Mobile technology is revolutionizing health care (Photo Courtesy of Date Dyne)

by: SERENA MARSHALL, ABC News

Imagine for a second that you were a woman giving birth in sub-Saharan Africa, your chance of dying during childbirth or pregnancy: 1 in 16; however, if you were in a developed country, only 1 in 4,000.

Now imagine you are in sub-Saharan Africa with a cell phone. I'm sure you are asking yourself, what a cell phone could possibly have to do with my having a successful pregnancy? More than you'd think.

Around the world researchers and health care providers are utilizing smart phones and cellular technology to help improve both maternal and infant mortality.

This past week at the annual mHealth Summit in Washington,D.C. experts described how cell phones are showing enormous potential to improve health among women and children.  Here are three new developments that are already making a difference:

Texting to Breastfeed in India

" Barely 23% of mothers in India start breastfeeding within the first hour of a child's birth."  On the left is a child who has been breastfed while the child on the left has not. (Photo courtesy of UNICEF)

Currently India tops the list when it comes to deaths from nutritional deficiencies.  But researchers in India are hoping to prove that encouraging mothers to breastfeed by sending text messages could help save the lives of more than 200,000 infants.

"If universally practiced, exclusive breastfeeding could save an estimated 13% of all the under-5 deaths," said Leena Dhande, an Associate Professor in the Department of Pediatrics at Lata Medical Research Foundation in India.

According to Dhande, barely 23% of mothers in India start breastfeeding within the first hour of a child's birth.  She and her colleagues hope to change that by implementing lactation counseling through the use of daily SMS, or text messages, and phone calls. In a study not yet published, the researchers found simple texts could improve breastfeeding rates among the women in the study.

At 6 months of age, more than 95% of infants whose moms received text messages about breastfeeding, were being exclusively breastfed, versus only 67% in the control. Dhande and her collegues also found that bottle-feeding rates were higher at all ages among infants of mothers not receiving text messages.

"Cell phone counseling shows unprecedented improvement," Dhande said. "Home based counseling using cell phones is highly relevant when mother has several hindrances in getting healthcare."

And, with India's 865-million cell phone subscriber base, it is easy to see why a cell phone can make an enormous difference when it comes to saving infants' lives.

A Wireless Lifeline in Zanzibar

According to UNICEF, 8 million babies die every year before or during delivery or in the first week of life.  "The single most critical intervention for ensuring safe motherhood,"  according to the UN Population Fund, is having a trained medical professional present at the time of delivery.

But when a skilled medical professional isn't available, having a cell phone can make the difference between life and death.

In Zanzibar, health officials are hoping to reduce infant mortality 80% by providing cell-phone vouchers to help link pregnant woman with health care providers. According to Azzah Nofly of Zanzibar's Ministry of Health, the cell phones send one-way communication via text messages or two way communications through the use of vouchers than can be used on any phone.

At the mHealth Summit, Nofly described a woman who experienced a bleed during her ninth month of pregnancy and  used one of these vouchers to call the health provider.  The health care provider was able to direct her to go to the clinic and get help. Nofly noted that maternal hemorrhage is the leading cause of death in Zanzibar among pregnant mothers.

Sixty-percent of women who were provided cell phone vouchers had increased access to trained medical professionals during delivery, compared to 47% in the control group.*  

Messaging for health in Ghana*

As of 2008, one in seven children will die before their fifth birthday in Sub-Saharan Africa, according to the UN Development Program. This accounts for the highest rates of child mortality worldwide.

One of the problems  according to  John Koku Awoonor-Williams the Guyana Upper East Regional Director of Health Services, is the continuum of care, or lack thereof among pregnant women and new moms. "So we thought if we could mobilize demand and mobilize supply, then definitely we'd have the desired outcome," Awoonor-Williams said at the mHealth summit.

Awoonor-Williams and his team implemented a program called MoTech (Mobile Technology for Community Health), which seeks to examine how a cheap mobile health system can improve the quality of care and effectiveness of services provided by health workers and to patients in rural Ghana.  The system provides

community workers with basic mobile phones so they can interact with their community and patients in a new way.

"Almost 80% own phones," Awoonor-Williams said.  The system works by allowing health workers to track and send reminders (either SMS or voice translated into the local language) for appointments to patients, as well as the health staff. This ensures that no patient will miss antenatal and prenatal care.

"Mothers who are pregnant, register….You get specific messages that are [tailored] to the mother: 'You are due for your immunization, or you missed your services.' You will get a reminder to come over," he said.

Text4Baby in the United States  

MoTeCH is similar to Text4Baby in the US, a free texting service that provides new and expectant moms critical health tips three times a week through text messages. It is a particularly valuable service for low-resource women who may not have access to prenatal care.

An expectant mom can enroll in the program by simply texting the word " Baby" in English or " Bebe" in Spanish to 511411. She'll then be prompted to enter her due date or her baby's birthday, and from that point on she'll receive customized texts messages with critical health tips during pregnancy and through the first year of her baby's life. To sign up Moms can go directly to:  www.abc.text4baby.org

To date there are about 250,000 women signed up for the service, but with 4 million births each year in the US, organizers are setting the goal of a million moms by 2012.

**None of the studies presented at the mHealth Summit are published, and therefore peer-reviewed.