Each year, approximately 350,000 women around the world die unnecessarily as a result of preventable causes related to pregnancy and childbirth. Half of the 7.5 million deaths among children under five years of age occur during the first 28 days of life, also from largely preventable causes. These deaths occur primarily in the Global South – in sub-Saharan Africa and South Asia.
Cell phones could be saving their lives.
Mobile Technology Is Everywhere
In a world with 7 billion people, 6 billion of them are mobile phone subscribers. A new report “Leveraging Mobile Technologies to Promote Maternal and Newborn Health,” found that combining mobile technologies with existing health system resources would provide women and newborns with:
- Timely interventions that promote decisions to seek care and stimulate demand for available services– such as text messages that provide health education and increase awareness of health resources;
- Improved access to health services and facilities, for example through services that equip community-based health workers with mobile tools, extending health coverage into households and the community; and
- Health care that is delivered efficiently and expertly, through communication services that connect women to peer networks or local expert resources.
Mobile technologies are rapidly expanding throughout the world. The question is whether we can harness these technologies to impact the health and lives of women and children ("mHealth"), particularly in the Global South.
New mHealth tools are emerging, including:
- mCheck, which helps women in India identify health risks in the first week after delivery and seek treatment;
- Cellphones4HIV in South Africa, which aims to prevent the transmission of HIV/AIDS from mother to child through text messages with educational messages and reminders for appointments, tests and treatment; and,
- Mi Bebe, which enables health workers to monitor women with high-risk pregnancies remotely to provide early warning of abnormalities and refer them to treatment in a timely way.
So, how do we make sure every mobile user can access these kinds of tools?
Bringing mHealth to the broader public
Currently, mHealth applications for maternal and child health are in the formative design and test stages of implementation. As a result, evidence of their effectiveness is only now emerging. It is critical that we develop and implement more rigorous evaluation of mHealth tools currently in place. If these are shown to positively impact maternal and child health, we also need to make sure we can bring these tools to those countries, cities, and towns that need them most.
We cannot look at mHealth technology in a technology vacuum, though. For us to take it to scale in the places worldwide where it is most needed, we will have to address many other related issues, such as social factors, strategic partnerships and business models. For example, by addressing social factors like literacy and inequities in women’s access to mobile phones, we can remove barriers that impede the reach of mHealth services. We can also adapt services to meet user needs—such as using voice messaging instead of text messaging where literacy is low. Helping to remove barriers to using the technology will ultimately lead to broader adaptation and better health outcomes.
Innovation will also need to be flexible and adaptable to the quickly evolving nature of technology, and build on existing information and communication technology capabilities. We don’t need to reinvent the wheel.
The Innovation Equity Problem
Not everyone has equal access to mHealth. Countries as diverse as Kenya and Peru lead in the level of innovative mHealth activity among the countries reviewed – as evidenced by the integration of mFinance with mHealth in Kenya or the role of Universidad Peruana Cayetano Heredia in promoting local capacity development in Peru – while Liberia and Brazil lag behind. This cannot be explained on the basis of health, development, and technology indicators alone.
We need to identify critical existing resources – such as each country’s human resources, scientific and technological research infrastructure, regulatory frameworks, and business and investment environment – and assess how they may influence any country’s capacity to innovate. Many countries need support in developing the infrastructure that would improve their ability to develop and scale up mHealth interventions.
Mobile technology has the power to transform health systems and to save lives. The solutions are, quite literally, in our hands.
I encourage readers to share your insights, information and experience on extending mHealth for maternal and child health below.