640 - Phone Intervention for Maternity Care Workers and Nurses to Address Perinatal Deaths in Cameroon: Pilot Study
Sunday, April 26, 2026
9:30am - 11:30am ET
Publication Number: 3620.640
Henna Budhwani, Florida State University College of Nursing, Tallahassee, FL, United States; Comfort Enah, Univeristy of Massachusetts Lowel, Lowell, MA, United States; Lily B. Cooper, Tulane University, New Orleans, LA, United States; Gregory edie. Halle-Ekane, University of Buea, Cameroon, Buea, Sud-Ouest, Cameroon; Eric Wallace, University of Alabama School of Medicine, Birmingham, AL, United States; Victoria C. Jauk, University of Alabama School of Medicine, Birmingham, AL, United States; Jeff M. Szychowski, University of Alabama at Birmingham, Birmingham, AL, United States; Waldemar Carlo, University of Alabama, Birmingham, AL, United States; Rahel Mbah, Cameroon Baptist Convention Health Services, Bamenda, Nord-Ouest, Cameroon; Mary Glory Ngong, Cameroon Baptist Convention Health Services, Bamenda, Nord-Ouest, Cameroon; Pius Tih, CBC Health Services, Bamenda, Nord-Ouest, Cameroon; Alan Tita, University of Alabama at Birmingham, Birmingham, AL, United States
Endowed Professor Florida State University College of Nursing Tallahassee, Florida, United States
Background: Maternal and perinatal mortality remain a persistent challenge in sub-Saharan Africa. Cameroon has an infant mortality rate of 47 deaths per 1,000 live births, one of the highest rates globally warranting concentrated investment in tailored interventions to address preventable deaths. Strengthening clinical support systems via such interventions is one opportunity to improve quality of care, pregnancy outcomes, and the health of neonates. To address this need, the Medical Information Service via Telephone (MIST) was scientifically adapted into a mobile model (mMIST) to facilitate real-time consultations to maternity care workers, nurses, and other providers in remote settings. Objective: To pilot a health system strengthening clinical support, phone-based intervention, mMIST, in rural Cameroon, to enhance nurse-provider response to pregnancy complications and improve infant health outcomes. Design/Methods: mMIST was contextually tailored for use by peripheral providers to receive support from trained midwives, OB/GYNs, and pediatricians. A 12-month pilot (03/2022–02/2023) assessed call volume, referral patterns, and changes in perinatal outcomes. Pre-post comparisons were conducted for key outcomes including fetal and neonatal mortality. After Advanced Life Support in Obstetrics (ALSO) trained nurses and expert pediatric providers were trained on how to support and answer the mMIST system, peripheral providers, typically nurses and midwives were trained on how to call into mMIST to access support, for transfer, and request complex case consults. Results: Over the pilot, an average of 14 calls per month were logged and 30% required escalation to an expert provider for consultation. Twenty percent of calls related to neonatal needs; neonatal calls primarily focused on prematurity (23%), infection (18%), and asphyxia (18%). The rates of stillbirths (0.7% vs. 0.7%) and neonatal deaths (0.4% vs. 0.2%) were not statistically different between time periods.
Conclusion(s): The mMIST phone-based health intervention was adequately utilized, showing promise for enhancing provider-to-provider communication and early recognition of maternal and perinatal complications. This health system strengthening mMIST intervention demonstrated improved utilization patterns and administrative outcomes that support its scale-up, when considering reach, public health priority, and potential for impact. These pilot findings support progression to full-scale stepped wedge implementation to assess impact on neonatal and fetal mortality.
