa is 23% less likely than a man to own a mobile phone.

The report, conducted with the Cherie Blair Foundation for Women, found that in total, 300 million fewer women than men in developing countries own a cellphone.

The association rolled out a programme called mWomen last month, with support from US state secretary Hillary Clinton and former British first lady Cherie Blair, aiming to halve this 'gender gap' within three years. It plans to provide 150 million women around the world with access to mobile technology.

According to the GSMA, 20 global mobile phone companies operating in over 115 developing countries support the programme, pledging more than $10 million in total.

“Mobile phones are an indispensible personal, economic and development tool, but 300 million women are missing out on the mobile revolution,” Blair said in a release. “Helping more women access mobile technology means they can feel safer, improve their literacy, access vital health information and generate a better income.”

Lebogang Marishane, information and media manager at Women'sNet, an organisation focused on using ICT to promote gender equality, says women are struggling to access the most basic healthcare services. This is especially the case in rural areas where these are either very far or there is no service delivery.

“It is worse when they have to access services that are personal, such as counselling; sexual health, including family planning and access to ARVs; and healthcare services for their babies.” She adds that mobile technology is particularly useful, since women are sometimes unable to access help because of the stigma attached to these services.

Mobile phones are an indispensible personal, economic and development tool, but 300 million women are missing out on the mobile revolution.

Cherie Blair, founder, Cherie Blair Foundation for Women

Marishane notes that growing mobile access in sub-Saharan Africa makes cellphones a powerful tool for distributing information on HIV/Aids and pregnancy to expectant mothers. As women tend to share what they learn, the benefits could extend to the broader community, she adds. “Ensuring that women have access to relevant healthcare information, using tools that are accessible to them, would mean information gets passed on to other women with no access.”

This could contribute to tackling the MDGs related to mother and infant health, where progress has stagnated. Research from Ericsson shows many of the world's poorest countries are falling behind particularly in goals four, five and six - reducing child mortality, improving maternal health, and combating diseases such as HIV/Aids.

“Of the more than 11 million deaths each year among children under five, over half are due to preventable and treatable and diseases, while more than 300 000 women die each year due to complications during pregnancy,” says Ericsson in a report on digital health.

UNAIDS estimates that globally more than 50% of all HIV-infected women (15 years and older) live in southern Africa. According to Cell-life, a company which develops mobile-based initiatives to help combat HIV/Aids, research shows young women between the ages of 14 and 25 are at greater risk of being infected. It says prevention campaigns need to be aimed at this group.

Peter Benjamin, MD of Cell-life, says an area where cellphones have great potential is in programmes for the prevention of mother-to-child transmission (PMTCT) of HIV. In these cases, certain amounts of ARVs have to be administered at exactly the right time to the mother and baby before, during, and after pregnancy and delivery; as well as during breast feeding.

Benjamin says mobile phones are a good way to support mothers through the process, helping to get them into the system, and to stay in it, by promoting testing and access to PMTCT treatment.

He notes that health services often focus on the baby's wellbeing, with mothers getting lost along the way. ”For women who find out they're HIV positive while going through pregnancy it can be overwhelming because they're facing so many issues.” He adds that 15% only learn about their HIV status at the end of pregnancy.

Also, responsibility for infant testing and treatment ultimately lies with the mother, notes Benjamin, and they are the ones who have to find out how to get and administer medication.

“Out of every 100 mothers, only 60 come back after six weeks for the PCR test to find out their baby's HIV status.” He adds that 40% don't return after 10 weeks.

Cell-life is working on a possible intervention programme using cellphones to inform and encourage pregnant HIV-positive women to follow the PMTCT regime. After delivery, SMSes would be sent to remind mothers of follow-up tests and appointments. It says a primary focus is empowering them with information and access to services.

Benjamin notes it's hugely stressful for mothers to find out their baby is HIV positive and that mobile networks can offer essential psychological support and reduce the level of lost follow-up. Through please-call-me-based services that prompt a response from a counsellor, to community groups on Mxit, the potential to use cellphones as a way to access peer support is extremely promising, he says.

Despite the possibilities, Benjamin notes there's a huge amount of hype around m-health globally, and that realistically it's at the proof-of-concept stage, with initial trials still being conducted.

“It's a no-brainer that it should work, but there's little actual proof yet. Where it does get exciting is that the environment has changed - in the way people are thinking and in terms of government policy.

“The transformation lies in the ability to provide health information and care to the vast majority of people in the country.”

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