Safer childbirth with skilled birth attendants

Safer births, for moms and babies

Timor Leste has some of the highest maternal and infant mortality rates in Southeast Asia. These high mortality rates are attributed to a combination of factors, including limited access to skilled birth attendants, inadequate nutrition, poor sanitation and limited awareness about maternal and child health.

For pregnant women in remote and rural areas of Timor Leste, access to antenatal care can be limited and many women deliver at home without a skilled birth attendant. Women often find it difficult to get good advice on how to have a safe pregnancy and healthy baby.

Liga Inan means “connecting women” in Timor-Leste’s national language, Tetun. The program enrolls pregnant women on their first antenatal medical visit and sends twice-weekly text messages with important health information and reminders to attend regular pre- and post-natal care. Women receive phone calls from midwives at key points of their pregnancy, as well as ‘nudges’ via text message for clinic visits, birth preparation and post-natal care. Women can also request a call back from a health provider and receive messages about important community health information.

The program enables enrolled women to actively participate in their own health journey by reaching out to their midwife with a question or concern during their pregnancy. The system also allows midwives and doctors to register pregnant women to track their progress, easily contact them, know when they go into labour and make arrangements for attending the delivery

Enhancing two-way communication between pregnant women and midwives

Liga Inan allows health providers to broadcast tailored health messages to enrolled women in a specific community, writing in a culturally appropriate style or using local dialects to inform mothers about vaccination campaigns and mobile clinic schedules.

The program’s mobile app collects birth-related health data including where enrolled mothers delivered their babies (health facility, home with skilled birth attendants, or home without skilled birth attendants), allowing health providers to monitor trends and make decisions about health services.

Independent research conducted by Timor-Leste’s National Health Institute found:

• 64% of women surveyed identified Liga Inan as their primary source of maternal health information
• 58% of women surveyed said they received the best quality information on maternal and child health from Liga Inan

Liga Inan has also been expanded to include a parallel program Liga Familia, which encourages those closest to pregnant women (such as fathers-to-be, in-laws) to actively support women and their babies throughout the pregnancy-to-parenthood journey.

To further support new mothers, the Liga Familia program provides maternal and child health information to family members (particularly dads) to help them assist with the pregnancy, the need to plan delivery at a health centre and reducing risks for mother and baby.

Utilising the Liga Inan messaging system, those registered with Liga Familia receive tailored advice on birth planning, contributing to positive relationships, and the importance of postnatal health appointments.

The goal of long term child health is also extended by the 1000 days program, which continues to send messages regarding child health, nutrition, vaccination and disease prevention.