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mHealth in Mozambique—fulfilling our mission during a global pandemic

Norberto Banze, MEL Program Officer, Mozambique

As the world scrambles to mitigate the spread of COVID-19, Pathfinder’s team in Mozambique quickly adapted its mCenas program to do its part—making information on the virus widely available to Mozambicans.

mCenas, which translates to “mobile scenes” in Portuguese, is a mobile health (mHealth) intervention developed by Pathfinder that reaches young people across Mozambique with sexual and reproductive health (SRH) messages. Over the past six weeks, Pathfinder rapidly adapted mCenas to share information with Mozambicans about how to protect and prevent the spread of the COVID-19 virus.

What is mHealth?

mHealth is the use of mobile technologies—mobile phones, personal digital assistants, and other wireless devices—to support improved health. mHealth programs reach people quickly, offering cost-efficiency, security, and connectivity.

Pathfinder has led mHealth projects in Africa for more than a decade, using a variety of mobile tools including mobile case management applications and data collection tools, geographic information system mapping, mobile money, and short message service (SMS) platforms.

How does mCenas work?

mCenas uses an SMS platform. Its unique approach has allowed young people to learn about SRH, including family planning, safe abortion, healthy gender norms, gender-based violence—and now COVID-19. Pathfinder has integrated mCenas into its most of its programs in Mozambique.

mCenas ‘scenes’ are short stories sent to mobile subscribers three times a week. The story young people receive depends on their particular circumstances—sexually active or not, have children, or not, etc. The short stories have contributed to more knowledge about SRH and positive shifts in perceptions: significant declines in the number of young people who believe using contraception would make it difficult to have children after stopping use, and significant increases in the number of young people who agreed it was okay for a young married/unmarried woman to use contraceptive methods other than condoms.[1]

In addition to stories, subscribers received information on contraceptive methods and frequently asked questions on SRH.

How was the mCenas platform adapted to respond to COVID-19?

The first confirmed case of COVID-19 in Mozambique was March 23, 2020. As of June 1, there have been 254 confirmed cases, but projections say that the country could approach close to 20 million cases, close to 65% of the population. Currently, there is limited testing capability, with it centralized in Maputo, and limited personal protective equipment for health care workers. A state of emergency was declared April 1 and has been extended to the end of June as of today.

It is critical to get messages out to communities about stopping the spread of COVID-19, and what to do if someone suspects a case.

mCenas uses a short code, (short number of 4 digits) to subscribe. Anyone in Mozambique with the short code can send an SMS containing the key word (COVID) to automatically subscribe to the platform and immediately receive answers to frequently asked questions about COVID-19. Pathfinder integrated this code within the three primary mobile carriers in the country to ensure that the platform was available throughout Mozambique.

The advantage of using SMS is that it can reach almost everyone. Other web-based systems require smartphones or downloading specific applications. Word about the platform quickly spread through WhatsApp and social media. In the first couple of weeks, over 1,500 people signed up, but  more than 2,000 accessed the initial set of COVID-19 related content. Users that were already signed up for mCenas were notified and given an option to ‘opt-in’.


Past Pathfinder mHealth Projects

 

Tanzania—Mobilizing Maternal Health (October 2013 to September 2016): mHealth helped to increase antenatal care attendance, and improved communities’ knowledge of pregnancy-related care and support.

Nigeria—m4change and mCCT (January 2014 to December 2015): mHealth helped with reducing barriers to skilled antenatal care and offering financial incentives to women for antenatal and postnatal care.

 

Haiti—mSanté (October 2013 to September 2016): mHealth helped to standardize care, strengthen referrals, and improve the health of Haitians.


Learn more.


When users first sign up for the adapted mCenas platform, they are automatically guided to a series of questions. These questions, and the information that follows, comes directly from Mozambique’s Ministry of Health and the World Health Organization:

  • What is COVID-19?
  • What are the signs and symptoms?
  • What are the means of transmission?
  • How can you protect yourself and others?
  • What is quarantine?

The platform also includes questions on domestic violence, given the marked increase in gender-based violence since COVID emerged.

Once users register, they have two options: reviewing a menu of questions and ‘self-screening’ their symptoms. The self-screening mechanism replicates the Ministry of Health’s web app. Those that fall into medium or high risk of having symptoms suggestive of COVID-19 then receive a specific message indicating so and are referred directly to the Ministry of Health hotline, which is staffed by clinical staff ready to answer medical questions 24 hours a day. If someone is expressing serious symptoms, they are referred to health facilities designated for COVID-19 response by the Ministry of Health. To date, more than 1,000 users have gone through the self-screening process.

Pathfinder works as part of a larger coalition of organizations collaborating with the Ministry of Health to develop innovative solutions and disseminate information about COVID-19. Each week, Pathfinder sends the Ministry information about new registrants, geo-location information, and the number of people who have accessed COVID-19 SMS information via the mCenas platform.

As COVID-19 spreads in the countries where Pathfinder works, using mHealth technologies will allow Pathfinder to rapidly disseminate new information about COVID-19 and SRH, ensuring we continue to fulfill our mission while responding to the global pandemic.


[1] https://www.e2aproject.org/publication/assessing-the-effects-of-mcenas-sms-education-on-knowledge-attitudes-and-self-efficacy-related-to-contraception-in-mozambique/