For many women in South Africa like Lerato, a pregnant woman in Mabopane Township in Pretoria, pregnancy brought questions with answers that weren't always easy to come by. In a country with roughly five nurses and midwives for every 1,000 people, help during pregnancy for Lerato and others often came from friends or family, if at all.
But with estimates showing 300,000 infants are born annually to mothers living with HIV and more than 60 percent of all deaths for children under age 5 are preventable with better health care -- there wasn't enough help to go around.
As the maternal mortality rate continued to rise, South Africa looked to innovative health solutions. While access to health services can be limited, there was a surplus of a tool with the power to deliver better health education: cell phones. With more than 135 cellphones for every 100 people, the solution was just a text away.
With the leadership of the National Department of Health and more than 20 partners, including Johnson & Johnson, a mobile health (mHealth) program for South African mothers called MomConnect launched just one year ago. As MomConnect hit its first anniversary milestone this August, the program celebrated with unparalleled successes:
- Almost 1 in every 2 pregnant mothers has been registered with MomConnect
- Over 500,000 women are currently enrolled in the program
- Almost 34,000 health workers have been trained to register patients
Through the free program, women receive timely SMS messages that provide information on their pregnancy and their children's first year of life. Women are reminded when to go in for a check up. They learn when their baby is growing fingers or when to expect more regular kicking. They are told when their child should start crawling or eating solid food.
Not only that, but women are able to submit their own health questions to a help desk for answers, as well as provide feedback on the health services they've received. This data is being used to improve health services nationally and build South Africa's first-ever registry of pregnant women.
But the successes of MomConnect aren't just about numbers. They're about significant improvements in maternal health taking shape across South Africa.
These changes are even impacting women experienced with childbirth, like Lerato, who is now pregnant with her second child and sharing the new information she learns with her mother and grandmother, who helped her through her first pregnancy.
These changes are telling women like Thapelo from Mabopane Township to go to the clinic when she experiences stomach pains so she receives the medical care she needs.
And these changes are even reaching experienced health workers like Johanna, a midwife at the KT Motubatse Clinic in Pretoria, who said, "Our clients are [now] more informed. At times they will even teach you through asking questions."
So what are the top 5 lessons we can take from the successes of MomConnect?
1. National leadership is key. The South African government understands the power of MomConnect as a national solution to meeting the Millennium Development Goals. With their leadership, MomConnect has been able to reach women all over the country, and efforts are already underway for program expansion.
2. Empower individuals with knowledge. MomConnect empowers women to know more about their own health. The free, opt in/opt out service arms women with information that guides them to make healthy choices. It also reduces feelings of loneliness and stigma, especially for single women and those who are HIV-positive. In the words of Kamotso, a pregnant woman in Soshanguve Township, "MomConnect helps if you don't have someone with you. If you ever feel alone, there's [now] always someone there for you."
3. Health workers are catalysts for change. By training health workers to enroll women in MomConnect, health workers in South Africa are delivering more quality, comprehensive health care. As Sister Madi, a nurse midwife at the Tlamelong Clinic in Pretoria explained, MomConnect helps moms ask questions and teaches health workers the latest information.
4. Feedback matters. MomConnect tells women -- no matter their health, employment, or ethnic status -- that their opinion matters and their feedback can drive improvements to health care for everyone. Women can report on whether the services they received were good or bad and on the quality of facilities. As Evelyn, a first-time pregnant woman in Soshanguve, said, "MomConnect is the connection to me and the government."
5. Meet people where they are. Most of all, MomConnect is something that mothers can adapt to and use effectively. MomConnect works because it leverages the power of something mothers already use -- mobile phones -- and uses that tool to deliver new information. Texts are also translated into six languages and tailored for women who identify as having HIV.
Mobile phones have helped fuel tremendous growth in mHealth across the world. Last week's one-year anniversary of MomConnect marked another mHealth success -- a victory for everyone involved. MomConnect shows us all how a simple text message can effectively impact lives on a national scale.
Sometimes the best solutions are the simplest ones.