Monitoring MAMA: Gauging the Impact of MAMA South Africa

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Abstract

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Introduction In South Africa a number of Millennium Development Goals relating to maternal health have been worsening while the use of mobile phones to support health services (mHealth) has been shown to improve health outcomes in the developing world. South Africa is one of the focus countries for the Mobile Alliance for Maternal Action (MAMA) which also includes Bangladesh and India. MAMA South Africa (MAMA-SA) uses a multi-channel mHealth approach to communicate healthy pregnancy and newborn child support behaviours, with a country specific focus on prevention of mother to child transmission (PMTCT) of HIV. This presentation provides an overview of MAMA-SA’s five mHealth communication channels and details the monitoring and evaluation (M&E) that is being conducted on each.

Methods MAMA SA’s five ‘channels’ are SMS, USSD, Mobi, MXit (a South African mobile phone-based chat platform) and voice. With such a variety of communication methods on offer, a detailed M&E plan was necessary to gauge MAMA-SA’s impact on women within the country. To ensure similar levels of M&E across multiple countries, MAMA-Global (MAMA’s global coordination team) supported the initial M&E planning. This process established standardized indicators for all MAMA countries, while leaving room for adding additional indicators for country specific circumstances. Building on the standardized indicators, South Africa has added a number of additional indicators, some of which are based on national PMTCT indicators. Automated and manual data collection methods have been implemented, as well as focus group discussions and user feedback and testing.

Results Since the launch, over 20,000 unique users have interacted with MAMA SA which translates into over 67,000 unique page views, hundreds of mobi-site comments, and more than 110,000 SMS’s and 8500 USSD messages being sent thus far. Most registered mobi-site users (73.01%) have already delivered and are looking for information to care for him/her, while the rest (26.99%) have yet to deliver. A large portion of SMS users (21.88%) opted to receive HIV-related messages, while this is lower than the national HIV rate which currently stands at 29.5%. Focus groups and user testing has shown that users of the service have found MAMA-SA valuable.

Conclusions Preliminary MAMA-SA data indicates high acceptability and satisfaction with the project. Detailed planning of M&E for such a diverse mHealth service offering has been essential. Service uptake has been satisfactory, but strategies for greater publicity are necessary. Further research is necessary (and planned) to ascertain health outcomes of HIV-positive women.