Improving Maternal Child Health Using mHealth Technology in a Middle-Income Country with Community Health Care Workers

Purpose: For this pilot project our team trained eight community health care workers (CHW) to monitor pregnant third trimester women for complications of pregnancy by evaluating them in their homes. Data collected at each home visit was transmitted through the use of mobile cell phone technology to the monitoring primary care physician to determine the health status of the mother. The pilot was implemented with data collection over a 6 month period.  This pilot was implemented in El Cercado, located in the rural and remote “frontier” of the Dominican Republic (DR). Maternal mortality in the DR (150 per 100,000, an increase from 130/100,000 in 2000, and infant mortality (22 per 1,000 in 2010) rank among the highest in the Latin America/Caribbean area (World Health Statistics, 2012) with a  2.5% decrease for maternal mortality, a number representing only half of that needed to achieve the relevant MDG target. 

Methods: Descriptive and quantitative analysis based on the Community Based Participatory research framework.       

Results: Training community health care workers to provide 3^rd trimester prenatal care assessments and communicate collected data using mobile health technology to a primary care provider has the ability to improve maternal and infant mortality in the El Cercado region of the Dominican Republic.

Conclusion:  This pilot study involved 3 communities and provided an opportunity to understand the processes involved in implementing the use of community health care workers with mobile cell phone technology in this region. An application to the NIH is in consideration for implementing investigation of the efficacy for 13 communities in this region.