The first baby born on the blockchain is expected to enter the world at a small clinic in rural Tanzania this week.

What does that mean – to be born on the blockchain? Has the world finally gone too far with its distributed ledger obsession? Just the opposite, Niall Dennehy, COO of AID:Tech would argue – more like it’s finally found a use case that is more practical and more noble than cryptocurrencies.

That use case, said Dennehy, is to guide Tanzanian mothers through their pregnancies and establish digital identities for their babies at birth, which he says will make it easier for those mothers and children to receive aid from governments and non-profits throughout their lives.

AID:Tech uses digital identity and blockchain tech to create a new, more transparent way for governments, enterprises and NGOs to deliver digital entitlements. It has teamed up with PharmAccess Foundation, a group focused on improving healthcare access throughout Africa, to devise this creative new use of distributed ledgers.

In a recent interview with Karen Webster, Dennehy explained how AID:Tech and PharmAccess Foundation came together to innovate this humanitarian application for blockchain tech, what benefits the organizations believe they can deliver and why they say blockchain was the right tool for the job.

Transparency

From lack of healthcare funding to high child and maternal mortality rates, the Tanzanian healthcare system presents quite a few substantial challenges when it comes to caring for mothers and babies. One of them is the difficulty of getting funds from well-meaning donors to end recipients.

Even when charitable organizations try to step in and offer aid, those funds don’t always get to their intended destination. Dennehy said that’s how AID:Tech got started: Monitoring how aid is delivered to eliminate the corruption that exists around cash delivery.

A distributed, immutable ledger creates transparency to ensure that donations and government services and remittances, such as welfare, go where they are needed instead of into sticky pockets.

“We use blockchain,” Dennehy said, “but at heart, we’re a data logistics company, ensuring that something gets from Point A to Point B.”

Blockchain Babies

Dennehy said the greatest potential for blockchain in this setting is with the unborn: two billion people lack a form of legal identity, and the world’s population is only growing. Assigning people an identity at birth could help trace services and aid to ensure they’re received by the people who need them.

If people can be assigned an identity at birth – with, of course, the mother holding control of the data until the child comes of age – then Dennehy said the person’s identity can become an aggregator of data for welfare, aid remittances and donations, eliminating the fraud that can be all too common in the no-man’s-land between well-meaning donors and end recipients.

The aggregator facet is a key part of what Dennehy said AID:Tech and PharmAccess are trying to do. He said a blockchain identity alone doesn’t do people any good; it’s tying it to necessary services that will create value as these blockchain babies come of age.

Healthy Moms

As for the mothers, said Dennehy, using blockchain to track their healthcare activity throughout the pregnancy and after birth can help ensure a healthy process and delivery, reducing the potential of either the mother or the baby dying in childbirth.

Today, women receive a paper booklet upon learning they’re pregnant, and each time they go in for prenatal care, the doctor or midwife writes down data from the visit in the booklet. That booklet is later sent to a processing center where it is manually entered – but that doesn’t happen until three months after the child is delivered, and since it’s entered manually, the data is error-prone.

Logging that information on the blockchain instead, said Dennehy, enables healthcare providers to incentivize healthy, proactive pregnancy behaviors. For instance, if a patient shows up for all her appointments, she may receive a digital asset representing an umbrella, which she can present at a shop to receive the umbrella.

Incentivizing healthcare at this critical time in a woman’s life gets her through the door, said Dennehy, which generates data – and presenting that data back to the woman empowers her to make better decisions around her own (and her baby’s) health.

Scalability

When Mastercard came up with a way to track medication compliance for Hepatitis C patients in countries with limited resources, it leveraged its card rails and underlying infrastructure for rewards points to track healthcare activity and to incentivize patients to receive the care they needed.

Patients who took all of their medication as directed could be completely cured, but many were not compliant with their treatment plans, so they remained sick. So, figured Mastercard, if it could use a loyalty/rewards structure to incentivize patients to take better care of themselves and follow their doctors' instructions, more people could be cured.

One of the main criticisms against blockchain today is that it’s slow – much, much slower than traditional card rails like the ones Mastercard used for its medication compliance incentives. If AID:Tech and PharmAccess’ offering takes off like they’re hoping, won’t the companies soon hit the ceiling of what the blockchain rails can handle?

Dennehy said the partners have made strategic decisions to avoid that scenario. They’re using what he calls a permission ledger with a high level of scalability, processing a couple thousand transactions per second. He said it’s built on the Hyperledger fabric, which touts itself as the blockchain for enterprises, with a higher throughput than alternatives.

Permission ledger, he added, also lets the organizations completely avoid the volatility inherent in blockchain’s most prevalent use – cryptocurrencies – and just focus on getting healthcare to women who need it, when they need it.