University of Washington School of Public Health

UW SPH News: 'Mobile Moms' to Boost Health of Women in Timor-Leste

'Mobile Moms' to Boost Health of Women in Timor-Leste


Susan Thompson
Susan Thompson of HAI with Timor-Leste mothers. The woman in the middle is holding her 13th child.

Timor-Leste, one of the world's newest and poorest countries, has one of the world's highest rates of maternal death, and many infants die within a month of birth. To improve the odds for mothers and their newborns, Health Alliance International (HAI), a non-profit affiliated with the School of Public Health, has launched a first-ever mobile phone project there to send important health messages by text to expectant mothers.

Many women in Timor-Leste live in remote, mountainous villages, lack land lines and electricity, and rarely visit medical clinics. About 70 percent of women give birth at home, and most do it without help from a midwife, according to Susan Thompson, HAI's director of Timor-Leste programs. After birth, women are often secluded in the home for up to six weeks.

Mobile phone use has rapidly increased in recent years, offering a new way to reach expectant mothers. Women taking part in the program will receive two messages a week reminding them to take iron pills, eat well and have regular prenatal visits. Women will also be able to call for an ambulance or trained midwife when they go into labor.

The messages, in the local language of Tetum, will be tailored to each woman's estimated due date. Phones and messages will be in place for six weeks after birth for follow-ups and to help mothers monitor signs of illness in their newborns.

"It's all about improving the quality and access to maternal care," said Mary Anne Mercer, HAI's Maternal and Child Health adviser and a senior lecturer in the school's departments of Global Health and Health Services. The mobile phone service will allow health workers to "bridge bad roads and long distances with messages."

Mobile Moms is supported by a four-year $1.75 million grant from the US Agency for International Development. The first messages are scheduled to be sent out about Oct. 1.

 Andrea d'Aquino
Mother and child in Timor-Leste

HAI is working with the Ministry of Health and Catalpa International, a non-profit agency building the mobile phone platform. The project will be a first of its kind in Timor-Leste, according to Catalpa, and has the potential to change the way people interact with their local health professionals.

Timor-Leste, also known as East Timor, was a former Portuguese colony before it was occupied by Indonesia. It achieved independence a decade ago. The small island country north of Australia has one of the highest rates of maternal mortality, at 557 deaths for 100,000 births. In the US, the rate is only 8 per 100,000. In Timor-Leste, more than 2 percent of infants die within a month of birth.

HAI has been active in Timor-Leste since 1999, and partners with the Ministry of Health. The organization works to raise awareness about health services, screens movies with messages about family planning, and strengthens skills of district health-care workers. Access to maternal and newborn services has steadily increased since HAI began working in Timor-Leste, Thompson said. So far, nine UW students – from Global Health and the Community-Oriented Public Health Practice programs – have carried out research projects and assessments there.

 rural house
Health workers in front of a typical Timor-Leste village home. All photos courtesy HAI

One of the greatest challenges? The large number of children the typical Timor-Leste woman bears – up to 6 or more. "It's concerning that many couples don't understand that spacing their children is healthier," Thompson said.

The Mobile Moms project ignited the passion of young Seattle-area professionals looking for a global health project to support. The group formerly known as Party with a Purpose – now renamed Agency – dedicated its annual fund-raiser in July to Mobile Moms. More than 700 people attended, raising $20,000 to pay for texting services, said Kristen Eddings, program associate for the Washington Global Health Alliance. (See a brief video of the party.) "It will buy a lot of SMS messages," Thompson said.