MCHIP’s overall goal is to contribute to the reduction of frequent, preventable maternal and newborn deaths through increased quality of known, life-saving interventions in countries facing the highest disease burden. Nearly half of all births in developing countries occur in facilities, yet the quality of care provided is often unknown. Reported clinical practice may differ greatly from observed practice.

What MCHIP Is Doing Using Mobile Technology
MCHIP has developed a Maternal and Newborn Quality of Care (MNH QoC) Toolkit consisting of five mobile, electronic data-entry tools for assessing the quality of services provided in hospitals and health facilities. These are primarily checklist tools for observing health worker performance related to services provided for labor and delivery and essential newborn care. The tools are designed to capture health worker responses to spontaneous complications, such as pre-eclampsia/eclampsia (PE/E) or postpartum hemorrhage (PPH), two of the leading causes of maternal death.

Capturing Data: How it Works
Obstetricians and nurse-midwives are trained to use mobile phones for capturing observational health worker performance data at hospitals and health facilities. Data—including clinical observation checklists on labor and delivery services, antenatal care, facility inventories, health worker maternal and neonatal knowledge tests, register, maternity chart and partograph review—is entered on Windows Smart Phone forms with Range, Logic, Skip and other data quality controls. Quantitative and qualitative data is captured via interviews, simulations and observation checklists including audio noted and partograph pictures. Data is backed up to an internal SD card and then transmitted via GPRS to in-country servers. Results are uploaded to the web in predefined table, graph and map templates.

Improving Monitoring and Evaluation
An area of innovation for MCHIP is the application of mHealth tools to monitoring and evaluation (M&E) activities. There are ongoing rapid advances in mobile hardware, software and connectivity, especially in Sub-Saharan Africa, with the potential for greater usability and data quality for different types of future assessments under MCHIP. MCHIP plans to test and utilize Android tablets for mHealth data collection, especially for facility level and observational assessments due to their mobility, larger screens and ability to synchronize from the field with remote servers. One example of MCHIP ‘s work in this area is the M&E data collection and analysis system for the quality of care for prevention and management of common maternal and newborn complications (QoC MNC) facility assessments, consisting of a suite of mobile mHealth data collection tools and a web-based system for remote data management and tabulation. Developed by MCHIP and deployed on smart phones are separate survey and observation checklist data-entry tools for assessing the quality of maternal and newborn health services.
 
Results
Mobile phones have improved the quality of data and expedited the timeliness of results reporting. Specific needs for effective interventions for screening, prevention and treatment of obstetric and newborn complications are being identified as results come in from the MNH QoC Assessments.

Data collected and analyzed provides an opportunity to guide the development of Program interventions to improve the quality of facility-based maternal and newborn care services. By providing a baseline and endline measures in countries where the survey is part of an evaluation of interventions being implemented, data also provides an opportunity to inform policy change and resource allocation. These indicators and data collection tools can be used in multiple countries to provide information on key screening, prevention and management of interventions of the most frequent direct maternal complications.