mBirthCare – Integrating basic primary birth care and mHealth records in Sub-Saharan Africa

Rationale: Facility-based births must be superior to home deliveries for both the mother and the infant. This is not always the case in remote poorly equipped first level maternities in SubSaharan Africa with poorly trained staff.  Approach:  A multi-pronged combination of proven elements and innovation to improve the birth care in first level maternities: 1) Novel use of mobile phone registration for pregnancies and their outcomes, two-dimensional barcodes as ID proxy, automated decision-support during labor and referral and an automated work flow feedback incentive; 2) Skills training of staff members at first level maternities in a simplified package of essential interventions of birth care; 3) Improved birth-planning during antenatal care; 4) provision of free-of-charge "mama kits" at the maternity as demand creation.Objective and Impact: To decrease maternal and perinatal mortality and morbidity by increasing the number of women who have access to quality delivery care at the first level of care; to create a mobile registration system able to record mortality changes and to develop a model to improve quality of basic birth care within the existing health infrastructure that can be applied and sustained in the three countries.  Innovation: Our intervention is a multi-pronged strategy where the strength is the integration of proven elements (such as staff training using simulation, improved birth care and mama kits) and innovation, where the most innovative elements are the system for mobile registration of pregnancies, the mobile incentives and 2D barcode as ID proxy.