The use of WhatsApp breaks down traditional hierarchies and allows doctors to communicate more freely with their immediate clinical team. The groups allow doctors to work together more effectively, and enable shy or less-experienced team members to seek help when they need it.
Because of this, the maternity and obstetrics department staff members at Masaka Regional Referral Hospital are relying on a WhatsApp group for effective and fast communication while monitoring patients.
Dr Gonzaga Ssenyondo, the department head, says the decision to start the ‘OBGYN DRs AND MIDWIVES WhatsApp group was motivated by the death of a patient he says could have been saved had it not been for an unfortunate communication breakdown.
“After looking at the deceased’s report, I realised that there were gaps that would have been avoided if the midwife sought consultation. But at the time, there was no effective way to do so,” Ssenyondo recalls.
He says he later realised that the best ways of closing this gap was to creat a WhatsApp group to link all staff in the department. Initially, the group comprised only medics in the maternity department but has since expanded to include store attendants, pharmacists, anesthetists, sisters in charge of theater, head of blood transfusion bank, and hospital administrators.
Dr Ssenyondo says more members means there is easier communication between the departments. “For example when you receive a mother in need of blood transfusion, one easily sends a message to specify the blood group needed and the response is immediate,” Dr Ssenyondo says.
He notes that the group is also helpful in an event where there is a mother meant for caesarian delivery and the theater needs to be prepared in time.
Beatrice Asibazuyo Monday, the unit in-charge, says the group helps them to look at the emergencies, and routine reports regarding the general situation in maternity.
“It is easier to tell the senior doctors about a patient in emergency and brief them on the state of the patient so that as they head to the facility they know what to do,” Asibazuyo says.
On a daily basis about five to six reports are taken and posted on the group by the midwife on duty to allow members study, react and share views on the best way to treat a patient.
On this platform, health workers can take a picture or video and share with the rest of the team who can give possible treatment plans according to the situation. They also share continuous medical education reports. For example, education videos say on how to conduct a breach delivery and shoulder distortia are posted as well as power point and PDF presentations on various subjects.
For the confidentiality and privacy of the patients, Dr Nathan Onyachi stresses that whatever is shared on the group should aim at saving a life and should not be shared outside the group.
Dr Ssenyondo notes that unlike other groups that are flooded with irrelevant content, as the group administrator, he restricts posts to only those that are relevant to maternity health.
“We decided to have a different notification for this group and the moment you hear it, you expect an emergency or a task to perform immediately,” he says.
Dr Ssenyondo says that for encouragement, group members reward whoever posts the most valuable, relevant and helpful information with data bundles.
The modal has since been replicated to lower health centre IV’s such as Rakai and Kalisizo, who usually engage them while referring an emergency case.
“They take a photo of a patient’s referral form and send it via WhatsApp such that it is seen before the patient arrives. This helps the team to prepare the theater, blood and any other requirements before the patient arrives,” notes Asibazuyo.
She says this enables them to offer urgent attention which helps to save a mother who has delayed to go to the medical centre.
Monday says since its inception, the group has seen a significant reduction in the hospital’s maternal mortality rate. Records from the hospital indicate that only one death has been registered in three months, compared to 15 cases previously recorded in four months.
Although this move is trying to reduce maternal mortality at the facility, Edward Kabuye, the hospital administrator, notes that they still have existing underlying factors such as the continuing delay of mothers to seek medical attention.
He adds that traditional birth attendants also delay to make the decision to refer difficult cases to health centres for proper management which has led to many deaths. He, however, advises mothers to always keep their antenatal appointments and in case of any complications, visit the hospital immediately.
Maternal Mortality at a glance
Although the 2017 Annual Health Sector Performance Report indicates a significant decline in maternal and infant mortality rates, with the maternal mortality rate decreasing from 438 deaths per 100,000 live births to 336 deaths per 100,000 live births, there are still a lot of challenges facing the sector.
There is an urgent need for the government to recruit skilled staff especially medical officers and midwives to run Health Centre IVs and IIIs. Government should also aim to renovate and equip hospitals and Health Centre IVs, especially those aiming to improve access to maternal health services.