Afghanistan: Bringing health to rural communities using mobile technology

Nasima, the local health worker [black dress] beside Nafas Gul; she used her mobile to save Nafas Gul and her baby's life.  Photo: ©2013 Narges Ghafary/World Vision

Nasima, the local health worker [black dress] beside Nafas Gul; she used her mobile to save Nafas Gul and her baby’s life.
Photo: ©2013 Narges Ghafary/World Vision

Contributed by Narges Ghafary, World Vision Afghanistan

In Herat, Afghanistan, most mothers still prefer to deliver their babies at home. Women feel uncomfortable receiving care from men at health facilities (educated female medical professionals are scarce). Additionally, health facilities are difficult to reach during the winter season.

However, most families are not able to recognize complications or emergencies during pregnancy and early labor, and typically they are unprepared for timely transportation to a skilled birth attendant when help is needed.

World Vision is helping to protect women and their unborn babies through a project called Better Health for Afghan Mothers and Children, funded by USAID. Through this project, local health workers are trained and equipped with mobile health technology, called mHealth, which allows community health workers and midwives the ability to provide routine care for pregnant women and newborn babies in their community and, as needed, communicate directly with a 24-hour on-call senior midwife and or obstetrician at the Maternity unit of Herat Regional Hospital. Through mHealth, they are able to initiate referrals and follow-up. Through the system, they are also able to send pictures and data to the obstetricians and senior midwives to allow for informed technical advice.

Simple technology, saving lives
Nafas Gul, 27, gave birth to her first baby four years ago. Nafas Gul was only seven months pregnant when she went into labor and gave birth at home, with just the help of a traditional birth attendant. Without specialized care, her baby died after just three days.

“When I lost my first baby, I got so sad and thought I never will be able to become a mother,” she remembers.

The following year, her sister was pregnant. Unlike Nafas Gul, her sister received regular visits throughout her pregnancy from Nasima, the community health worker, and she delivered her baby at the health clinic. Her baby survived. Says Nafas Gul, “At that time, I promised myself [that] if I got pregnant, I would consult with a community health worker and go to [the] hospital for delivery.”

Nafas Gul was faithful to her promise. “As soon as I understood that I was pregnant [again], I went to Nasima’s home with my mother-in-law,” she remembers. Nasima offered her basic advice and a delivery kit, while encouraging Nafas Gul to go to the clinic deliver her baby.

Once again, Nafas Gul’s pregnancy progressed well until month seven. Nasima visited Nafas Gul at home for a visit and upon examination, determined that her belly was bigger than a normal size.

“When I examined her belly, I understood that it is bigger than a normal size,” remembers Nasima. “I referred to my mobile device. I found that in this case the patient should be referred to the hospital.”

Nafas Gul was referred to the hospital where it was discovered that she had a build-up of amniotic fluid. The doctors monitored her condition for one week and then released her to return to the village. “When I came back to the village, the community health worker visited me more than in the past and all my family took care of me,” remembers Nafas Gul. “When my premature labor pains started, Nasima came with me to the hospital.”

Nafas Gul with her baby Rezaee. Photo: ©2013 Narges Ghafary/World Vision

Nafas Gul with her baby Rezaee.
Photo: ©2013 Narges Ghafary/World Vision

Nafas Gul gave birth prematurely to Rezaee, who weighted less than 2 pounds. The baby was kept in an incubator and received special care.

Eight days later both Nafas Gul and her baby are still at the hospital. “I feel good and every day I feed the baby with my milk,” says Nafas Gul. “The midwife who works in the neonatal [unit] is very kind. She taught me the kangaroo method to keep my baby warm and how to [properly] feed her.”

Tragedy Avoided
Nafas Gul is very grateful. She credits Nasima and the mHealth system for saving her little girl. “I think if Nasima and the mHealth system were not in our village and if the neonatal assistance did not exist in the hospital, my baby would not be alive,” she says.

Last year the pilot mhealth program was able to make 150 consultations with senior midwives, helping to save the lives of many more babies.

Note: Strong Women, Strong World’s commitment to this project was fulfilled in July 2013. Through your support, the Midwifery Extension Project at Herat Maternity Hospital in Afghanistan helped to reduce maternal and infant death by training 24 midwives at Herat Maternity Hospital, who provide improved care for expectant mothers—especially those with difficult deliveries.

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