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mHEALTH FOR SAFER DELIVERIES: EZYPESA MOBILE BANKING SERVICEA mobile money transfer service for traditional birth attendantsIn response D-tree International, in collaboration withEtisalat Group telecommunications and their localmobile service provider, Zantel, is utilizing mobiletechnology to meet this challenge through thecombination of mobile decision support, data storage,on-line banking and communications on a single deviceat the point of care. mHealth for Safer Deliveries is acomplete suite of services enabling traditional birthattendants (TBAs) and midwives to ensure saferpregnancies and deliveries. It not only enables healthworkers to quickly and accurately identify obstetricemergencies, but also features Ezy Pesa, a mobilebanking service that assists them in arranging obstetricrelatedtransportation for the pregnantwoman to a health facility where shecan receive appropriate care.Implementation date: October2011 to December 2014About Ezy PesaThe application provides a step-by-stepprotocol for the following: identifyingdangers signs during labor and delivery,the phone number of vehicle ownerswho can transport the patient on anemergency basis, access to money onthe phone to pay the vehicle owner fortransportation, a record of permissionsneeded from the family or localdecision makers to transport motherand infant in case of emergency, andthe ability to contact the referralfacility so they can be prepared for thepatient’s arrival.Most women, especially in low-income countries,continue to deliver at home for a variety of reasons,including cost, preference, culture and lack ofinformation. In Zanzibar, half of all pregnant womendeliver from home and only one-third of mothers andnewborns receive timely postnatal checkups. Homedeliveries can, in part, be made safer by assuring theprovision of adequate care.Mobile banking accounts were established for the TBAsworking with the project. After registering them withtheir mobile banking accounts, Zantel assisted with theproject by opening pay points in the project areas andby providing training to the TBAs on Ezy Pesa.Additionally, D-tree worked with the health facilities andthe villages to identify appropriate transport providers,enroll them in the program and pre-negotiate rates.Once a month, D-tree calculated cost estimates basedon the TBAs’ total expected delivery estimates for themonth. This was transferred to the D-tree Ezy Pesaaccount, and then using either a mobile phone or theInternet, the money was transferred to the TBAs’mobile banking accounts.Evaluation and ResultsThe Zanzibar Ministry of Health and Social Welfare(MoHSW) helped develop the project and select twopilot areas, the North A District of Unguja and theMicheweni District of Pemba, based on their low facility36 mHEALTH COMPENDIUM | VOLUME 3