PORTLAND

March 13, 2011

'Mobile Midwife' helping Ghana's poor

Ordinary cell phones prove powerful new tool

By John Richardson jrichardson@pressherald.com
Staff Writer

PORTLAND -- Bruce MacLeod has seen how digital technology can improve medical care in developing countries since he helped introduce computers and floppy disks to Sudanese health centers 30 years ago.

But mobile technology -- the ordinary cell phone -- is a powerful new tool, according to the University of Southern Maine computer science professor.

MacLeod and two of his graduate students helped create a system that uses cell phones to improve the delivery of health care to pregnant women and newborns in a poor agricultural region of Ghana. The system -- known as Mobile Midwife -- has been operating since last fall, and parts of it may soon be replicated in India and other poor areas of the world.

Nurses in northeast Ghana can now keep electronic medical records, filling out forms and retrieving patient information using cell phones. And pregnant women and new mothers are getting regular cell phone messages telling them about the importance of good nutrition or reminding them when they are due to get a pre-natal exam or have their child immunized.

"In the last five years, it's been more about mobile technology, which represents an incredible revolution in the way information is handled," MacLeod said.

While telephones, laptop computers and the World Wide Web are still available only to the relatively wealthy, inexpensive cell phones -- and the towers to serve them -- have become common in remote, rural regions such as northeast Ghana.

"That's their primary communication," said Matt Blanchette of Scarborough, who worked full-time on the project both before and after receiving his master's from USM last year. "Where we have things like Internet connections and wifi, they really have the cell phone network."

In northeast Ghana, a poor, agricultural region where families live in rustic compounds, about 60 percent of households now have access to a cellular phone, MacLeod said. Some households share, he said, although "everyone wants to own a cell phone."

In fact, Ghanaians are much more sophisticated with their phones than Americans, he said. They use them to do electronic banking and to check prices at the market, for examples.

The Bill and Melinda Gates Foundation saw the potential for improving health more than two years ago, when it financed a project called the Mobile Technology for Community Health. MacLeod and his students were brought into the project by Columbia University to create the applications, or programs. Other partners included the Grameen Foundation, an anti-poverty organization, and the Ghana Health Service.

The Gates Foundation had a simple challenge, said McLeod: "Can you use mobile phones to save lives?"

It took about two years to create and launch the system. Most of the programming work took place on the USM campus in Portland. MacLeod and Brent Atkinson of Hollis, one of his students, traveled to Ghana to work with nurses and develop and troubleshoot the system.

Nurses in district health centers now use their phones to fill out electronic forms, such as when a child is born or is immunized. They can easily keep track of exam schedules and look up whether a young mother has had a tentanus shot, or the family has mosquito netting to prevent malaria.

Before, all record-keeping was on paper, and it took much longer to fill out and retrieve medical information. Saving time is important to the nurses, who serve as the only health care providers in rural areas.

Women in the region are asked to sign up for the message service, and it has become a popular phone app, according to MacLeod.

The women get periodic calls with recorded health messages. Texting didn't work because there is no written equivalent for the local language, McLeod said.

(Continued on page 2)

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