mHealth in Tanzania: Improving Delivery & Quality of Community Home-Based Care

Lulu Gama, a home-based care provider in Tanzania, uses her mobile phone to better serve her clients. Here, she visits Sauda Nuru, a mother who decided to limit her family to two children after receiving information about family planning.

Pathfinder’s mHealth work in Tanzania began in 2008 with funding from the Centers for Disease Control under the Tutunzane project, and used mobile technology to improve communication and reporting between health clinics, home-based care providers, and clients. In collaboration with D-Tree International, Pathfinder and its Tutunzane partners used a mobile phone-based application, CommCare, to improve HIV and AIDS, tuberculosis, malaria, and family planning services offered at the community level. 

Community home-based care providers use mobile phones to provide better care during home visits, to follow referrals, and to improve client data management and use. Each month, CommCare sends a short message service (SMS) or text message summary of community home-based care activities to the home-based care providers' supervisors. District level coordinators access the collected data online, which further improves communication and information-sharing between community-based providers, facility providers, and district coordinators. There are currently more than 300 home-based care providers in and around Dar Es Salaam using this mobile phone application.

In addition, Pathfinder worked in collaboration with FHI360 and D-Tree International to develop the content for a family planning application based on the Balanced Counseling Strategy Plus approach to guide home-based care providers through client counseling. 

Mobile Money: Using mPesa to support our work
Since 2010, Pathfinder Tanzania pioneered the use of mPesa for office operational costs, as well as delivery of payments for Pathfinder-supported community health workers in Tanzania. From November 2010 to May 2013, Pathfinder Tanzania became the second largest corporate user of Vodacom mPesa services and has sent $1.8 million through the mPesa platform to over 20,000 recipients. Now, more than 95 percent of all its office transactions are initiated through mobile money. All community health workers supported in Pathfinder’s projects are paid monthly via mPesa and all training recipients receive stipends via mPesa. Pathfinder is currently working with partners to write a multi-country case study of the use of mobile money in Tanzania, Kenya, and Uganda.

Mobilizing for Maternal Health, Sengerema District
Pathfinder, in partnership with the Touch Foundation and Vodafone Foundation, are developing a partnership to reduce maternal mortality by expanding the availability of comprehensive emergency obstetric care, in addition to community level activities aimed at reducing maternal mortality during delivery and childbirth. As part of this project, Pathfinder and its partners will implement an innovative emergency transport system using SMS and mPesa to ensure clients have access to the services they need. Community health workers equipped with a mobile phone decision support application will also be trained to ensure clients in need of transport for delivery receive the necessary care at the community level and are referred in a timely manner.

Expanding Method Mix with Standard Day’s Method
Pathfinder's E2A Project is supporting the Government of Tanzania and the Shinyanga region to systematically introduce the Standard Day’s Method using Cycle Beads through a network of existing community-based providers in the region. This activity will build on over a decade of continuing investment at the national level in community based programs by Pathfinder under the Tutunzane project. The project builds on the existing system for community-based family planning services in Shinyanga by adding new approaches: the use of IEC materials, palm cards for counseling, Standard Day's Method, and use of mobile phone applications for improving counseling, follow-up, and data collection. Under the program, community health workers use a mobile application to offer counseling to users on all methods.