Using cell phones to collect postpartum hemorrhage outcome data in rural Ghana

Objective: To evaluate the use of cell phones by professional and traditional birth attendants in rural Africa for reporting postpartum hemorrhage (PPH) data. Methods: Ten birth attendants from the remote Sene District of Ghana participated in the study. Subjects were trained to send Short Message Service text messages from cell phones using a simple numeric protocol to report data regarding PPH: maternal age; PPH; use of bimanual uterine compression; maternal and neonatal mortality; and prenatal care. Participants sent texts to a pre-programmed number to report data for all births they attended over a 90-day period. Results: In total, 425 births and 13 (3.1%) cases of PPH were reported during the 90-day period after training. All attendants followed the reporting protocol correctly, although with uncertain data integrity. Conclusion: The results indicate that it is possible to train professional and traditional birth attendants to use cell phones to report health-related outcome data via a specified protocol. Reporting from rural-based providers may present a more accurate picture of what occurs in remote communities because it happens in real time. These findings could be exportable to other program evaluation or population-monitoring applications (healthcare and other) where rural outcome tracking is necessary.