The aim of the present case study is to assess prospectively the HIA of a proposed mobile health intervention to reduce MMR in 10-years. PHIA was carried out on a proposed mHealth intervention to MMR. In addition, an online feasibility pilot study was carried out involving 41 participants from September 1st, 2021, to January 2022. The intervention improved the well-being of pregnant women via education on good nutrition. It reduced MMR, travel costs, frequency of visits to healthcare centers, and increased equality in healthcare accessibility. Due to the reduced frequency of hospital visits, the risk of transportation and road accidents were noticed. About 88% of participants stated the intervention is feasible and worthwhile. While nearly 95% said they are eager and prepared to use the intervention when implemented. The intervention can improve the health of mothers, MMR, and reduce health inequality. Feasibility and willingness to use the new intervention were very high, hence the intervention should be tested on a larger population and in different geographical regions. .
TopIntroduction
Health interventions are necessary to alleviate and improve the health of inhabitants in a community. Though there have been some improvements in healthcare services in Ghana, residents in rural communities are unable to experience the full benefits for diverse reasons. Consequently, they continue to face inadequate healthcare services, increasing health inequality among rural communities. All in all, women and children suffer more, and unacceptably, maternal and under-5 mortalities continue to be a public health concern globally. However, the rate is high in many middle-income and low-income countries (MLIC), especially in sub-Saharan Africa. So, there is an urgent need for a more easily accessible health intervention to reduce maternal mortality.
Maternal and under-5 mortality remains a great concern in many countries globally. However, over 86% of global maternal deaths occur in middle and low-and middle-income countries (LMIC) annually though they are mostly preventable (WHO, 2021b, WHO., 2014). In Colaci et al’s study (2016), 99% of global maternal deaths occur in developing countries, usually in rural communities. About 50% of pregnant women in LMIC lack adequate care during child delivery resulting in high maternal mortality rates (MMR) (Moyer et al., 2013). For example, the prevalence of pregnancy-related hypertension is one of the leading causes of maternal mortality (Mudjari and Samsu, 2015). Nonetheless, most pregnant women in developing countries are oblivious to this knowledge and, hence, they are unable to detect it early or to seek medical attention during pregnancy. Although most organizations are determined to reduce the occurrence of maternal and under 5 mortalities, it continues to persist. This is unsurprising because, the top-three preventable factors that adversely affect most maternal mortality (MM) have been identified; inadequate antenatal care delivery, lack of maternal health awareness, and tribal belief systems (Colaci, et al., 2016). In 2015, WHO launched a strategy to end preventable maternal mortality (EPMM). The aim and target of the program were to reduce the global MMR to less than 70 per 100 000 live births by 2030 (SDGs 3.1) (WHO., 2014). Even though the prevalence has reduced, a lot needs to be done to further reduce the occurrence to its barest minimum. As the saying goes “knowledge is power”, it has become prudent that pregnant women are educated and encouraged to attend antenatal services. They should also be informed about immunization against tetanus, iron and folate supplementation, voluntary counseling, testing for HIV, the importance of good nutrition, and resting. Due to the challenges in accessing healthcare, especially, in rural areas, the health education is partly hampered.
There is a need to devise other ways of monitoring, disseminating information and communicating with the women concerning their health and well-being. This has become necessary and imperative because it has been established that poor access to quality healthcare is a strong contributor to high maternal and under-5 mortality rates in developing countries especially sub-Saharan Africa (Adam et al., 2021). Furthermore, due to the shortage of doctors and other health professionals, interventions that will serve and monitor the health of many pregnant women but are not resource intensive are highly recommended. This will help healthcare professionals easily detect and identify women who are at risk and need urgent healthcare. Following the advancement of technology globally, there is a need to explore ways of communicating with others with ease. Generally, perinatal periods can be very demanding for mothers, especially new mothers. The period comes with emotional, physical, financial, and social adjustments to the new norms and expectations (Dol et al., 2020). Due to the overwhelming nature of pregnancy, it is imperative that pregnant women are monitored and provided with the needed information to ease their stress.