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Ann Med Surg (Lond)
Ann Med Surg (Lond)
MS9
Annals of Medicine and Surgery
2049-0801
Lippincott Williams & Wilkins Hagerstown, MD

10.1097/MS9.0000000000000247
00043
3
Correspondence
Improving maternal health services utilization in Ghana: should digital health be considered? Correspondence
Asumah Mubarick N. BSc, MPhil, RGN anungbaso.asumah@uds.edu.gh

Mohammed Mahmud Y. BSc, MPhil, RGN amohammedyusif335@gmail.com

http://orcid.org/0000-0002-7906-9419
Abubakari Abdulai BSc, PhD, MPH babubakari.abdulai1@uds.edu.gh

Padhi Bijaya K. BSc, PhD, MPH bkpadhi@gmail.com
c
a Ministry of Health, Nurses’ and Midwives’ Training College
b Ghana Health Service, Tamale Central Hospital, Tamale, Northern Region, Ghana.
c Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India
* Corresponding author. Address: Ghana Health Service, Kintampo, P.O. Box 565, Tamale, Northern Region, Ghana. Ghana.Tel.: +233240701265. E-mail address: nungbaso.asumah@uds.edu.gh (M. N. Asumah).
3 2023
17 2 2023
85 3 557558
5 1 2023
8 1 2023
Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.
2023
https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/

OPEN-ACCESSTRUE
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pmcIn developing countries, maternal deaths and morbidity remain serious problems despite significant attention being paid to the issue globally. Despite the safe motherhood program and national health insurance program being implemented, which were viewed as efforts to promote maternal health, women continue to pass away during childbirth. Over half of all maternal fatalities, or 99% of all maternal deaths in developing countries, are thought to occur in sub-Saharan Africa (SSA)1.

From the foregoing, the use of extreme measures to stop the tide is required. Enhanced utilization and availability of maternal healthcare services (MHSs), such as prenatal care, an increase in the number of women receiving skilled medical attention during childbirth, and the provision of postnatal care services to both mothers and babies are some of the various measures taken to curb the maternal and child mortality and morbidity2. Over time, antenatal care (ANC) has shown to be an effective solution to the issue of mother and infant mortality3. ANC is a key metric for Sustainable Development Goal 3 goal 3.1, which asks for lowering the worldwide maternal mortality ratio to fewer than 70 per 100 000 by 2030. ANC has been noted as the bedrock of maternal and child health because by attending ANC, the likelihood of having a skilled health professional attendant assist with delivery and receive postpartum care is seen as high.

The WHO defines postpartum care as the treatment provided to a mother and her newborn child in the early hours following the delivery of the placenta and throughout the first 42 days (6 weeks) following birth4. Available literature shows that more than half of the 585 000 maternal deaths that occur each year worldwide occur on the first day after giving birth5. Therefore, having a trained birth attendant deliver you and using postnatal care services afterward could prevent these deaths.

Despite the apparent importance of MHS, the availability and utilization of MHS in several African nations are reportedly hindered by a multiplicity of factors. Although numerous studies have been conducted to suggest ways to improve MHS utilization, telemedicine or digital health have not been exploited enough as a tool to improve MHS. Digital health technology has been demonstrated to expand access to health information, as well as to improve the quality and coverage of care6. It has also been found to encourage healthy behavior changes that delay the onset of both acute and chronic diseases7. Telemedicine can enhance mother care and lower infant mortality in a variety of different ways6. By providing access to accurate and up-to-date information about sickness and therapy as well as the cutting-edge methods of treating certain medical disorders, they can support the in-service education of healthcare practitioners. In addition to providing healthcare professionals with access to this information, it also helps them know where to find more information about a variety of health conditions8. Additionally, due to the low socioeconomic situations of many rural residents, it saves a significant amount of time traveling and increase productivity as patients do not need to take the day off from work. Urban areas need telemedicine as well; it might reduce the strain on understaffed healthcare institutions and minimize overcrowding as many patients receive medical attention at home.

Mobile devices make it easier to treat chronic diseases, care for mothers, and prevent disease outbreaks8. They improve the effectiveness and efficiency of the medical system through patient surveillance and reporting and offer badly needed healthcare to underserved communities7–9. Mobile’s benefits are particularly obvious in developing nations. In many parts of the world, phone apps, telemonitoring technologies, and eLearning resources are becoming more prevalent. This has provided medical practitioners, including midwives, who are supporting rural populations that require healthcare and direction with up-to-date information8.

Results demonstrate that these mobile health (mHealth) activities are producing fruitful outcomes8. In China, for instance, a study has shown that ‘text message and telephone reminders improved appointment attendance by 7%’10. A voice message on infant and child feeding (IYCF) treatments may enhance IYCF behaviors in early childhood, according to a study conducted in Senegal11. SMS-based mobile phone interventions have greatly increased the use of MHS in Ethiopia12. The potential for mHealth interventions to lessen barriers to equal access to maternity and child healthcare services for remote women and health professionals was demonstrated by a study conducted in Ghana9. Another study done in Ghana found that utilizing mHealth to improve the availability and uptake of MHS in Ghana is very cost-effective and should be considered for growth13. A scoping review in development also indicated that digital health interventions can improve access to maternal and child health services7.

Beyond these advantages that digital health comes with, digital health inequalities are still pervasive in Ghana, where the increased adoption and use of digital health are challenged. Medical professionals, government organizations, and private sector organizations are starting to comprehend how phone technology might be used to create and inspire solutions that improve people’s and nations’ health. As such, the government should invest in the promotion of digital health infrastructure, sponsor capacity building for health workers, and sensitize the citizenry to utilized digital platforms. The daily lives of people may be significantly improved thanks to the quick development of mobile technology and its use in mHealth, and Ghana and its population should not be left behind.

Ethical approval and informed consent

Ethical approval and informed consent were not required for this study.

Sources of funding

There was no source of funding for this research.

Author contributions

M.N.A., M.Y.M., and A.A.: conceptualization. A.A. and B.K.P.: validation. M.N.A. and A.A.: resources. M.N.A. and M.Y.M.: writing – original draft preparation. B.K.P. and A.A.: writing – review and editing. B.K.P., A.A., M.Y.M., and M.N.A.: visualization. B.K.P. and A.A.: supervision. All authors have read and agreed to the published version of the manuscript.

Conflicts of interest disclosure

The authors declare no conflict of interest.

Research registration unique identifying number (UIN)

None.

Guarantor

All authors.

Provenance and peer review

Not commissioned, externally peer reviewed.

Data availability

Data sharing is not applicable to this article as no new data were created.

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Published online 17 February 2023
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References

1 WHO and UNICEF. UNFPA, World Bank Group and the United Nations Population Division. Trends in maternal mortality 2000 to 2017: estimates by WHO, UNICEF. UNFPA, world bank group and the United nations population division. Geneva; 2019.
2 WHO. Standards for improving quality of maternal and newborn care in health facilities. 2016.
3 Osman ASA Ahmed MA Mohamed MH . Factors affecting the utilization of antenatal care among married women of reproductive age in Merca, Lower Shebelle, Somalia. J Biosci Med 2022;10 :165–75.
4 WHO. WHO technical consultation on postpartum and postnatal care. WHO; 2010.
5 Hordofa MA Almaw SS Berhanu MG . Postnatal care service utilization and associated factors among women in Dembecha District, Northwest Ethiopia. Sci J Public Heal 2015;3 :686–92.
6 WHO. Monitoring and evaluating digital health interventions: a practical guide to conducting research and assessment. 2016.
7 Venkataramanan R Subramanian SV Alajlani M . Effect of mobile health interventions in increasing utilization of Maternal and Child Health care services in developing countries: a scoping review. Digit Heal 2022;8 :20552076221143236.
8 West DM . Using mobile technology to improve maternal health and fight Ebola: a case study of mobile innovation in Nigeria. Cent Technol Innov Brookings 2015;19 :308–12.
9 Laar AS Bekyieriya E Isang S . Assessment of mobile health technology for maternal and child health services in rural Upper West Region of Ghana. Public Health 2019;168 :1–8.30660898
10 Chen Z Fang L Chen L . Comparison of an SMS text messaging and phone reminder to improve attendance at a health promotion center: a randomized controlled trial. J Zhejiang Univ Sci B 2008;9 :34–8.18196610
11 Downs SM Sackey J Kalaj J . An mHealth voice messaging intervention to improve infant and young child feeding practices in Senegal. Matern Child Nutr 2019;15 :e12825.30950190
12 Atnafu A Otto K Herbst CH . The role of mHealth intervention on maternal and child health service delivery: findings from a randomized controlled field trial in rural Ethiopia. Mhealth 2017;39 :3.
13 Willcox M Moorthy A Mohan D . Mobile technology for community health in Ghana: is maternal messaging and provider use of technology cost-effective in improving maternal and child health outcomes at scale? J Med Internet Res 2019;21 :e11268.30758296
