(Chemba District, Dodoma Region)
Jesca Juma was already four months pregnant (her first pregnancy) and yet not booked for antenatal care (ANC) when she noticed an unusual situation for her pregnancy. She noticed fluid leaking from her private parts, worried she decided to call Burhani Ramadhan Omari a Community Health Worker (CHW) in Goima village in Chemba district, Dodoma.
“It was evening when I noticed that there was fluid leaking from my private parts. I was worried and the only thing that came to my mind was to call Burhani because he is known here for connecting sick people with health care workers at our dispensary. He is famous here and thanks God he arrived in time.”
Jesca delayed booking herself for (ANC) and already she had an early ruptured membrane caused by underlying conditions which mostly causes excessive bleeding, a life-threatening infection, or obstetric fistula. It is required that a pregnant woman start ANC services at least within 2 months to help Health providers detect any threat at an earlier stage and address them timely.
This kind of delay is most common in rural areas and is even worse in an environment with ineffective referral systems that link communities with health facilities for early emergency response. Goima village had a similar challenge where emergency pregnancy complications were dealt manually through filling of paper-based forms and letters, a process which prolonged arrival and preparedness of the health facility.
Thanks to the innovation of a quick and reliable mobile App that helps to facilitate emergencyresponse like this in Chemba District to save lives. Burhani is among 34 CHW linked with 18 health facilities in Chemba empowered by Mkapa Fellow Program Phase III project with mobile phones installed with a digital App termed as Community Health Assistance Information and Decision (CHAID) tool that helps to respond with healthcare challenges in community through the Irish Aid support. When he arrived at Jesca’s home, the assessment got his attention on what he believed could be a life threatening condition.
“The MFP III project gave us this mobile phone and in it they have installed an application which guides us to assess clients through tailored questions. When I was assessing Jesca, I noticed a danger sign through guided questions from the CHAID tool and it guided me to click a referral as she was in the danger category. I filled the form in the CHAID and pushed a button that alerted the Medical Officer Incharge at Goima Dispensary,” narrated Burhan.
Miles away, Dr. Samson Iman Makowe’s mobile phone squealed. On his screen was the referral message from Mr. Burhan, the CHW alerting on the condition of the client which needs immediate attention. Samson figured what to do. Immediately he alerted his team to get prepared.
“I was home that evening when Jesca arrived at the Dispensary, we were all set for an emergency task. Thanks, it wasn’t complicated, we handled it perfectly. She experienced premature rapture of membrane and it was an inevitable abortion, so we had to administer oxytocin to argument expulsion of conception materials,” said Dr. Simon Makowe
The CHAID tool system tackles the three delays that stand in the way of women and children accessing high-quality health care: delays in making the decision to seek care, reaching Care, and receiving proper care at a health facility.
Community Health Care workers like Burhan have been working closely to link the communities with health facilities by providing sensitization through education and follow ups while making timely referral decisions for any identified danger sign among women and children. To complement their work, MFP III innovation to introduce the CHAID tool has been instrumental not only for an emergency referral like this but also to collect and administer data including tracking of clients for easy follow up.
“This tool is very useful, and it has completely simplified Buruhani’s work. With the tool Buruani can directly refer the client for immediate care. It has also been very easy for me to make all the initial preparations even before the client arrives at the facility because there is an option of seeing the cause of referral. I can say with tools we have reduced the client management delay especially when it comes to management of pregnant women presenting with dangersigns and has significantly strengthened the community facility linkages.” said Dr. Makowe.
Thanks to the support from the Irish Aid and collaboration with the Ministry of Health Community development Gender and Children (MoHCDGEC) and the President’s Office Regional administration and Local Governmen (PORALG), to date the Benjamin Mkapa Foundation through its led project MFP III have been able to scale up this innovation to over 1000 CHWs in different regions across Tanzania.