Monday, 9 September 2013

SMS project improves midwives’ counseling competencies in Indonesia

The first Info Bidan Message broadcasted to the midwives which explains about the risks of not doing birth spacing. Lombok, 18 July 2012.

Jakarta, September 2013 - Midwives are at the forefront of health care in Indonesia and they play a critical role in communicating key messages on safe pregnancy, delivery and child health to pregnant women and their families. Many midwives however, especially in rural and remote areas, are inadequately trained and lack the necessary knowledge and expertise to provide quality counseling.

Through an SMS-based pilot project called Info Bidan (Information for Midwives) UNICEF engaged in innovative ways of strengthening the capacities of midwives in rural areas. The results have been positive and UNICEF is now in discussion with the Ministry of Health and other partners on how best to introduce the model as a training tool for all 100,000 midwives in Indonesia.

The project was made possible through a partnership between UNICEF, the Ministry of Health and two private sector partners – Nokia and XL Axiata. It involved 200 midwives in Pemalang in Central Java and in West Lombok in Nusa Tengarra Barat (NTB) over a period of one year – from July 2012 to June 2013. Through Info Bidan they received key information on pregnancy, safe motherhood, nutrition and immunization, as well as on early childhood development and learning. A total of 180 messages were developed, based on the guidebook Facts for Life. The midwives received three messages per week.

This public-private partnership capitalizes on the rapid growth of mobile phone technology in Indonesia. As of end June 2013, 86 per cent of all Indonesians, 14 years of age and older, owned a cell phone. Even in rural areas eight out of ten people have a mobile phone.

A midwife in Pemalang reads Info Bidan message and writes it down on her note book.

Retno, a midwife in the Pemalang Health Office, says that Info Bidan has become an important counseling tool for her. “Not every midwife reads the text books diligently. But everyone has a cell phone and they will certainly read a text message.”

Another midwife adds: “If I receive the messages during my working hours at the Puskesmas (community health centre), I discuss them with my colleagues and then communicate them to my patients.”

Info Bidan messages have not only helped improve one-on-one counseling, but have also stimulated the formation of discussion groups with pregnant women and mothers with young children. These “mothers’ classes” are organised by village midwives. "The SMS project brought about a lot of change . Now we have mothers’ classes every month in this village. During the classes we discuss the messages from Info Bidan and the women share them with their friends,” explains Cholisoh, a midwife in Sitemu village, Pemalang.

Enita Rohayani in Karang Bongkot, West Lombok, highlights how the project helped her teach the husband of a pregnant woman about the dangers of smoking to his unborn child. “I showed him the message. I let him read it so that he knew the source. I told him that it was from UNICEF and the Ministry of Health. That way, he did not think that I made it up."

A midwife in Puskesmas Kebondalem, Pemalang, reads out an Info Bidan message through the Puskesmas' speaker to the waiting patients.

UNICEF now aims to facilitate the creation of a public-private partnership, involving the Ministry of Health as well as private sector partners and the National Midwives Association (IBI) in order to scale up the pilot project reaching all 100,000 midwives in the country. Nokia will make the service available via a mobile internet site which will make it possible to also transmit visuals and short video clips.