Saving the lives of pregnant women and children with ICTs and mobile health

•  In 2010, 287,000 women died during and following pregnancy and childbirth.

•  Each day, 800 women die from preventable causes related to pregnancy or childbirth complications.

•  99% of these maternal deaths occurred in developing countries, with more than half taking place in sub-Saharan Africa.

•  24% of these deaths are attributable to HIV in Sub-Saharan Africa.

•  Most of these deaths could have been prevented.

PROBLEM: Unacceptably High Maternal Mortality

[source: WHO Maternal Mortality Fact Sheet]

•  In 2012, 6.6 million children under the age of five died.

•  44% of child deaths under the age of five occur during the neonatal period.

•  About 45% of all child deaths are linked to malnutrition. •  More than half of these early child deaths are due to conditions

that could be prevented or treated with access to simple, affordable interventions.

•  Safe childbirth and effective neonatal care are essential to prevent these deaths.

PROBLEM: Unacceptably High Child Mortality

[source: WHO Child Mortality Fact Sheet]

A global and innovative project to save the lives of pregnant women, new mothers and their babies through the systematic use of information and communication technologies (ICTs) and mobile health.

SOLUTION: Zero Mothers Die

ZERO MOTHERS DIE A Multistakeholder Public-Private Partnership

Zero Mothers Die tackles the MDGs

Global Plan

[source: UNAIDS 2013 Progress Report on the Global Plan]

Leveraging Mobiles & ICTs

[source: 2012 Information and Communications for Development]

[source: ITU World Telecommunication / ICT Indicators Database]

6.8 billion mobile subscriptions worldwide

Significant growth of mobile subscriptions in the developing world.

Mobile phone networks cover 96% of the world's population. •  77% of all mobile subscriptions are held by nearly 90%

of the population in low- and middle-income countries. The impact of mobile phone technology on health, including maternal health, can be far-reaching, cost-effective and replicable.

WHY MOBILE HEALTH?

MOBILE HEALTH for MATERNAL HEALTH

Mobile health initiatives cover a wide range of activities, including:

Mobile health initiatives targeting MDGs 4 and 5 are reaching over 140 million women. See:

•  data collection •  disease surveillance •  health promotion

•  diagnostic support •  disaster response •  remote patient monitoring

PROJECT OBJECTIVES Reducing maternal and child mortality through increased access by pregnant women to appropriate healthcare information, via mobile voice and text messages in local languages and dialects.

Accelerating mobile phone ownership and use by pregnant women to increase access to healthcare, empower women with information, and reduce the mobile phone gender gap. This includes facilitating connections with healthcare workers through allocations of free airtime restricted to calling assigned local healthcare facilities and workers.

Education and capacity-building of local health workers using tablets preloaded with up-to-date and tailored training materials and content in local dialects and languages to improve maternal and child health in their communities.

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Capacity-building and education of local health workers using ICTs and localized content. Mobile money savings scheme to help finance and increase access to skilled care during childbirth. Solar power business generation scheme to bring financial empowerment to pregnant women and provide sustainable energy to support the charging of their mobile phones.

MumHealth, a mobile messaging service delivering health information to pregnant women and new mothers in local languages and dialects. 100,000 mobile phones per year to pregnant women. 36,000,000 minutes of free airtime per year to pregnant women to enable their communication with local health workers and facilities.

PROJECT COMPONENTS

Target Beneficiaries

Pregnant Women & New Mothers 100,000

Local Healthcare Workers

•  Midwives •  Nurses •  Community & Frontline Health Workers

MumHealth & In addition to locally developed content, MumHealth will incorporate evidence-based mobile messages from MAMA. The messages will be tailored and localized by UniversalDoctor.

Culturally sensitive and stage-based messages created by BabyCenter according to UNICEF and WHO guidelines, and vetted by WHO. Used by 266 organizations in 61 countries. The messages are built around key health behaviors and interventions which evidence shows can improve health outcomes. Topics: antenatal care, nutrition, vaccination, PMTCT, infant feeding, oral rehydration, use of insecticide-treated bednets, and post-partum family planning.

KEY RISKS:

Discrimination due to HIV stigmatization

PROPOSED SOLUTION Zero Mothers Die will target all expectant and new mothers, instead of only HIV-positive pregnant women, by employing a comprehensive approach to improving maternal, newborn and child health, while maintaining the prevention of mother-to-child-transmission of HIV (PMTCT) and systematic use of ICTs as key elements. This strategy will also ensure women who would become HIV seropositive during pregnancy will not be lost by the project.

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KEY RISKS:

Language and illiteracy barriers

PROPOSED SOLUTION •  The MumHealth repository of mobile messages will be

developed in key languages/dialects in the area of implementation.

•  The messages will be tailored and localized for target beneficiaries.

•  Regarding illiteracy and disabilities, Interactive Voice Response (IVR) technology will be used to develop voice messages as an alternative solution by offering pre-recorded audio information in different languages/dialects.

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KEY RISKS:

Low mobile phone ownership levels

PROPOSED SOLUTION •  Local intelligence gathering suggests there is no mobile

phone gender gap in Greater Accra.

•  According to local partners, it is almost 100% certain that women will own at least one mobile phone.

•  Spouses controlling the mobile phones and restricting access by the women is an unlikely risk in Greater Accra.

•  In any case, Zero Mothers Die endeavors to equip at-risk, low-resource pregnant women who do not own a mobile phone.

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KEY RISKS:

Misuse or resale of the mobile phones

PROPOSED SOLUTION •  The mobile phones distributed through the project* will be

uniquely designed with limited (i.e. non-smartphone) functionality to avoid this.

•  If this is a significant risk, the project can restrict the numbers that can be dialed through the mobile phone.

*Zero Mothers Die will ensure the mobile phones acquired and distributed by the project to the pregnant women will come from responsible mobile phone manufacturers who are reliable in providing quality mobile phones.

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GUIDING PRINCIPLES

Sustainability Scalability

Engaging local Ministries, agencies and stakeholders in the project processes (design, implementation, evaluation, etc.) to promote buy-in and local ownership. Seeking alignment with the Ministry of Health’s national health priorities and plans and the National eHealth Strategy. Ensuring Zero Mothers Die is integrated with local health services and health information management systems, and thereby within local health ecosystems. Establishing an inclusive business model to ensure long-term sustainability and limit burdens on budgets.

This will be achieved through concrete actions:

Ghana, one of the UNAIDS Global Plan target countries, has been chosen in consultation with the partners as the first implementation country for Zero Mothers Die. The initial implementation phase will take place in Greater Accra in partnership with the Ministry of Health of Ghana, Office of the First Lady &other key local partners.

GHANA: 2014: First Implementation Phase

Partnership & Investment Opportunities

Mobile Phones for Vulnerable

Pregnant Women

Smartphones/Tablets for

Community Health Workers

Content for Capacity-Building

of Community Health Workers

Airtime & SMS for Delivering

Healthcare Information to

Pregnant Women

and more…

For more information and partnership opportunities

Please contact:

Jeannine Lemaire Zero Mothers Die Project Coordinator

at: Lemaire.Jeannine@gmail.com

http://www.millennia2015.org/Zero_Mothers_Die

http://www.adaorganization.org/index.php/projects/zero-mothers-die