A new program uses mobile phones to help moms know when and where to go for treatment, while also improving the quality of home-based care.

When Idiss Konzani, a young mother from Chiyendausiku village in Malawi, grew worried about her baby’s health, she called a toll-free hotline for advice.

She relayed the child’s symptoms to a sympathetic expert who asked her several questions. “The hotline worker suspected pneumonia and referred me to the hospital,” recalled Konzani. At the hospital, the diagnosis was confirmed.

Callers dial the shortcode 59090 and are connected directly to health workers.
Callers dial the shortcode 59090 and are connected directly to health workers. Photo: Sam Strickland

Konzani had called Chipatala Cha Pa Foni (CCPF), or Health Center by Phone, a hotline and text messaging service for pregnant women and families of babies and young children in Malawi.

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Medical help by phone

CCPF helps mothers like Konzani in rural and hard to reach areas get prompt attention when necessary, so that they can get to the nearest health facility quickly, without losing valuable time. But unlike Konzani, most of those using CCPF don’t need to rush to a hospital. The mobile phone service — which not only refers those with danger signs to care but also provides callers with timely health information and advice — in fact helps reduce unnecessary trips to hospitals and clinics. Families also receive text or voice messages with “tips and reminders” tailored to a mother’s week of pregnancy or a child’s age.

Nurse Tiwonge Chisale from the Kabudula Community Hospital holds a mobile phone, Lilongwe District, Malawi.
Nurse Tiwonge Chisale from the Kabudula Community Hospital holds a mobile phone, Lilongwe District, Malawi. Photo: Sam Strickland

 CCPF started in July 2011 as a two-year pilot by our Innovations for Maternal, Newborn and Child Health initiative, in partnership with our Concern office in Malawi, the Malawi Ministry of Health, and our implementing partner VillageReach. A 2013 evaluation showed that CCPF led to improved healthy behaviors, such as women seeking prenatal care early in pregnancy, breastfeeding their newborns, and using bed nets for themselves and their children. The project began with scale up in mind and this is exactly what has happened.

A bigger, better hotline service

After starting in the remote, rural Balaka district, CCPF now serves eight of the country’s 28 districts, reaching a quarter of the country geographically and 515,000 women and children. In December 2015, CCPF merged with Airtel Malawi’s Dial-a-Doctor, which has expanded the reach of CCPF, and provided information beyond maternal, child, and reproductive health while keeping the calls free. Airtel is Africa's largest mobile carrier. The Malawi Ministry of Health plans to take on the service and make it available nationwide by 2017.

Reminders for women — and men, too

For pregnant women who live far from a health facility in a country that has among the highest maternal, newborn, and child death rates in the world, CCPF can provide critical access to health information and services. “I’ve been getting messages during my pregnancy,” said Chisomo Justin, from Kuntiyani village. “One of them was about nutrition and getting enough of the six food groups. And also starting antenatal care visits as early as possible.”

“I didn’t know before this about what pregnant mothers needed"

This service is directed at men as well, helping to make them more active participants in their families’ heath care. Nelson Selemani said he had learned a lot about the needs of pregnant women through the service. “I didn’t know before this about what pregnant mothers needed like nutritious foods and also that they needed time to rest from work.”

Trusted advice

Staffed by health workers at Balaka District Hospital, CCPF simultaneously strengthens both home-based and facility-based care, making it a “win-win” for Malawi’s health system. Families are saved time and money on traveling far distances to hospitals and are empowered to treat mild symptoms and ailments at home, while the pressure on an overstretched health system is relieved. But the link with the hospital, an institution that Malawians trust, remains strong.

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 “Chipatala Cha Pa Foni has been very helpful,” said Lucia Afiya, a mother from Mwalalo village. “When I call them, they advise me on whether I need to go to the hospital or not. Because they are from the hospital, I trust them and take their advice.”