In a poorly resourced country like Bangladesh, low cost, community-based interventions can help change health seeking behavior. During pregnancy, health is neglected for a variety of social reasons. Public facilities are inadequate, not easily accessible to women, and plagued with long waiting times. Restriction on the movement of pregnant women, plus the cost of transportation, often mean women don’t access prenatal care on time. This can lead to maternal disability or death.
Last week I visited three rural sites of a pilot intervention using mobile phone technology for maternal and child health care at Dhaka District to overcome obstacles. [Sajida Foundation](http://healthmarketinnovations.org/program/sajida-foundation-health-program) is one of the ever-increasing number of NGOs in Bangladesh that focus on integrated social development at the community level. Sajida has partnered with Click Diagnostics, a social enterprise bringing affordable and quality mobile phone-enhanced health services to under-served communities.
Sajida Bandhu or ‘friend from Sajida’ are community health workers trained on primary care for pregnant women. They screen women for problems like anemia, jaundice, high blood pressure, and diabetes. Saijda workers examine newborn respiratory rate, skin color, body temperature and proper breast feeding. Sajidas go house to house, checking on prenatal and post natal women who registered with Sajida’s micro-finance program. Sajida workers use a checklist to examine pregnant or postnatal mothers and record inputs in software-enable mobile phones. They then connects to doctors housed at Sajida Hospital to obtain necessary prescriptions and advice, which are displayed on the Sajida mobile phone screens. The health worker shares the information with the mother and prints a copy for her.
Last week, I shadowed the Sajeda Bandhu workers at Galimpur village of Nawabganj Upazila, in Dhaka. We went to visit the home of a women who had recently given birth. The Sajida worker greeted the family and started recording information according to her checklist. I noticed the mother had kept the copy of her records from her pregnancy. After the examination, the community health worker uploaded the information via her mobile phone. The doctor reviewed the information and gave advice instantly via this mobile link. The mother told me she was satisfied to get advice from the doctor at no cost while sitting in her home. While there is no fee for checkups for microfinance program members, Sajida Foundation charges for diagnostic tests, for example pregnancy and diabetes tests. The process took only 30 minutes from beginning to end.
What’s more, the Sajida Bandhu are young women from the community who feel empowered to be trained in health, use technology, and serve their fellow community members by connecting them to trained doctors.
As the intervention is in pilot phase, the organization is closely monitoring progress and management. The hope is that this type of intervention will help improve maternal health and move Bangladesh toward achieving MDG 4 and MDG 5.