Pregnancy care during crises is challenging. This is how mobile technology can help

This article is brought to you thanks to the collaboration of The European Sting with the World Economic Forum.

Author: Anna Cecilia Frellsen, Chief Executive Officer, Maternity Foundation

• Half of all maternal deaths each year occur in humanitarian contexts while the number of neonatal deaths is also highest in these settings.
• When medical supply chains are disrupted and access to hospitals or health centres is limited, frontline healthcare workers must rely on their clinical knowledge and skills to provide the necessary care.
• Mobile solutions, such as apps providing guidance on maternal and neonatal care, can help empower healthcare workers to deliver safer births.

Did you know that one in five women of childbearing age living in war, conflict or crises around the world are likely to be pregnant? For them, giving birth can be life-threatening, not just life-changing.

On top of trying to survive in such circumstances, these women face harsh realities during pregnancy and childbirth. Crisis-affected countries and regions are often left with insufficiently trained and resourced frontline healthcare workers, meaning that far too many women cannot access the skilled care they need.

In these remote and fragile settings, mobile technology is vital in reaching healthcare workers and ensuring safer births and pregnancies by providing easy-to-use and up-to-date clinical guidance.

Mobile technology can help deliver safer births

The difficulties experienced in emergencies vary from normal low-risk childbirth to common complications responsible for most global maternal and newborn deaths. Premature birth, intrapartum-related complications, such as an absence of breathing at birth, infections and other causes of neonatal mortality and morbidity are some issues that can emerge once a baby is born.

The challenges of treating these problems are further aggravated when medical supply chains are disrupted and access to hospitals or health centres is limited. Here, frontline healthcare workers must rely on their clinical knowledge and skills to provide the necessary care.

That’s why it is crucial to provide more agile ways of solving such challenges, such as through digital solutions and mobile technology. For instance, we at the non-profit Maternity Foundation developed the Safe Delivery App with the University of Copenhagen, the University of Southern Denmark and practising midwives to give healthcare workers access to the tools needed to deliver better maternal healthcare.

The free app, which works offline once downloaded, provides simple animated instruction videos, action cards, drug lists and guidance on practical procedures to manage various scenarios. For example, it provides guidance on handling severe bleeding after childbirth, a leading cause of mortality, resulting in about 70,000 maternal deaths globally each year.

Maternal mortality in humanitarian contexts

Pregnancies and childbirth don’t pause during wars, conflicts or other crises. In fact, the needs of women and girls increase during these high-pressure times, while their access to life-saving services and support may radically diminish.

Every day, 800 women die during pregnancy and labour and over half of all these deaths happen in crisis-affected countries. Newborn mortality is also the highest in these settings. In total, 2.4 million newborns die each year.

The reality is that most maternal and newborn deaths are preventable if pregnant women have access to skilled care during pregnancy and delivery. Evidence shows that when the quality of maternal healthcare decreases, maternal mortality increases.

Maternity Foundation believes scaling up the disbursement of mobile solutions can help rein back this trend. It has seen how this has helped healthcare workers deliver safer births through its current delivery in refugee camps, such as one of the largest in Cox’s Bazar, Bangladesh, conflict zones like Afghanistan and Ukraine and complex and fragile environments such as Somalia, as well as developmental settings – another context where far too many women die trying to give life.

In total, Maternity Foundation has reached more than 300,000 healthcare workers across 40 countries since the app was first launched in 2015.

Technology cannot stand alone

Technology can be a vital tool in addressing the need for skilled birth attendants but it cannot stand alone. Simply creating a digital tool and making it available on the App Store and Google Play, hoping it will be discovered, is not enough to make a difference.

That’s why Maternity Foundation works closely with partners at the global and country level to integrate its app into existing structures and activities. In the case of Ukraine, Maternity Foundation works with the Global Medical Knowledge Alliance and the Red Cross movement. It is also in dialogue with other interested partners to roll out the Safe Delivery App in the country.

In developing and other contexts, Maternity Foundation is also exploring how its app can be included in the training curriculum for midwifery students or become recognized as part of the professional development pathway of practising midwives. In this case, Maternity Foundation collaborates with national governments, other NGOs, midwifery associations and universities. Ultimately institutionalization and integration into ongoing initiatives in a country is the goal and key to sustainable interventions.

To further advance the maternal health agenda and help deliver safer births, Maternity Foundation has recently joined the World Economic Forum and is taking part in the EDISON Alliance, among a range of other organizations committed to improving 1 billion lives through digital solutions across health, finance and education by 2025. Furthermore, Maternity Foundation is part of the Women’s Health Initiative at the Forum, engaging in a cross-sectorial collaboration to improve the health of women and girls.