Mobile telephone provider to provider helpline: A pilot study in Cameroon

Abstract

Background: Despite the availability of effective strategies, countries in Sub-Saharan Africa continue to be disproportionately affected by maternal and perinatal morbidity and mortality. Mobile health interventions are recognized for their potential usefulness in addressing gaps to quality maternal and neonatal care in low-income countries, including those for health care providers. Objectives: To measure feasibility and acceptability of an adapted 24/7 mobile phone-based medical information service via telephone (mMIST) provider-to-provider intervention in one district of Cameroon. Study Design: We implemented a multimethods pilot study of mMIST in Ndop Health District in the Northwest region of Cameroon from March 2022 to February 2023. We projected on average one call every 2 days as an acceptable demand level, and at least 70% of providers rated the mMIST intervention as satisfactory for acceptability. We evaluated the feasibility of collecting administrative data on maternal and neonatal morbidity and mortality for the assessment of mMIST on clinical outcomes. Results: Thirty front line and on-call expert maternal healthcare workers who staffed the mMIST answering line and 76 peripheral maternity providers in the Ndop Health District were trained to use the system. A total of 3991 births were reported during the mMIST pilot year. Monthly calls ranged from 2 in the first month to a high of 28 calls by the 6th month, with an average call volume of 14 per month. Forty-six out of 48 providers (96%; 95% confidence interval [78,95]) were satisfied with mMIST. Providers reported that intermittent electricity and internet connectivity issues were the main barriers to usage. We found that it was feasible to obtain administrative data on relevant neonatal and maternal outcomes in the district but inconsistencies in local reporting prevented reliable comparisons. Conclusion: Overall, the mMIST intervention was feasible to implement and was acceptable to maternal healthcare providers who staffed or used the intervention. Adaptation to local context, engagement of, and buy-in from multiple stakeholders in our formative work contributed to feasibility and promising findings to inform larger scale evaluation of the intervention.