RapidSMS Rwanda

Problems to solve: – Early registration of pregnancy and increasing ANC visits – Tracking pregnancy cycle for high risk mothers in the community – Allows CHW to follow up pregnant mother who present a critical situation (danger signs) to ensure assisted deliveries in a health facility – Sends red alerts which triggers ambulance pickup and preparation for emergency care services at the receiving health facilities – Improving postnatal maternal and newborn care visits – Stores and provides crucial information about childhood killers in all villages – Impacts on behavior change on key family practices and hence reduce maternal, newborn and morbidities – Avails real time data triangulated with other data sources to inform decisions for improved care.

RapidSMS Rwanda is an innovative mobile technology tool that saves lives by tracking pregnant women, newborns and children under two years of age at community and health facilities that receives reports on key MNCH indicators from over 45,000 community Health Workers (CHWs) in 15,000 villages across Rwanda. The RapidSMS-MCH system was designed to provide an SMS-based platform, enabling effective and real-time two-way communication for action, between CHWs at community level, and the rest of the health system (ambulance, health facility staff, District Hospital and Central level) through mobile phones. The primary expected result of the system is an improved access to antenatal, postnatal care, institutional delivery, and emergency obstetric care and RED ALERT emergency response system on real time In addition, RapidSMS provides a database for keeping clinical records of maternal,Newborn and Child care delivery. RapidSMS technology receives short messages (sms) from CHWs and sends a short feedback message to a centralized computer which is able monitor incoming information about emergencies (red alerts) and high risk cases in real time, and provides a reminder when follow up care is required. RapidSMS is one of strategies that Rwanda has employed in the effort to reduce maternal and child death. RapidSMS is a free and open source platform for mobile system built in Python and Django, which was customized for application to track key maternal, newborn and child health indicators across all villages in Rwanda. The platform was implemented to facilitate communication between CHWs and the ambulance system, health facilities staff, and the central government. CHWs are the lowest level of service delivery at the community level, offer preventive and basic curative services at village level, transmit key MNCH indicators to the system directly. They are intended to be the first point of contact with the health system for the population and to create a liaison between community health services and health facilities. Each village has three elected CHWs (two in charge of maternal and newborn, and one in charge of child health). In 2009 RapidSMS Rwanda began as a pilot in one district of Rwanda (Musanze District) located in Northern Province. The pilot system with tracking pregnancy cycle beginning with pregnancy confirmation, child health from 0-9 months, and RED ALERT emergency response system. In 2012 RapidSMS Rwanda was upgraded to track a full 1000 days of maternal and child health including postnatal mother and newborn care services, community-based nutrition from 0 to 2 years, immunization, and major childhood killers (malaria, pneumonia [&] diarrhea) through community case management, and scaled up at national level ( in all 30 districts). As part of RapidSMS, CHWs in Rwanda were equipped with mobile phones and code cards to enable them collect and submit data on key maternal, neonatal and child health indicators to RapidSMS in real time. Data that includes a broad range of child continuum of care like antenatal care, delivery, post-natal care, growth monitoring, as well as death indicators such as maternal and neonatal and child mortality collected during the first 1000 days of life (pregnancy until birth, and newborn until 2 years) are submitted and recorded in RapidSMS. The system then generates automatic reminders for clinical appointments, delivery, and post-natal care visits, with the intent of increasing attendance at antenatal care and postnatal care visits. Additional intended outcomes include the provision of a quick link to emergency obstetric care through so-called Red Alerts, and the creation of a database of clinical records on maternal, newborn, and child care delivery. The red alerts triggers emergency response and preparedness by the receiving health facility which contributes to real time management and hence contributes in reduces maternal, newborn and child mortality.

Solution: – Use of real time data to inform quick decisions – Prevents loss of lives – Reduces transport costs – Tracks child continuum of care at village/household level – Used to mobilize resources for clinical services