**A Pilot Study Exploring the Feasibility of Using the Bornfyne Prenatal Management System (PNMS) Mobile Application to Increase Awareness of COVID-19 in Mumbwa District, Zambia**

**Clementina Phiri1, Mirriam Nkangu2, Mwenya Kasonde3, Mweene Chibonta4, Donald Weledji5 , Denis Foretia6, Sanni Yaya7, Samson Shumba8, and Choolwe Jacobs9,10**

1Ministry of Health Mumbwa, Mumbwa, Zambia

2School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada

3Liverpool School of Tropical Medicine, Liverpool, United Kingdom

4Global Health Corps, Lusaka, Zambia

<sup>5</sup> Sprl Donwel Systems, Belgium

6Denis and Lenora Foretia Foundation, Cameroon

7School of International Development and Global Studies, University of Ottawa, Ottawa, Canada 8Department of Epidemiology, University of Zambia, Lusaka, Zambia 9Department of Epidemiology and Biostatistics, School of Public Health, University of Zambia, Lusaka, Zambia

10Women in Global Health, Lusaka, Zambia

Since the start of the COVID-19 pandemic, healthcare has seen the adoption of several digital solutions with the goal of accelerating progress toward Sustainable Development Goals and Universal Health Coverage. The Bornfyne mobile application system, introduced in Cameroon in 2018, is a digital application that aims to increase access to maternal health services in rural parts of sub-Saharan Africa. The tool offers digital health technology adapted for resource-poor settings, with the potential to reduce maternal and neonatal morbidity and mortality and further support the COVID-19 response. This study aims to assess the feasibility of enrolling women into the BornFyne-PNMS project using household mobile phones and to increase awareness of COVID-19 in the Mumbwa District in the Central Province of Zambia. A cross-sectional study was conducted in two selected communities of the Mumbwa district between October 2021 and November 2021. Community health volunteers and the district medical team mapped out households in the catchment area and administered 470 surveys. Ethical approval and authority were obtained from the Ethics Committee and the Ministry of Health, respectively, in support of the study. Descriptive statistics were done using STATA software. Preliminary results indicate that of a total of 429 households surveyed, 424 (90.0%) had one or more pregnancies in the past year, while 383 (81.5%) were not vaccinated against COVID-19. Further, of the total 429 households, 219 (51.0%) owned a mobile phone, and 133 (30.5%) owned a smartphone. A total of 380 (81.55%) were willing to receive medical advice, and 414 (88.1%) were willing to listen to COVID-19 specific advice over the phone. This baseline survey demonstrates that the use of digital innovations such as the BornFyne PNMS is feasible in a rural district such as Mumbwa as a means to share reproductive and maternal advice, including advice on COVID-19 with potential to reduce maternal and neonatal morbidity and mortality in rural settings.

Clementina Phiri1, Mirriam Nkangu2, Mwenya Kasonde3, Mweene Chibonta4, Donald Weledji5, Denis Foretia6, Sanni Yaya7, Samson Shumba8, and Choolwe Jacobs9,10

1 Ministry of Health Mumbwa, Mumbwa, Zambia


Objective**:** This study aims to assess feasibility of enrolling women into the Bornfyne-PNMS project using household mobile phones and to increase awareness of COVID-19 in Mumbwa District, in the Central Province of Zambia.

#### Background

Since the start of the COVID-19 pandemic, healthcare has seen the adoption of several digital solutions with the goal of accelerating progress towards the Sustainable Development Goals and Universal Health Coverage.

The Bornfyne Mobile Application system, introduced in Cameroon in 2018, is a digital application which aims to increase access to maternal health services in rural parts of Sub- Saharan Africa. The tool offers digital health technology adapted for resource-poor settings, with the potential to reduce maternal and neonatal morbidity and mortality, and further potential to support COVID-19 responses.

#### Results

Preliminary results indicate that, of a total of 429 households surveyed, 424 (90.0%) had 1 or more pregnancies in the past year, while 383 (81.5%) were not vaccinated against COVID-19. Further, of the total 429 households, 219 (51.0%) owned a mobile phone and 133 (30.5%) owned a smartphone. A total of 380 (81.55%) were willing to receive medical advice and 414 (88.1%) were willing to listen to COVID-19- specific advice over the phone.

#### Conclusions

This baseline survey demonstrates that the use of digital innovations such as the Bornfyne-PNMS is feasible in a rural district such as Mumbwa as a means to share reproductive and maternal advice, including advice on COVID-19, with the potential to reduce maternal and neonatal morbidity and mortality in rural settings.

*Figure 1. Expectant woman using a mobile phone to communicate with a doctor in Nakanjoli village, Mumbwa, Zambia*

*Figure 2. Midwife attending a pregnant woman using the Bornfyne-PNMS platform in Mumbwa District, Zambia.*

#### Methods

A cross-sectional study was conducted in two selected communities of Mumbwa district between October 2021 and November 2021. Community health volunteers and the District Medical team mapped out households in the catchment area and administered 470 surveys. Ethical approval and authority were obtained from the Ethics committee and the Ministry of Health, respectively, in support of the study.

Descriptive statistics were presented using STATA software.
