Lagos to Accra
Leaving for Accra, Ghana, via Lagos, two days after returning from London gave me a lot to look forward to. Although tired, as I had to leave my house at 4.30am to catch the early morning flight, the flight was a very short and interesting one. Barely dozing off on take-off, I was just about to change gear when I heard the flight hostess’ voice announcing our arrival at Kotoka International Airport, where the ever smiling and warm airport staff welcomed all passengers with “Akwaaba”, a good sign of their hospitality and warmness to visitors. Getting to the hotel was another wow experience, as the hospitality again blew me away. So much so, that I felt I needed to relocate here for a short while. What! Time to wake up from my dreams, concentrate on my in-country mission objectives and begin direct engagements with mHealth stakeholders in Ghana.
Ghana is home to some 25 million people, the 82nd largest country in the world and 33rd largest country in continental Africa by land mass. It is home to Lake Volta, the largest artificial lake in the world, by surface area.
mHealth in Ghana
As I learned, Ghana is one of the few West African countries making good progress towards reaching its Millennium Development Goal (MDG) targets. The maternal mortality rate in Ghana has reduced from 450 in 2008 to 350 in 2010. In 2011, under-five mortality rate in Ghana was 82 per 1,000 live births and neonatal mortality rate was 32 per 1,000 live births. Essential healthcare staff to ensure that pregnancy is safe and that both mother and baby survive each pregnancy and birth is critical to achieving this. In Ghana, the number of midwives per 1,000 live births is 5 and the lifetime risk of death for pregnant women is 1 in 66.
The big question here is how do women access maternal and child health (MCH) information that can impact pregnancy outcomes and the quality of life. There is a need for an enhanced and concerted effort along with interventions that can allow healthcare workers to reach these women and vice versa, especially in the rural parts of Ghana.
The situation provides an opportunity for innovative programmes, to complement the already good work being done by the Ministry of Health, Ghana Health Service and other development partners. One such success has been Grameen Foundation’s Mobile Midwife on MOTECH’s platform. This initiative informed my various levels of stakeholder engagement, targeted at the public and private sector players in health, effectively jumpstarting the GSMA’s Pan-African mHealth Initiative (PAMI) in Ghana.
The engagement started with the core leadership of the Ghana Health Service, who welcomed the GSMA’s planned support for the health ecosystem in Ghana. Other stakeholders engaged included the Ministry of Communications, international development partners, mobile operators and healthcare providers. It is obvious that there is a good opportunity for mHealth in Ghana, as there are currently only two or three commercial mHealth services being implemented by mobile operators, focusing only on one use case. The other successful mHealth service targets women in the bottom of the pyramid (BOP) and is offered free, which could have serious implications for scaling and sustainability.
Meeting with healthcare workers and pregnant women
Interestingly, I attended a meeting with a group of healthcare workers and pregnant women in one of the local health centres.
The healthcare workers all agreed that it is time to leverage the power of mobile in disrupting the provision of healthcare services. They agreed that mobile will surely lead to greater efficiency and better coverage of services. The pregnant women, for their part, agreed with me that nutrition is key to their health and, by extension, a positive pregnancy outcome.
It is known that the weight of pregnant women is a major predictor of low birth weight. Low birth weight babies are, in the first instance, disadvantaged for life as catch-up is rarely achieved, leading to severe consequences for the educability and productivity of these children. Malnutrition also has consequences for the GDP of many African countries, estimated as responsible for up to 3% of yearly GDP, while malnourished children are at risk of losing more than 10% of their lifetime earnings potential.
This group of women agreed that MOTECH has benefited them tremendously, supporting them with crucial nutrition information. However many of them concluded that more robust and direct nutrition information is required to address various pre-pregnancy, pregnancy and post-natal care issues related to nutrition, for a large majority of the population across Ghana. Addressing this opportunity can impact and save lives among women and their children under the age of 5.
The stage is now set to make a difference. The streams are already flowing to leverage and mainstream nutrition into all mobile related MCH interventions here and operationalise the mHealth ecosystem partnership in Ghana, with a critical emphasis on nutrition. This is where it is happening: great hospitality mixed with impactful innovations, targeting the most vulnerable group in society.
Akwaaba to Accra, the great city of hospitality.
For more information on the GSMA Mobile for Development mHealth, please contact us on mhealth@gsma.com. For information on various mHealth initiatives, click here. For more information on GSMA mHealth resources, click here.