White Ribbon Alliance

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What’s Working: Technology For A Healthier Future

Global Motherhood, HuffPo

November 25, 2015
One of the starkest and most pressing divides between developed and developing nations is the differing life expectancies of mothers and infants. Around 6.3 million children under the age of 5 die every year, mostly of preventable causes, and mostly in underdeveloped countries. This is more than twice the total number of deaths in the United States annually. Eight hundred women die due to pregnancy and childbirth complications every day, according to facts released by the World Health Organization in 2014 -- and the developing world suffers 99 percent of these fatalities. But now, thanks to a number of innovative, elegantly low-tech solutions coupled with aggressive development goals coming out of the most recent United Nations General Assembly, the next few years could look radically different for families around the world.

The recent case of a 10-month-old Bangladeshi child afflicted with severe pneumonia offers one of many signals of change. A racing heartbeat, rapid breathing and a telltale gasping sound that often accompanies collapsing lungs are among pneumonia’s symptoms. In much of the developed world, this illness would be treated with the most advanced medical care. And luckily for this child, his parents were also able to obtain life-saving treatment -- by no means a guarantee in their region. They happened to arrive at the International Centre for Diarrhoeal Disease Research (ICDDR) in Dhaka, where a groundbreaking, low-cost oxygen therapy is being developed. Thanks to this deceptively simple device, the child made a full recovery from the type of severe pneumonia that claims 900,000 infants each year.

Chief among the U.N.’s 17 latest Sustainable Development Goals are health and well-being targets specifically aimed at improving outcomes for mothers and children: reducing maternal mortality rates around the world by over 60 percent and mortality rates for children under 5 by almost 50 percent. Getting there will require great cooperation, participation and technological assistance. Innovative solutions like the ICDDR’s oxygen therapy are already making an impact in saving developing-world families facing serious yet treatable health and medical issues. We’ve partnered with Johnson & Johnson to bring you five of the most inspiring tools and techniques that are improving the lives of children, and their mothers, around the world.

Telemedicine
Clinical Expertise That Crosses Continents

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At its simplest, telemedicine transports medical knowledge and support using telecommunications systems to areas where facilities and personnel aren't always readily available. It has been one of this century’s most important developments in health care. From smartphone apps to surgeons assisted by Google Glass, telemedicine lowers costs and saves lives.

MomConnect, an initiative launched by South Africa’s National Department of Health (NDoH) and supported by a group of maternal-health–focused NGOs, uses SMS technology to communicate with the country’s pregnant and postnatal moms via their mobile phones. Now in its second year, the program sends women who have registered with MomConnect messages that are tailored to their stage of pregnancy and, later, early parenthood. The information offers advice on good maternal health, safe labor practices, newborn care and more. MomConnect users can also provide feedback about their maternal-care experiences to a confidential help desk, bringing the NDoH’s attention to issues and complaints in real time. The program is off to a promising start: More than a half million women have already received MomConnect messages, and one in three pregnancies in South Africa were recorded during its first year.

Even in environments where access to smartphones and the Internet is limited, telemedicine can still make a huge impact. In India, the White Ribbon Alliance deployed an interactive voice response system using a toll-free number and basic cell phone technology that, similarly to MomConnect, provides assistance to expectant mothers. Perhaps more importantly, the system also allows them to provide feedback on the health care services they've received.

The so-called MoM-QC program aims to improve health care for mothers and infants by not only educating patients on what to expect, but also by creating a feedback loop where their actual experiences encourage facilities to improve. “MoM-QC helps empower women to know their rights and make informed choices and decisions about where they wanted to have their children,” explains Andrea Miles, director of partnerships at the White Ribbon Alliance.

After the five-month pilot, which ended in 2014, nearly all participants had improved their knowledge of quality of care, and 87 percent said the information received and quality of care feedback provided had empowered them to make better choices for themselves and their family members.

“When my first child died, I didn’t even ask the doctor why it happened," says Sunita Devi, 22, who participated in MoM-QC’s pilot program during her second pregnancy. "Now I would ask more questions.”

In a country that's home to 17 percent of all maternal deaths worldwide, the importance of giving women in India a voice in controlling and regulating the quality of their health care cannot be overstated.

FoneAstra Milk Pasteurization Monitor
Smartphones Are Helping Provide Safe, Pasteurized Breast Milk to Infants in Need

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While breast milk is widely considered the preferred for source of nourishment for babies, many infants in the developing world cannot get breast milk from their biological mothers or milk banks, which have long been hindered by fears over HIV transmission. Smartphones are changing that.

Working with the University of Washington’s department of computer science and engineering, and supported in part by a Bill & Melinda Gates Foundation Grand Challenges Grant, PATH, an international health organization, developed the FoneAstra system. It’s a smartphone-based monitoring system that offers a low-cost way to monitor and regulate the flash-heat pasteurization of human milk. The system is especially critical for many milk banks that either don't require or can't yet afford commercial-grade milk pasteurization units.

“People are afraid of [milk banks]. HIV was found in breast milk in the 1980s, and milk banks just never recovered from that,” says Kiersten Israel-Ballard, senior program officer and technical officer at PATH. “People have a fear of the quality and the safety.”

Helping people to overcome those fears has been one of the most significant -- and rewarding -- benefits of the FoneAstra system. “To watch [the staff of the South African clinics] go from being afraid of donor human milk, afraid of what a milk bank is, to learning the system and learning the benefits, becoming completely converted and supportive and advocates, is amazing,” remarks Israel-Ballard. "That message carries. It carries not only to the mothers they care for, but to other nurses and their colleagues. That fire has started there."

Bubble CPAP
A Low-Cost Oxygen Therapy Seeking to Help the Nearly 1 Million Children Who Die from Pneumonia Each Year

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Dr. Md. Jobayer Chisti has devoted the past several years to perfecting a system of delivering bubble continuous positive airway pressure, or "bubble CPAP," to children in low-resource settings. Bubble CPAP has been available in higher income countries for decades and is the accepted treatment for newborns experiencing respiratory distress, thanks to its ability to help keep neonate lungs from collapsing. The high cost of equipment, however, has prevented its use in low-resource environments.

Chisti's low-cost system -- initially designed using a sterile shampoo bottle and standard hospital tubing -- has shown promising results in early testing; children who received Chisti’s bubble CPAP oxygen therapy had a significantly lower risk of death than children who received standard low-flow oxygen therapy. Based on these results, it has become the standard of care at the International Centre for Diarrhoeal Disease Research, where Chisti is based.

While he hopes his system becomes the standard throughout Asia and Sub-Saharan Africa, "The low-cost bubble CPAP technology requires further clinical testing,” Chisti says, “and [ICDDR] is working with international colleagues to develop further research plans to scale-up bubble CPAP in district hospitals in Bangladesh and other developing countries."

Many more inspired, sustainable solutions to the world’s most urgent health concerns continue to see success as they scale up. For instance, a recent nominee in the Saving Lives at Birth: A Grand Challenge for Development initiative was the NIFTY cup, a pioneering silicone cup that promises to help 9 million children who struggle to breastfeed due to craniofacial anomalies and other reasons. In order to save the lives of millions of children and hundreds of thousands of mothers, it’s imperative that we support these types of lifesaving innovations on a global scale.

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