PHI-Tanzania

Mlinde Mama

Mlinde mama Project Tanzania

Sept 16, 20236 min read

Mlinde Mama Project

“Mlinde Mama” is a two-year project funded by the Bill and Melinda Gates Foundation (BMGF). The project aims to develop and pilot a digital health intervention that will enhance care and reduce adverse birth outcomes during antenatal care through a Group ANC (GANC) Model as a platform for implementation. The project is being implemented in Geita region and will build on the prior investments under Jhpiego-led USAID Boresha Afya- Lake and Western Zone Project that provided platform for implementation of GANC randomized control trial study.

Why Mlinde Mama, Geita

Maternal morbidity and mortality remain a significant public health concern in Tanzania and globally. In Tanzania, maternal mortality leading causes are post-partum Haemorrhage (PPH), infections, unsafe abortions, hypertensive disorders (pre-eclampsia and eclampsia), and obstructed labor. These leading causes of maternal deaths are preventable and manageable, if preventive measures and timely clinical decision making is made and instituted.

Prime Health Initiative Tanzania (PHIT) is strategically focused on solving new and existing community public health challenges through innovative and scientifically proven methodologies in partnership with Government of Tanzania through Ministry of Health (MOH) and Presidents Office-Regional and Local Governments (PO-RALG) Ministry. The system is powered by a Machine Learning (ML) algorithm with the aim of; leveraging existing digital health systems and adding new innovations to increase functionality and make improvements hence strengthening community linkages with the health facility improving service delivery and outcomes. This will be achieved by facilitating clinical decision making and referral services and improving the level of knowledge, awareness and support to pregnant mothers so that they can take timely actions to improve their pregnancy outcomes.

Mlinde Mama lays the foundation and leading the way on integrating ML/AI in improving the quality of care in health settings in Tanzania. Also, Mlinde Mama contributes directly the addressing of the first and third delays in maternal care and access to services, and partly the second delay.

Mlinde Mama lays the foundation and leading the way on integrating ML/AI in improving the quality of care

Interventions

“Mlinde Mama” project demonstrates the use of ML for stratifying pregnancy risks among women attending ANC clinic stratified by those who will opt to attend GANC vs those attending individual traditional ANC. Regardless of whether a woman attend GANC or individual ANC the project utilizes machine learning platform to help health care providers make appropriate and timely clinical decisions to ensure that clients are put on the appropriate care pathway e.g. higher risk pregnancies are referred to higher level health facilities timely for proper management. The machine learning collects data on all pregnant women.

Project Coverage

Geita is an ideal region for high impact during initial deployment of “Mlinde Mama” where Jhpiego had previously implemented the Group ANC and Unified Community System App (UCS), PHIT increases Mlinde Mama’s chances for success by learning from Jhpiego experience in this region. The “Mlinde Mama” project is implemented in seven health facilities purposively selected among the 20 health facilities which were implementing GANC during USAID Boresha Afya- project time. This pilot study includes the Geita Regional Referral Hospital (for referral follow-ups), two conveniently selected district hospitals (Nzera and Chato District Hospitals), two health centers implementing Comprehensive Emergency Obstetric and Newborn Care (CEmONC) (Katoro and Bwanga Health Centers) and two dispensaries (Butengorumasa and Nkome). The seven health facilities represents various levels of health care delivery referral system through the continuum of care.

Objective

The goal of this project is to test a digital health system that will enhance care and ultimately reduce adverse birth outcomes using GANC model as a platform of implementation. Primary Objectives

To pilot and test functionality of a digital health system to facilitate timely clinical decision making for pregnant women attending ANC.
To pilot implementation of GANC model in Geita Region of Tanzania.
To assess the feasibility and acceptability of GANC among pregnant women and health care providers.

Expected Outcome

It is expected that the implementation of ML system and the Group ANC in the project will demonstrate efficiencies in use of technology in supplementing provision of care by reducing the burden on understaffed and low resource healthcare facilities while ensuring patients are attended at the appropriate level of care according to their risks. Additionally, there will be increased awareness of the role of digital solutions in healthcare amongst MOH, PO-RALG and other stakeholders. The project will also explore from pregnant women and health care providers on the feasibility and acceptability of GANC.

Road to Sustainability

PHIT is working in collaboration with the MOH, PO-RALG and a team of developers to extend the existing tools through participatory design. Extending the existing system using local knowledge ensures the continuous support of the tools through the community, hence making sure the tools will not go without support.

Apart from the development, data collection is also based on standard Antenatal Care Practices in Tanzania and collected using locally available medical tools hence when the project ends, there won’t be a need for another stream to print tools.

Measures taken by “Mlinde Mama project”, make it easy for other projects and implementing partners to adopt the system in their areas of support easily with no significant costs in the implementation, but rather training of service providers.