Bill & Melinda Gates Foundation

How a Modern Library Keeps Mothers Healthy in Rural Ghana

November 26, 2013

I’d been living in Ghana for five months when I visited the Northern Regional Library in Tamale, a cavernous facility with white and cream-coloured walls that used to be a post office. What I found was rare and wonderful in a country high illiteracy rates and little access to computers: a traditional library that also served as a modern technology hub.

In the library’s main reading room, visitors sat in small cubicles reading and working quietly, while down the hall was a robust computer lab used to teach young people essential technology skills. Nearby in the Maternal Health Corner, funded by EIFL’s Public Library Innovation Programme, women watched videos about what to expect during childbirth on computers pre-loaded with practical information.

That’s where I met Rosina Atchulo, the mother of healthy, happy eight-month old Aziza, who sat quietly on her lap.

Atchulo, who wore a beautiful aqua dress and smiled often, told me that while she was expecting she received advice and encouragement through the simplest of devices — her mobile phone.

Atchulo, 36, lives in Kanvili, just outside Tamale in Northern Ghana, where roads and Internet access can be poor, leaving many pregnant women without access to information and professional medical support. But Atchulo received weekly text messages as part of the library’s Technology for Maternal Health project funded by EIFL’s Public Library Innovation Programme.

“They will ask me, is my baby kicking?” Atchulo told me. “They will ask me, my baby can hear my voice, always sing to her. Sometimes they’ll even tell me if I have a problem with my baby, if she doesn’t kick normally, contact my midwife.”

Atchulo has avoided the fate of many women in Northern Ghana, where maternal mortality is high. Estimates suggest that between 1,400 to 3,900 women and adolescent girls die in childbirth every year. With rapid advances in mobile technology, it is now possible to tackle the problem with flexible, affordable and innovative solutions, bringing mothers closer to the services they need to keep them healthy and safe.

The library as a modern community hub

In his office, head librarian Aaron Kuwornu told me the idea for the Technology for Maternal Health project grew out of a monthly public lecture series hosted by the library and Savana Signatures, an NGO that promotes the use of information and communication technology for development.

After a health worker expressed concern about maternal mortality in the region, the library decided to team up with Savana Signatures to develop an innovative method of distributing reliable health information.

“It’s not a diversion from the traditional [public library service] but it’s rather a complement,” Kuwornu said. “We’re now in the ICT era, or technology or computer age. The library should lead the way.

With funding from EIFL, the library and Savana Signatures worked with three local hospitals to develop a database of 94 expecting mothers, complete with each mother’s due date and phone number. A committee with representatives from the hospitals reviewed pre-written text messages from an organization called Mobile Alliance for Maternal Action (MAMA) to ensure they were appropriate for Ghanaians.

“We adapted it, we didn’t just take it wholesale,” explained Abdul-Rashid Imoro, a project officer with Savana Signatures, which coordinated the technical side of the programme.

Using computer software similar to Skype and regular cell phone credit, Imoro explains, messages were sent to the women weekly, giving them advice about everything from what foods to eat to the importance of taking their medication. The messages were timed to coincide with different stages of pregnancy.

“We’re looking at the reduction of maternal mortality in childbirth, and also to improve the health of these women,” Kuwornu said. “It has been a success because so far the women who have come here, we've never heard that they've lost their pregnancy or passed on.”

Kuwornu says the program also helped break down cultural taboos associated with talking about maternal health and childbirth, and strengthened the relationships between women and their midwives.

Connecting mothers to midwives

At the Tamale Central Hospital, women in Ghanaian fabrics of every colour sat patiently in the antenatal clinic waiting room, some with children in tow.

Justina Dakurah, midwife and assistant matron at the hospital, credits the text messaging service and its patient database for allowing the midwives to establish vital lines of communication. “Before, we couldn’t communicate and now we are communicating,” she said.

 “Before the program there were difficulties,” admitted Hajia Amina Bukari, a midwife at Tamale West Hospital. “You educate [women] to come to clinic, they won’t come. They stay in the house.” But now, she explained, they come to the hospital regularly for check-ups — and to deliver their babies safely.

The health workers have also been trained to use the computers at the public library. Dakurah said she benefited from the videos and information available there: “Nursing is dynamic, so there were new things I learned,” she explained.

Kuwornu told me one of his long-term goals is to make sure mothers and their children have life-long relationships with the library, which he sees as the home of the community.

“You hope to see that when you follow (up) and take statistics you can say that because your mother attended this programme, that’s why you are here today,” he said.

As a devoted life-long library user, I hoped so, too. 

 
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