Peter Barron National Department of Health, South Africa

MomConnect Aims: Responding to sub-optimal MCH indicators Strengthen information systems: Introducing a mechanism for registering electronically pregnancies in public health system using unique ID number. Strengthen demand side of health system: Send targeted health promotion messages to pregnant women to improve their health and infants To provide pregnant women with an interactive mechanism to feedback: ask questions; rate service; complain/compliment To empower and support nurses with regular content; encourage study and peer support groups; provide feedback mechanism for nurses to make suggestions (NurseConnect) Each of these uses mHealth in a different way

Innovation Political leadership and multi-sector partnerships Public sector pregnant women get registered free on DOH database Receive messaging linked to stage of pregnancy and age of baby up to 1 year Women interact with helpdesk; get more information & provide feedback about quality of care Nurses (NurseConnect) also register and get suitable information to support them

Some Achievements After 27 months of operation: Over 1 million pregnant women linked to SMS messaging They ask 1000 questions a day - helpdesk Nearly 7 times as many compliments (7064) as complaints received (1079) NurseConnect introduced in May 2016; 14000 nurses connected Specific eMTCT additional messaging for HIV positive women Some impact on the supply side of health system

Outcomes: Telephonic Survey with Mothers The survey took place in July 2015 Of nearly 10,000 women who were surveyed 21,6% responded Over 98% (1962) of these users felt that MomConnect messages had helped them Over 80% (1611) had shared the messages with friends or their partners Over 80% (1606) reported that the messages helped them to remember their clinic visits Over 75% (1531) of users reported that the messages had helped them feel more prepared for childbirth and delivery. Over 70% (1414) actually wanted more messages than the 100 plus messages they already receive during pregnancy /first year of child's life​. This survey was done to supplement the M&E component

Impact Overall M&E report being finalised: Preliminary findings show that pregnant women do have increased knowledge and attitudes towards health

Challenges Behaviour change difficult Some difficulties with registration (USSD) Volume of enquiries for helpdesk Cost of SMS/financial sustainability Babies reaching 1 year System capacity to innovate Integration (multiple mHealth projects and apps continuously popping up)

Response to Challenges Moving to data – WhatsApp NurseConnect extending to all nurses Upgrade of helpdesk (and integration of other helpdesks in Health Department) Extension of MomConnect Getting mHealth into mainstream health conversation More precise monitoring (behaviour change experimentation)

Thank you Siyabonga