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Strengthening Health Systems with Mobile Technology: Innovative Solutions to Improve Antenatal Care

2010-2011 || U.S. Agency for International Development

Abstract

The Mobile Delivery of Distributed Diagnostics (MD3) pilot project designed and tested mobile health (mHealth) technologies in order to address the long-standing challenge of improving maternal healthcare in Tanzania. Wireless networks, portable diagnostic tools (specifically ultrasound technologies), mobile computing devices, and mobile phones were used simultaneously to try to improve the delivery of obstetrical care in three wards of the Temeke district of Dar es Salaam, Tanzania. Deloitte Consulting LLP understands that crucial to any lasting solution is the creation of a sustainable business model that supports improved allocation of scarce financial resources and, in turn, strengthens overall health systems. Accordingly, Deloitte worked in a participatory fashion with local stakeholders including representatives of the Tanzania Ministry of Health and private health facilities to support costing activities and the creation of financial planning tools. MD3 was a collaborative effort of Deloitte Consulting LLP, Deloitte Tanzania, the Bienmoyo Charitable Foundation, and local stakeholders from the public and private health sectors.  

The Challenge

In Tanzania, 950 per 100,000 women die from complications during pregnancy and childbirth. By contrast in western societies, such as Ireland with the lowest figures, the estimates are 1 per 100,000 deaths.1These deaths result in Tanzania's ranking of 33rd in the world for maternal mortality. According to specialists, many of these deaths can be prevented with basic obstetrical care, allowing healthcare workers to early diagnose and even treat potential issues. Estimates claim about 15 percent of births have dangerous complications, but they are almost impossible to predict within Tanzania's current health system.2

How We Helped

Deloitte provided overall project management, as well as ongoing technology support, strategic planning, and costing and financial analysis to build local capacity to pilot and deploy the MD3 solution. Critical to our work was the team's ability to quickly adapt to local settings while contributing relevant technical knowledge and leading practices in financial costing.

MD3 integrated key components of obstetric care into a single mobile platform to facilitate diagnostic tool use, health records collection, and communication at the community level about healthcare services. By connecting the community to healthcare facilities, MD3 provided an opportunity for early detection and follow up of pregnancy complications, as well as referrals for the most serious cases to more advanced facilities. Furthermore, MD3 proved to be a valuable data collection tool facilitating sharing of information about patient needs, status of supplies, and other essential information with central hospital facilities. Simultaneously, Deloitte supported costing activities and the creation of a budgeting tool to support the integration of MD3 related financials into the current health system planning process. The MD3 technology was piloted using mobile clinics of partner health facilities.

Solution

MD3 demonstrated that when appropriately applied, mobile solutions may enhance the quality and efficiency of patient care. Further, mobile tools have the potential to improve data collection at the community level in support of stronger health information systems and evidence-based decision making at the central level. Overall, innovation in service delivery supports health systems strengthening by identifying opportunities to improve health supply chains, enhance health workforce training, facilitate better health information exchange, and promote local ownership and leadership. In the developing world where delivering healthcare is a constant challenge, Deloitte is directing its efforts to innovations that can help improve health systems.

1 UNICEF; World Health Organization; Collins Bartholomew
2 Grady, Denise. "Where Life's Start Is a Deadly Risk." The New York Times. 23 May 2009.  

As used in this document, “Deloitte” means Deloitte Consulting LLP, which provides strategy, operations, technology, and human capital consulting services, Deloitte Financial Advisory Services LLP, which provides financial advisory services, and Deloitte & Touche LLP which provides governance and risk oversight and reporting advisory services. These entities are separate subsidiaries of Deloitte LLP. Please see www.deloitte.com/us/about for a detailed description of the legal structure of Deloitte LLP and its subsidiaries. Certain services may not be available to attest clients under the rules and regulations of public accounting.

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