By Olivia Nix, Suad Ali, Lin Yang, Tao Long and Alexis Lobodocky
For Suad Ali (MBA ’15), her Applied Management Research (AMR) project hit very close to home. She had the opportunity to return to her home country of Kenya to find a way to reduce maternal mortality. Throughout sub-Saharan Africa, maternal mortality rates remain high. For Kenya, the rate at which women die during pregnancy and birth (400 deaths in 100,000 live births) is far above levels in the developed world.
With the UCLA School of Nursing as their client, Ali and three of her AMR teammates traveled to Kenya to investigate the causes of maternal mortality in Kenya. Their goal was to gauge whether the UCLA School of Nursing can develop a solution using mobile phones to improve care for mothers and their babies.
Collectively known as mHealth (mobile health), the use of mobile technology to improve health care represents an exciting new area for improving public health research worldwide. In Kenya, nearly 80 percent of all people already use mobile phones, so mHealth has great potential to affect a public health care system that is often under-resourced and overburdened.
Traveling to the cities of Nairobi, Kisumu, Thika and Kajiado, the team met with county officials, hospital leaders, nurses and midwives. What they found was a persistent human resource shortage caused by a new government policy implemented in 2013 that made hospital delivery free for all Kenyan women. Although making delivery free went a long way toward getting more women to deliver in the safe environment of a hospital, many hospital workers complained to the UCLA Anderson team that the government policy did not come with more funds to cover the drastic increase in patient numbers. Service quality deteriorated as midwives worked longer hours with limited supplies and space in health care facilities.
The team also discovered that traditional birth attendants (TBAs), who are often trusted by women, were unrecognized and not utilized by the health system. These TBAs were often women who reside in villages and volunteer to help mothers through pregnancy and delivery. However, being unrecognized by the health care system, many TBAs were fearful when their patients had complications, and often delayed referring them to the hospital, or failed to pass adequate information about patient symptoms to hospitals during the referral.
The UCLA Anderson team offered a set of mHealth ideas that have been piloted in other places around the world. For instance, a mobile app can be developed and used as a catalyst to legitimize TBAs and to improve communication and care coordination between TBAs and nurses in hospitals. TBAs can use an app to collect basic patient medical information, and an electronic health record for that patient can be transmitted to hospitals to flag patients who have a higher risk for complications. Then, nurses can determine the best course of treatment and communicate to TBAs how to counsel their patients. The goal is to refer more patients to hospitals, especially those who have higher-risk pregnancies.
The team proposed an mHealth solution to county health officials in both Kisumu and Kajiado counties, two areas that have high maternal mortality rates. The idea is to have TBAs field a questionnaire on their phones to patients that they visit, with the patient data used to calculate the risk of complications for the pregnancy. This data is transmitted to nurses in hospitals, who can call the TBAs to coordinate care for specific patients. County health officials were very enthusiastic about the idea of helping them to fill a critical coordination and manpower gap. They acknowledged to the team that TBAs exist, and that more needs to be done to include them in a solution, despite official government policy that discourages patients from visiting TBAs. Officials in both counties offered logistical assistance, should UCLA School of Nursing decide to pursue the pilot project in their county.
On Friday, March 13, 65 AMR teams will present their final projects to their clients and a panel of industry judges at UCLA Anderson as the culmination of their six-month consulting projects. We will welcome more than 500 invited alumni, clients, students and faculty to campus to celebrate the completion of these thesis projects.
Anderson celebrates Women's History Month. We invite you explore the Women@Anderson portal throughout March for event information, stories, faculty profiles and more.