Bangladesh
MAMA Bangladesh – Connecting Health Information and Services to Mothers Through Mobiles
Kirsten Gagnaire is the Global Partnership Director of the Mobile Alliance for Maternal Action (MAMA).
IDEA/Mobile Solutions is an office at USAID that champions the use of mobile technology for development issues. Mobile Solutions provides support to mobile technology initiatives implemented by USAID pillar bureaus, such as mAgriculture and mHealth. One of the most prominent mHealth initiatives, launched by Secretary Hillary Clinton on Mother’s Day last year, is the Mobile Alliance for Maternal Action (MAMA).
MAMA is a Global Development Alliance founded by USAID and Johnson & Johnson, with support from the mHealth Alliance, United Nations Foundation and BabyCenter. In March, MAMA board representatives visited Bangladesh to meet with MAMA country partners and conduct field visits to meet pregnant women, new mothers and family members who have subscribed to the MAMA mobile phone service, which is called ‘Aponjon’ in Bangladesh. This blog post comes from MAMA Global Partnership Director, Kirsten Gagnaire, and is part of the “blog tour series” reporting on the site visits and experience in Bangladesh. Read how USAID is helping women connect to health services in the developing world.
In Bangladesh, as in so many low-income areas across the globe, pregnant women and new mothers don’t have access to timely, reliable and culturally relevant information about how to best care for themselves and their babies. Although there has been some improvement over the past ten years, it remains a fact that death due to pregnancy, childbirth and infancy-related causes are high in Bangladesh. And these deaths are often preventable with basic knowledge and care.
A young mother in Bangladesh using a cell phone. Photo Credit: MAMA
The Mobile Alliance for Maternal Action (MAMA) was created to provide new and expectant moms with vital stage-based information via mobile phones. Subscribers who register indicate their expected due date, or the birthday of their recently-born child, and receive weekly messages timed to the stage of pregnancy or the age of their newborn. MAMA’s first in-country program is an initiative catalyzed by USAID and local partner D.Net. Catalyzing the support of a public-private coalition in country, with strong support from the Prime Minister’s Office and the Ministry of Health, MAMA Bangladesh has developed and piloted an mHealth service called Aponjon, the Bengali word for “trusted friend”. Aponjon works as a mobile-messaging based service, providing moms and the gatekeepers within their families (usually spouses, mothers, and mothers-in-law) with information about how to take care of themselves and their babies, and includes an entirely separate service for husbands that reinforces messages that their wives are receiving and includes information on how to best care for their loved ones during pregnancy and early childhood.
MAMA messages include information on self-care during and after pregnancy, as well as information on when to seek care and how to care for a newborn. MAMA Bangladesh recognizes the need for linking subscribers to local health services, and has built strong relationships with local health providers.
“I can only visit my clients once each month,” one community health worker told us during a site visit. “But the mobile phone messages continue to provide information between visits; more information than I would be able to share during a single visit.”
The importance of the connection between information about health and information on where to seek assistance was highlighted during one of our site visits. When asked what was the most important message they received, Shoma and Sale, new parents, beamed at their healthy baby and said that it was a message that discussed the signs of newborn respiratory illness. They realized their baby was exhibiting the symptoms which required care, according to the message they received. They were able to connect with their local clinic, where their baby was treated and recovered.
Messages to moms and their families are one of the first, and critically important, steps in educating people about their health, connecting them to care and changing behaviors. MAMA Bangladesh has registered 1,800 women in three districts thus far, and aims to launch nationwide later this year.
To learn more about MAMA, visit http://www.mobilemamaalliance.org/.
Picture of the Week
Women dancing at the fair. Photo Credit: USAID/Bangladesh
In recognition of this year’s International Women’s Day, the U.S. Mission in Bangladesh, through USAID/Bangladesh , joined with female political leaders, celebrities, academic experts, thought leaders, musicians, mothers, daughters to celebrate the economic, political and social contributions of women in Bangladesh. The 2-day Gender and Development Fair, “Equal Access to Education, Training, and Science & Technology: Pathways to Decent Work for Women,” was held at the Bangabandhu International Conference Center over two days, March 14-15, 2011. The fair featured fair activities and several performances throughout the day by various development organizations and women entrepreneurs including a fabulous puppet show from JICA.
Bangladesh: Maternal Deaths Decline by 40 Percent in Less Than 10 Years
Bangladeshi mother, Minara Khan with her infant daughter Shira (left), who was resuscitated by a community health worker trained through Helping Babies Breathe (photo by Charlene Reynolds)
Bangladesh is on track to meet the 2015 deadline for U.N. Millennium Development Goal 5 (50 percent reduction in maternal deaths). The Bangladesh Maternal Mortality and Health Service Survey[PDF] jointly funded by the Government of Bangladesh, USAID, Australian Aid (AusAID) and the United Nations Population Fund (UNFPA) found that maternal deaths in Bangladesh fell from 322 per 100,000 in 2001 to 194 in 2010, a 40 percent decline in 9 years.
The decline in direct obstetric deaths is most likely the consequence of better care seeking practices and improved access to and use of higher-level referral care. The decline in total fertility rate due to the successful family planning program has reduced exposure to high risk pregnancies and has thus prevented a large number of maternal deaths.
USAID’s program in Bangladesh has historically been very strong in family planning through the world’s largest social marketing program for non-clinical contraceptive methods and through the public sector for long-acting permanent methods. We can confidently say that our long and unwavering investments in family planning have had direct impact in lowering the total fertility rate, and thus the maternal mortality rate, in Bangladesh. Over the past five years, USAID has also invested in scaling up active management of the third stage of labor to prevent postpartum hemorrhage in the public and NGO sector.
The USAID program has also long invested in promoting and providing antenatal care through the NGO sector which linked women to the health system thus contributing to increased awareness and care-seeking for obstetric complications. USAID and CDC’s long term commitment to the in depth training of local scientists has resulted in the creation of Bangladesh’s premiere research institute, the International Center for Diarrheal Disease and Research, Bangladesh (ICCDDRB) which has the capacity to effectively guide valid and reliable research efforts such as the 2010 Bangladesh Maternal Mortality and Health Care Survey (BMMS).
USAID supported and provided technical leadership in implementation of the 2001 and 2010 BMMS to monitor the performance of the overall maternal health program. Without these two surveys it would not be possible for Bangladesh to monitor its progress towards achieving the MDG 5 goal.
Amanda Glassman, Director of Global Health Policy and a research fellow at the Center for Global Development, wrote “the results are also a good reminder that investments in family planning and girls’ education drive much of maternal health outcomes, and that USAID investment in social marketing of family planning and health seems to be paying off in improved health (see blog post).”
The Bangladesh Ministry of Health and Family Welfare is scaling up emergency obstetric care and active management of the third stage of labor; the Ministry has also recently approved distribution of Misoprostol tablets to all pregnant women shortly after delivery to prevent postpartum hemorrhage. There is also increasing availability of Magnesium Sulphate for management of pre-eclampsia. The predominance of hemorrhage and eclampsia deaths and deaths after delivery indicate a need to strengthen access to treatment for these two conditions, improve referral systems, and improve referral level care.
Every year, USAID provides basic health care services to nearly 20 million Bangladeshis, including provision of low-cost, quality family planning services and maternal and child health care. With USAID and international support, under-five mortality rates have declined by more than 50 percent in Bangladesh since 1990. USAID has trained and mobilized community health workers to provide critical maternal and child health care to supplement broader health interventions and support country-level capacity. Bangladesh already received a country award from the United Nations for significant progress in reaching MDG 4 (reducing child mortality) during the MDG Summit in New York on September 19.
The Government of Bangladesh and the United States jointly rolled out President Obama’s Global Health Initiative in Bangladesh on November 23. GHI in Bangladesh will focus on providing quality services to reduce maternal and child mortality, resuscitate family planning programs, improve nutrition status among children under age five, and strengthen overall health systems over the next five years.
USAID’s Frontlines – October 2010
Read the latest edition of USAID’s premier publication, FrontLines for these stories:
President Barack Obama calls international development a moral imperative and a key element in U.S. national security policy during a landmark United Nations speech
Tech innovators and grown-up science fair fans test drive innovative devices on the fast track to production and deployment in poor countries struggling with development challenges
After 60 years in Indonesia, USAID looks back at its successes and ahead to what is shaping up as a precedent-setting relationship between country and mission
Talk of microfinance and opening small businesses replaces talk of entrenched fighting in Iraq’s once notorious Falluja
A product that measures the size of a mothball is having an outsized impact on Bangladeshi rice farms – and the incomes of the rice farmers
Read these stories and more in the new issue of FrontLines. If you would like to automatically receive FrontLines every month, you can subscribe here.
USAID’s Frontlines – June 2010
Read the latest edition of USAID’s premier publication, FrontLines for these stories:
Administrator Rajiv Shah supports the new $3.5 billion Feed the Future initiative with trips to two target countries, Bangladesh and Sudan
USAID responds to two back-to-back natural disasters in Guatemala in May
In the Agency’s new science and technology office, scientific breakthroughs are being touted as a way to tackle health, agriculture and water challenges in developing countries
Preventing trade in “conflict diamonds” in Central African Republic starts with helping miners clearly establish ownership rights to diamond-rich properties
The 2010 InterAction forum draws hundreds to debate the methods, policies, goals and rationale for U.S. foreign aid
Read these stories and more in the new issue of FrontLines. If you would like to automatically receive FrontLines every month, you can subscribe here.
A Postcard from Dhaka
USAID Administrator Rajiv Shah’s visit to Bangladesh.
USAID Administrator, Dr. Rajiv Shah, visited Bangladesh May 25-26th to participate in the opening of the Bangladesh Food Security Investment Forum, hosted by the Government of Bangladesh and launched by Prime Minister Sheikh Hasina. During his visit, he met with bilateral and multilateral development partners from the UN, FAO and DFID, as well as with the Prime Minister to discuss development issues and mutual cooperation. After addressing a press conference where he highlighted President Obama’s new Feed the Future initiative, Dr. Shah met with USAID staff working in the region.
Investing in food security with the Bangladeshi government, private sector, NGOs
Dr. Rajiv Shah, USAID Administrator, speaks at the Bangladesh Food Security Investment Forum in Dhaka on May 26, 2010
I’m in Bangladesh today to participate in the Food Security Investment Forum. What a crowd! The Prime Minister, Her Excellency Sheikh Hasina, who has shown a strong commitment to food security, spoke this morning, as well as luminaries such as Dr. David Nabarro, Dr. Shenggen Fan, and Dr. John Mellor.
We’ve all come together in Bangladesh because this country represents a situation that we need to address now. The rising population, decreasing availability of land for agricultural production, and the growing adverse consequences due to climate change means we need to think dramatically differently about what it takes to feed the future generations in this country.
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This Week at USAID – May 24, 2010
Currently in Beijing, Administrator Shah is taking part in development-specific talks led by Secretary Clinton at the U.S.-China Strategic and Economic Dialogue.
Later this week, Administrator Shah will be in Dhaka to participate in the Food Security Investment Forum hosted by the Government of Bangladesh. This forum is a country-specific element of Feed the Future, the U.S. Government’s global hunger and food security initiative.
