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Piloting Portable Ultrasounds in Rural Ghana

For women living in rural locations in Ghana, portable ultrasounds may be a useful tool in preventing pregnancy complications. Although the World Health Organization recommends that pregnant women have at least four antenatal care visits and skilled attendants at birth, many pregnant women in rural communities in low-income countries do not meet these recommendations.

Researchers affiliated with the University of Ghana, African Institute for Mathematical Sciences, Korle Bu Teaching Hospital, ETH Zurich, and Istituto Italiano di Tecnologia recently published the results of their 11-month pilot study.

The aim of the study, which focused on 323 women from four rural communities in the Central Region of Ghana, was to increase the number of antenatal care visits, reduce home deliveries, and supplement care given by antenatal clinics. They tested a system of care based on low-cost mobile phones and portable ultrasound scan machines in the pilot. In each community, at least one community health worker was trained and equipped with a mobile phone to promote antenatal and hospital deliveries.

For women who could not attend antenatal care, technicians acquired scans by using portable ultrasound machines, which they sent in near real time to be analyzed by a gynecologist working in an urban hospital. Though they received training, the technicians who performed the ultrasounds were not medical doctors nor had they received a full education as sonographers.

Overview of the project and technology used. Image Credit: Dr. Alessandro Crimi.

Dr. Alessandro Crimi, one of the researchers, explained that he and his team had decided to conduct a research project using medical imaging, but as MRI machines were too expensive, they opted for portable ultrasound machines and to focus on prenatal care.

By offering professional monitoring and supervision in rural areas where antenatal care was previously difficult, the project shows promising results. Conducting ultrasounds can allow early detection of specific adversities - such as ectopic pregnancies or breech presentations - which enables medical care to be sought earlier and potentially save lives.

An ultrasound scan is conducted using a portable machine. Photo Credit: from IEEE EMBC.

"The people of the rural communities were very happy and communications through the community health workers were very effective. Most of the Chiefs (or community kings) were enthusiast,'" explained Dr. Crimi. "However, the people of the community were sad when we told them that we were closing the project because it was just a pilot."

Dr. Crimi and his team have sent the documentation of the study's findings to the Ghana Health Center and proposed that the project be integrated in the national health care policies. They are seeking funding to hold additional studies, in the same location or using the same technology, and hope that the model can be extended to help more pregnant women in need.

In addition to Dr. Crimi, researchers include Benjamin Amoah, Evelyn A. Anto, Prince K. Osei, and Kojo Pieterson. More information about the project can be viewed here.