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Community Workers Adopt Mobile
Technology to Improve Maternal-
Child Health
Stefano Montanari 2015/06/04
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2. As world leaders get ready to meet in New York in September to set a new development
agenda for the next 15 years, their discussions will likely focus on maternal and child
health. A report published by the World Health Organization (WHO) last May 13, in fact,
highlights that progress has been insufficient to improve mothers’ health and reduce child
mortality.
800 women still die every day in the world from preventable causes related to pregnancy
and childbirth, while less than one third of all countries have achieved or will meet the
target of reducing child-death rate by two-thirds.
Although the Millennium Development Goals have helped address many important public
health challenges, there is still the need to ensure the “world’s most vulnerable people
have access to health services,” said Dr Margaret Chan, Director-General of WHO, in a
statement presenting the report.
Local solutions to a global problem
South Africa is a good illustration of these public health emergencies – and of possible
solutions. In a country where 30 percent of pregnant women do not access prenatal care,

3. more than 12 percent of the population live with HIV and around 40% of maternal deaths
are HIV/AIDS-related, a number of initiatives show encouraging results.
A study published last October by the Philani Maternal, Child Health and Nutrition Trust
together with the University of California, Los Angeles, and Stellenbosch University in
South Africa found that repeated home visits by trained community health workers to
neighborhood mothers led to significant health improvements both for mothers and
children, including in the prevention of mother-to-child HIV transmission.
Trained and recruited by the Philani, these health workers – known as mentor mothers –
provide a lifeline for families otherwise excluded from the reach of many public health
services. In the past 7 years, they have brought healthcare interventions into the homes
of tens of thousands of pregnant women and new mothers. They taught them how to
rehabilitate underweight children and improve their chances of giving birth to healthy
babies, helped obtain state welfare allowances and assisted in the prevention of
preventable illnesses.
Tablets for health workers
Mentor mothers’ work has now caught the attention of some professors at Stanford
University (California) who have started a project in February to support them with sturdy
tablets pre-loaded with education videos. These videos explain basic health and nutrition
facts in a simple and intuitive way, with the aim of helping mentor mothers in their work of
expanding access to health knowledge and improving health conditions.
Nomfusi Nquru, one of the twelve mentor mothers testing the project, cannot conceal her
excitement about using these tablets. “It is something new and a chance to use
technology that I do not get to use,” she said in an interview. “Mothers react excitedly to
the videos and seem to pay careful attention to what is being said. Hearing lessons in a
different way is something that catches the mothers’ attention and afterwards they ask
questions on how to feed their children well and look after themselves in their
pregnancies.”

4. The tablet project is the brainchild of Dr Maya Adam, a lecturer at Stanford School of
Medicine with years of experience in developing digital educational content. After running
a successful online course on child nutrition followed by thousands of people around the
world, she has now decided to use her experience to help mothers in the developing
world. “When we first introduced the teaching tablets, it was quite amazing to see how
quickly these mothers picked up the new technology” she says. “In a way we are
bypassing the blockage in access to education at least in the short term and providing
these women with the opportunity to access knowledge using the technology we have
today.”
According to Adam, who has spent years as a volunteer at Philani during her medical
school and undergraduate studies, recruiting successful mothers and training them to
become community health workers “is a powerful model for passing on good health
practices in a way that is sustainable because women are counseling within their own
communities. They are not going anywhere and they are not coming in from somewhere
else with a solution that will then disappear when they leave.”
Adam hopes that the tablets will facilitate the learning and accelerate the training of new
mentor mothers. Initial feedback from the twelve mentor mothers seems to confirm her
intuition: responding to a questionnaire prepared by Stanford University, they all reacted
enthusiastically to the introduction of the tablets in their work.

5. “Community health workers can help bridge the gap, in the short term, between what we
need in access to healthcare providers and what we have,” says Adam. “If we wait for
access to education and healthcare in South Africa to catch up with the need for it in
these under-resourced communities, we are going to wait for a long time. By using
technology like the tablets we can accelerate that process in communities otherwise cut
off from main infrastructures.”
Adam intends to start an evaluation of the project next year, but is already working on a
more ambitious goal of creating an open access health promotion library for community
outreach workers.
“That’s my dream,” she says. “We are now raising funds for additional tablets, each
costing around $170 U.S. dollars, and preparing translations of the videos into Spanish
and other languages to extend the reach of this project. The videos are all picture-based,
so they can easily be translated and used in other countries. We have the technology, we
have the equipment. If we can get support, we can really put our heads down and start
creating a comprehensive, multilingual, open access library to promote the health of
mothers and children everywhere.”
A promising tool
Stanford University’s is the latest of a number of projects providing health workers with
mobile technology. OpenSRP, for example, is a tablet-based open source platform that
allows health workers to register and track the health of their entire clients.
“The use of mobile health technologies is a promising mechanism to ensure that we can
better measure health outcomes in order to inform processes intended to improve health
along the continuum of care,” says Dr Lale Say, coordinator of the adolescents and at-
risk populations team at the Department of Reproductive Health and Research of the
WHO. “Digital technologies like those used in this project have proven valuable for both
community members as well as the health workforce to gain access to quality information
that can help make timely and well informed health decisions that can impact on the lives
of mothers and their children.”

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Tagged with: AIDS, child health, child mortality, HIV, Lale Say, Margaret Chan, maternal
health, Maya Adam, mentor mothers, Millennium Development Goals, Nomfusi Nquru,
OpenSRP, Philani, pregnancy, South Africa, Stanford University, Stellenboch University,
tablets, University of California, WHO, World Health Organisation
About Author
Stefano Montanari
Stefano Montanari is an Italian freelance journalist specialised in human rights. Graduated in
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7. Humanities, with a focus on History and International Relations, he obtained an M.A. in
International Co-operation and Project Design, after which he has been working for
international organisations promoting human development and human rights. He currently
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Rights. The views expressed here are his own and do not necessarily reflect the official
policy of the Council of Europe. View all posts by Stefano Montanari →
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