The Rapid SMS that is saving mothers and babies in rural Rwanda

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By Nyesiga Dias

Parents during the parent's evening (umugoroba wababyeyi).

Parents during the parent’s evening (umugoroba wababyeyi).

The sky was cloudy as Felista Ayinkamiye was clearing the last mass of the dry beans from the garden and her right hand poached deep into her Kitenge to pull out a mobile phone.

“It was a reply from the health center asking her to immediately take the expectant mother to the hospital,” said Ayinkamiye, a community health worker from Busogo sector in Musanze district.

The short service messages-SMS from the doctor was notifying the community health worker to inform an expectant mother to reach the health center as soon as possible.

“The health center sent the message basing on the expectant mother’s history which I had captured using the Rapid SMS system since her first visit to antennal care,” she further explained.

In fact, the expectant mother, Donatile Nyandegeya a resident of Gashaki sector in Musanze district who had a few days to deliver had developed bleeding which required urgent attention. Later she gave birth through cesarean section at Ruhengeri hospital.

“The community health worker and the doctor had told me to always be vigilant with any changes during my pregnancy,” a mother of two said.

Through a short message via a code 3103, the community health worker is able to share updates concerning the pregnant woman to the health center which making it easier in case of emergency.

Nyandegeya is one of the  mothers across the country that have already been recorded in the Rapid SMS systems that monitor’s their pregnancies and links them to community health workers and the doctors thus saving many rural women.

The system launched by Ministry of health in 2013 is a digitized way to address the delay in accessing maternal, new born and child health care operated by 45,000 community health workers in 15,000 villages.

Currently, most women mainly in rural areas have embraced the system, thus under five mortality rate falling from 150 per 1000 births to 50 deaths in 2014.

“These babies would have died of preventable causes if this rapid SMS system wasn’t there,” a senior Rwanda Biomedical Center said.

He also noted the “the campaign is being implemented at community level and community health workers are among the stakeholders,”

Introduced in 2014, Rapid SMS helps to track women from the first day of gestation to child birth.

In a bid to ease health care delivery, Rwanda’s ministry of healthy distributed free telephones to thousands of community health workers as each handset is installed with software that tracks and reports about mothers and their baby’s health condition.

In case of emergency, an SMS is sent to the toll-free number. The message is delivered to a central server. The system then sends a quick alert to a health center in the territory and tells them to intervene. The process takes a couple of seconds.

Nevertheless, most women are yet to be recorded in the system in the first two months of pregnancy which hinders the use of the system to monitor their pregnancy.

“Medical assistance through Rapid SMS technology can only start with early registration of pregnancy,” Naganze said.

On mothers who don’t report their pregnancy in the first two months, Teredia Uwihoreye, a community health work from Rugero sector in Nyabihu district says, “At times we have to request assistance from authorities to compel some expecting mothers to give us their antenatal history”.

But Theoneste Uwanzwenuwe, mayor of Nyabihu district says the district has intensified campaigns to involve men during the parents’ evening meetings at a village level.

“We send a clear a message up to the lower level and this has seen improvement also in hygiene, nutrition as well,” he said.

The health ministry official says in efforts to accelerate the reduction of maternal, child deaths and eliminate stunting, the Rapid SMS system was upgraded to track the full cycle of the first 1,000 days of a child’s life in Rwanda since 2012.

WHO recommends a minimum of four antenatal care visits. However, global estimates indicate that only about half of all pregnant women receive this recommended amount of care.

The mayor also noted that antenatal care helps women prepare for delivery and understand warning signs during pregnancy and childbirth. In addition to medications it also plays role in preventing mother-to-child transmission of HIV in cases of HIV-positive pregnant women.










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