Last year women in Senegal's Joal district faced a difficult decision-should they deliver their babies in the comfort of their own homes, but without available medical technology, or should they travel to the local health center to go through labor assisted by trained health workers, but in an unclean and uncomfortable environment? Health workers tried to convince expectant mothers that home births pose a risk to both mothers and newborns; babies delivered at home don't benefit from the early care that health centers are equipped to deliver. Despite the advice that the health center would be safer, the conditions there kept many women at home for delivery.

Well aware that the condition of Joal's facilities were a barrier to improvements in reproductive health, local specialists were determined to bring evidence of the negative impact of the center's dilapidated state to municipal decision makers. Working in conjunction with Management Sciences for Health (MSH) under a USAID-funded maternal health and family planning project, a local reproductive health coordinator used a personal data assistant (PDA or "palm pilot") to record data and present a regional health committee with the problem. The coordinator's presentation hit its mark; with the ability to collect and analyze data "at her fingertips," the coordinator documented the problem and convinced the health committee that Joal's facilities needed an upgrade. The group released finances to renovate the maternity wing, replace worn-out and rusty surgical instruments in the labor room, and refurbish the poorly functioning ambulance.

PDA use is expanding in Senegalese health centers, bringing the supervisory processes to a new level of efficiency and accuracy. Dr. Mamadou Dieng, head of the health center at Guinguineo, uses the PDA device to meet essential drugs needs of the local population. With the PDA, Dr. Dieng processes data on drug availability and expiration dates, anticipates stock-outs, and compares his center's performance to health facilities in neighboring districts and against national standards. In consultation with local pharmacists and the municipal health committee, underlying problems with drug supply and distribution are quickly identified. MSH assists local decision makers in solving the drug management issues.

The PDA is being used to support health norms and standards, as well as improve communication in Senegal. Its technology helps health staff achieve accurate data collection to improve health sector efficiency, making it easier for decision makers to make informed choices about scare resources. Through initiatives like the one that brought PDAs to local health centers, MSH and its partners are helping the government of Senegal to combat specific health management and service delivery problems by improving and sustaining fully functional service delivery points-where competent, well-equipped providers serve informed, motivated clients.

Learn more about MSH's work in Senegal:

• Maternal-Child Health Project in Senegal

• Advance Africa
• Basic Support for Institutionalizing Child Survival II
• Rational Pharmaceutical Management Plus
• West Africa Regional Project—AWARE