The Timor-Leste Ministry of Health (MoH) would like all pregnant women to receive timely and appropriate care before, during and after birth to assure healthy outcomes for mothers and newborns. The aim of the Liga Inan mHealth program is to assist the MoH to meet this goal. Liga Inan (“connecting mothers” in the local language) was initially funded by USAID’s Child Survival and Health Grant Program to pilot in one municipality in Timor-Leste in 2013. With promising early results, the Australian Government Department of Foreign Affairs and Trade began funding national scale up of Liga Inan in 2014. Working in partnership with the MoH, the plan is to have Liga Inan operational in all 13 of Timor’s municipalities by 2018 with the intention of full integration into the government-run health system. A plan to phase in full management and resourcing of Liga Inan by the MoH is also in process.
The Liga Inan service, developed by Catalpa International, is a web-based platform that sends automated text messages to pregnant women to promote a safe pregnancy, delivery and a healthy baby, and encourages increased connections between the women and their health care providers. MoH health staff are trained in how to register pregnant women into the program at their first antenatal care visit and how to interface with the Liga Inan service. Once registered, pregnant women receive twice weekly text messages with health information and tips and reminders to seek care. The Liga Inan service also facilitates two-way voice communication between pregnant women and health staff assisting mothers to contact their midwives directly if they have questions or problems, or need emergency services. The service also prompts midwives to call mothers three weeks before their estimated due date to promote planning for a safe delivery with a skilled provider. Midwives can also send broadcast text messages to all registered women in their catchment area regarding changes to clinic hours or reminders about outreach services.
HAI was funded by USAID to carry out operations research to evaluate the impact of the Liga Inan program. The research design included intervention and control municipalities where baseline (2012) and final (2015) Knowledge, Practice and Coverage (KPC) surveys comparing pre- and post-intervention time periods were conducted. The objective of the research was to determine whether receiving regular text messages that encourage healthy maternal behaviors is associated with increases in use of maternal health services for women enrolled in the Liga Inan program. Study results suggest that tips and reminders to seek appropriate care delivered via mobile technology were successful in increasing utilization of services. Women living in the intervention municipality compared to baseline and to the control municipality had higher odds of having a skilled birth attendant, a facility delivery and timely postpartum and newborn health checks.