Implementation of the PANDA mHealth system for providing a positive pregnancy experience in Tanzania

Background and Objective: Antenatal care (ANC) is an essential component of women’s reproductive health. Many women face difficulties in attending high-quality ANC visits for a positive pregnancy experience in low/lower-middle countries, such as Tanzania. Information and Computer Technologies (ICTs) are part of the core solutions for bridging the coverage and quality gap in health care. PANDA (Pregnancy And Newborn Diagnostic Assessment) is a mHealth system that incorporates WHO recommendations for ANC. This study aimed to assessing the effectiveness of PANDA system in provision of high-quality ANC in Mufindi district, Tanzania. Methods: A cluster-based non-randomized interventional trial were performed from June 2019 to September 2020 to compare the quality of ANC visits by using PANDA system in the intervention site with standard visits conducted in the control site. We enrolled pregnant women attending at analogous health facilities in both sites. The indicators used to assess the ANC quality were: performed measurements and screening tests (syphilis, HIV, malaria, hemoglobin, glucose, height/weight, blood pressure, temperature, fetal movement, fundal height, urine dip stick), and prophylaxis provided for malaria, anemia and intestinal worms. Data Analysis was done using SAS version 9.4. Results: A total of 597 pregnant women at the implementation site and 398 at the control site were enrolled. Most of them were in the age group 25-34 years (44.0%) and 15-24 (42.3%). The majority (60.8%) had more than one pregnancy. In the implementation area a significant higher coverage of performed screening tests and provided prophylaxis was recorded compared to the control area except for malaria prophylaxis. The provision of mebendazole and iron/folic acid was significantly higher in the intervention site. Conclusion: PANDA system has been shown effective in providing ANC according to WHO recommendations for a positive pregnancy experience. We recommend the mHealth solution for bridging the quality gap in low/lower-middle income countries.