Mobile Alliance for Maternal Action (MAMA) - South Africa

MAMA has developed free, adaptable messages informed by experts in maternal, newborn, and child health. These evidence-based, culturally sensitive mobile messages are being downloaded and used by over 140 organisations in 50 countries around the world. They are accompanied by guidelines on how to localise the messages for a specific country context. MAMA messages are offered free of charge, and any organisation can apply to use the messages.

MAMA provides two types of messages. The core messages are arranged by "age and stage" to cover weeks 5 to 42 of pregnancy, as well as the first year of the baby's life. The messages are built around key health behaviours and interventions, which evidence shows can improve health outcomes. These include antenatal care, nutrition, vaccination, and family planning. The messages blend health with baby development information so that mothers are motivated to get the right care at the right time for themselves and their babies. In addition to these core messages, MAMA has responded to requests for topic-based messages. They now offer messages on the prevention of mother-to-child transmission of HIV, and will soon offer messages on breastfeeding and family planning. They also offer messages designed for other household decision-makers in communities where phone ownership is often shared.

In South Africa, the programme uses five mobile channels to communicate with mothers:

• MAMA on mobi: This interactive, engaging mobi site is available to all moms in South Africa with an internet-enabled cellphone. Content is delivered to users based on their due date or the age of their baby, providing what is intended to be personalised, relevant, and compelling information to mothers.
• MAMA on SMS: MAMA on SMS is a personalised SMS (text messaging) reminder service, designed to support moms throughout their pregnancy, birth, and during their child's first year. Due to the high cost of SMSs in South Africa, the MAMA programme can unfortunately not offer this SMS service to moms at a national scale. The MAMA SMS service is currently available at selected clinics in Hillbrow, Johannesburg.
• MAMA on Unstructured Supplementary Service Data (USSD): MAMA on USSD is a set of interactive quizzes, designed to supporting moms throughout their pregnancy, birth, and during their child's first year. Any mom with a South African cellphone can register for the USSD quizzes by dialing *120*2112#, and then she can dial back into this same line, every "MAMA Monday" to get a personalised quiz that will help her learn about her pregnancy and baby. This quiz service is free for all moms on Telkom Mobile and Cell C. Vodacom; MTN users will pay 20 cents for 20 seconds to access the quizzes.
• MAMA on Mxit: Taking advantage of the more than 10 million users on MXit in South Africa, MAMA is establishing an educational portal on the social networking platform providing young men and women aged between 18 and 25 with important information just as pregnancy, childbirth, and parenting become something many of them have to grapple with.
• MAMA on voice: MAMA SA is testing the use of pre-recorded voice messages delivered to mothers in selected areas. A registered mom would receive a normal SMS notification that they have a new voicemail, and they would dial into their voicemail service and receiver their MAMA voice message, with relevant tips and information. MAMA on Voice is aimed at supporting moms who are illiterate or who have low levels of literacy.

MAMA's Global Learning programme uses the lessons learned by the three country programmes and expert knowledge across a range of sectors and subjects to inform the development of tools and resources that can be used by others in the field. The MAMA online learning courses consist of short learning modules designed to assist organisations as they work on their own projects to localise the messages. The modules cover the principles of behaviour change, localisation, how to handle cultural beliefs, and more.

Maternal Health, Children

According to the United Nations Children's Fund (UNICEF), 4,300 mothers die in South Africa every year due to complications of pregnancy and childbirth; 20,000 babies are stillborn; and 23,000 die in their first month of life. In total, 75,000 children do not make it to their fifth birthday. South African women living in poverty face many challenges - specifically, access to quality health care. In communities such as Hillbrow, there are high rates of unemployment and poverty, and HIV prevalence is estimated at 30% among pregnant women. Despite these challenges, mobile technologies are providing women with access to life-saving maternal health information. In South Africa, more people use a mobile phone than watch television or listen to the radio, and there are more subscriber identification module (SIM) cards in South Africa than people.