mHealth Solutions to Improve Maternal Health

By: Madeline Taskier, Partnership Coordinator at Women Deliver

In developing countries there are currently 5 billion mobile phone subscriptions, nearly three times the amount in developed countries. Given the prevalence of mobile phone use and the overwhelming predominance (99%) of maternal deaths occurring in the developing world, what kind of potential does mHealth technology have to change the state of maternal health? According to the presenters at the Maternal Health Task Force Policy Series event on mHealth, the impact of mobile phone technology is far reaching, replicable, and cost-effective. 

Last week at the Woodrow Wilson Center, the Maternal Health Task Force and UNFPA hosted the 8^th session in their maternal health policy series. The presenters highlighted the developments and challenges in mHealth with respect to scale-up, coordination between governments, and funding. Right now mHealth operates mainly as a communications system for health wellness messaging. But, David Aylward, Executive Director of the mHealth Alliance, predicted that we are about a year away from scaled-up patient monitoring systems that would allow clinics around the world to move beyond one-way communication and beyond one-way dissemination of messages. 

This is good news for improving maternal health, where patient monitoring is so important. In fact, one of the biggest challenges in combating maternal mortality is the process of monitoring and evaluation. mHealth patient monitoring allows for robust data collection, even in areas with limited health care access and inadequate data. The goal is to get a better sense of how, where, and why mothers are dying in childbirth in areas where we haven’t been able to get good data before. Plus, mobile phone patient monitoring and referrals follow the woman along a continuum of care from the start of the pregnancy all the way through her post-partum period. 

Alan Labrique, Associate Professor at the Johns Hopkins University Bloomberg School of Public Health, highlighted how simple mobile technologies can “compress the time between crisis and care.” The use of mobile phones will reduce delayed decision-making and transportation during childbirth. Professor Labrique’s research in the JiVita study in Bangladesh showed that 55% of women in a near-miss delivery event used a mobile phone to contact a provider or an ambulance. “Families who have mobile phones use them and share them with their community,” he reported.

Recent events, including the earthquake in Haiti, have also highlighted how useful mobile technology can be in saving lives during crises and disasters. By texting “4636” after the earthquake, Haitians could alert a central response system with their location and problem which would then be mapped into a geo information system. Disaster response teams on the ground would access this emergency database and respond to each call for help. Health organizations are just beginning to understand the many ways to harness the power of mobile technology for better health outcomes.

New and innovative research and pilot programs are being rolled out by young, enthusiastic social entrepreneurs. Josh Nesbit, Executive Director of FrontlineSMS:Medic and one of the speakers (and the only man) on the “Young Women Deliver” panel at the Women Deliver 2010 conference, spoke about his company’s ideas for new approaches to mobile technology. SMS text messaging is currently used in a variety of innovative ways, including equipping community health workers (CHWs) with SMS tech to monitor patients and send information back to the local clinics in rural areas. In addition, SMS will be used in a tracking system which follows patients and their line of treatment from large hospitals back to their local clinics, reducing the 75% of patients that fall through the cracks in the referral process. Other SMS technology allows CHWs to contact warehouses and keep digital records of drug stock-outs placing local clinics one step ahead of the supply chain. 

Though there is buzz and excitement around mobile technology, there are challenges that we have to overcome and major steps that we need to take to make real progress. First, we need to invest in initiatives like the mHealth Alliance which connect experts in ICT and maternal health to map solutions of how mobile tech can support the continuum of maternal health care. We need to continue to produce prototypes of mobile technology, test and research it rigorously, and collect data to track progress. We need to educate country leaders that have limited familiarity with mHealth and help them understand the potential of this technology to transform their health systems. We need to engage the private sector by showing companies how they can profit when women use mobile phones. Finally, as Josh Nesbit put it, “We need to recognize that mobile phones are not solutions, but tools. They become solutions when people on the ground use these tools.”

With the right combination of will, application, and information, we will be able to take mobile phone technologies and turn them into solutions that deliver for women.  

• Join the Maternal mHealth Initiative (MMI) at Health Unbound.
• Check out the upcoming mHealth Summit on November 8-10^th in Washington, DC hosted by the mHealth Alliance.