By Fabiano Teixeira da Cruz, Inter-American Development Bank

Ed note: Tomorrow, the author will participate in the Women Deliver conference panel ‘Mobilizing Reproductive Health: How Cell Phones Are Revolutionizing Women’s Health’, organized by the mHealth Alliance, which the Rockefeller, UN and Vodafone Foundations launched in 2009 to facilitate cross-sector collaboration to bring mHealth to sustainable scale. These are a preview of her remarks.



Maternal mortality remains a major challenge to health systems worldwide.

According to the World Health Organization (WHO), every minute, at least one woman died from complications related to pregnancy and childbirth, about 585,000 women each year. To make matters worse, for every woman who dies in childbirth, 20 more suffer injuries, infection or disease (about 10 million women each year). And 4 million babies die before they are 30 days old. Millions more die from diseases such as malaria that has largely been eradicated in the developed world.

This map shows the huge number of maternal deaths in Latin American and the Caribbean (LAC) countries. Although Chile is better placed than the other countries in the region, appearing as 46th in the global league table, 21.1 women die for every 100,000 live births. In the case of Haiti, the worst performer in the region and 155th (out 181) in the MMR global rank (numbers before the earthquake), the report shows 582.5 deaths for every 100,000 live births.

Maternal mortality ratio (MMR) – the number of maternal deaths per 100,000 live births – in the LAC countries.

Why is there so high maternal mortality?

Poor access to the health care system

Access to family planning – counseling, services, supplies

Low coverage of antenatal care (e.g. missing appointments)

Inability or difficulties to communicate with providers and health-care team in case of emergencies and when needed

No access to lab results

No health care-related information easily available

The promise of information and communications technologies (ICT) for health: a paradigm shift towards digital health care.

Modern information and communication technology (ICT) has a pivotal role to play in tackling health-related problems, by empowering individuals and equipping decision makers with timely information about critical health issues. It can, among other things, enable healthcare workers to conduct remote consultation and diagnosis, store and disseminate healthcare information, improve access to and use of information by patient, strengthen epidemiological surveillance and management, establish databases to track vaccination, raise awareness through knowledge sharing, improve quality of health services provision, improve patient compliance with treatment regimen, improve access to health services, expand access to ongoing medical education and training for health workers.

In the fight against maternal mortality, ICT can critically reduce the incidence of maternal death numbers by: facilitating access to information and healthcare services, and reaching women with information to prevent unnecessary deaths and complications.

Also, with the expansion of wireless networks, mobile technology is an important ally. It’s the most rapidly adopted technology in history and represents an exciting opportunity to “reach the unreached”.

According to International Telecommunications Union (ITU), mobile subscriptions globally will surpass the 5 billion mark by the end of 2010, two-thirds of which are in low- and middle-income countries (LMICs) – the total number of PCs in use worldwide including laptops is 1 billion.

Almost 90% of the LAC population has a cell phone. Some forecasts indicate that it could grow by 8.2% annually in the region in 2010. Cell phones have become firmly ensconced as essential goods rather than luxury items.

There is a growing body of evidence that demonstrates the potential of mobile communications to radically improve healthcare services — even in some of the most remote and resource-poor environments. The key applications for mHealth (defined as the use of mobile communications for health services and information) in developing countries are:

Education and awareness

Remote data collection

Remote monitoring

Communication and training for healthcare workers

Disease and epidemic outbreak tracking

Diagnostic and treatment support

Appointment reminders (to patients and workers)

To sum up, ICT by itself certainly play a key role in helping saving lives but it isn’t a silver bullet. Health system strengthening as a whole is the key to the success of any kind of mHealth intervention.

ICT are only as useful as the substantive requirements and expertise on which they are based. We need clinical and public health experts to explain the needs and challenges they face; then gather the ICT experts to find the points of intersection — where ICT can help along the continuum of care for pregnant mothers and newborn children, and for those with serious diseases.

References:

[1] “mHealth for Development: The Opportunity of Mobile Technology for Healthcare in the Developing World”. United Nations Foundation/Vodafone Foundation Technology Partnership (2009); www.unfoundation.org/technology

[2] “Innovation: Applying Knowledge in Development”. Authors: Lee Yee-Cheong, Calestous Juma, Jeffrey D. Sachs; UN Millennium Project 2005, Task Force on Science, Technology, and Innovation.

[3] “Focus on Five: Improving Women’s Health to Achieve the MDGs“. Author: Women Deliver No. of pages: 22. Publication date: 2009.

[4] “Barriers and Gaps affecting mHealth in Low and Middle Income Countries: Policy White Paper”. Authors: Mechael, Patricia N., Batavina H., Kaonga N., Searle S., Kwan A., Goldberger A., Fu L., Ossman J. May 2010. The Center for Global Health and Economic Development (CGHED), Earth Institute at Columbia University and mHealth Alliance.

[5] “Mobile Technology for Community Health (MoTeCH): mHealth Ethnography Report”. Author: Mechael, Patricia N.; Dodowa Health Research Center. The Grameen Foundation.

Fabiano Teixeira da Cruz is Program Manager at the Science and Technology Division of the Inter-American Development Bank (IDB), where he heads the Mobile Citizen Program, an initiative that aims to speed-up the implementation of mobile phone-based services to tackle acute social and economic problems in the Latin American and the Caribbean region.

Cross-posted to Innovations & Stuff blog.