Anna Frellsen is the CEO of Maternity Foundation. She has a background with McKinsey&Company, an MBA from IESE and sits on multiple boards.
During the pandemic, some countries in Africa saw increases in maternal mortality rates. Moving forward, I think we can expect to see increased mortality rates in other low- and middle-income countries. Additionally, I expect to see spikes in unintended pregnancies and unsafe abortions.
The Covid-19 pandemic is largely to blame. All over the world, the pandemic disrupted healthcare systems and cut off access to basic services for pregnant and laboring women.
Now, it is time to turn the tides, and we know what it takes. As the CEO of Maternity Foundation, I’ve seen that the vast majority of maternal deaths are preventable if women receive quality care from a skilled healthcare worker. In many places, healthcare workers practicing midwifery don’t have sufficient skills and knowledge to handle basic childbirth complications and emergencies. In addition, we currently lack almost 1 million midwives to ensure quality care for all women and newborns.
What can be done to close this gap, and how can we advance maternal health services? There are no easy answers or quick fixes, but one of the key components is to reach and support healthcare workers with essential and updated guidance on how to handle childbirth complications. Here, we see that technology can be used as cost-effective leverage to not only advance maternal health but, more broadly, to strengthen global development work.
Technology—A Magic Bullet?
At Maternity Foundation, we work to ensure safer births for women and their newborns. With our technologies, we have reached healthcare workers around the globe and supported them with essential instructions related to safer childbirths. However, technology is not a magic bullet. It needs to be applied with care.
Below are three key learnings from applying digital solutions to support and train healthcare workers and advance maternal health in low-resource settings.
1. Technology should not come first.
Today, over 4 billion people are mobile internet users. I’ve found that some people in sub-Saharan Africa have easier access to a mobile phone than to basic sanitation. This provides an immense opportunity to reach and support more people and to do it in a cost-effective way.
However, we must not forget that internet connectivity is still a huge challenge, especially in rural settings, where mobile devices also tend to be simpler, have fewer functionalities and less storage. During the pandemic, we saw a lot of digital solutions for people in such areas, but some required large internet connectivity and thus never reached target populations.
At Maternity Foundation, we have learned that simple solutions often make the biggest difference in low-resource settings. For example, through our app, we provide healthcare workers with simple animated instructions for instant support during childbirths. Once downloaded, the app works offline. We also work with a digital solution for old-feature phones, which provides information by text messages to pregnant women and has a voice message function for those with low literacy.
In my experience, many digital solutions are developed from a “what’s possible” point of departure rather than from a “what’s needed” basis. It should be the other way around. Therefore, before you jump on the technology wagon and bring in the best IT developers, you must scrutinize the problem and try to solve from a need- and context-based perspective.
2. Prioritize the ecosystem over the solution.
Your digital solution cannot stand alone. Putting a new app in Google Play or the App Store simply won’t make a difference. It needs to be an integrated component of a bigger system, complementing programs and tools already there—whether it is an educational program, a humanitarian response or a development project. This also requires that your digital tool is interoperable with other solutions, which you need to be mindful of in its design.
For my organization, strong partnerships are key to catalyzing scale and integration. We work with various partners, often governments and national institutions, and provide them with technical assistance to integrate our solutions within their existing national programs. We have learned not to launch new versions of our tools unless a partner endorses them and provides a financially sustainable model.
Scaling up your solution can effectively be done through strong partnerships. It strengthens ownership and thus heightens the probability of longer-term success, but it also entails building up dependencies and often makes planning less linear. In your strategic planning and target setting, it will therefore make sense to think about a “portfolio of engagements” rather than 1:1 project plans and target setting, as some engagements will succeed within a given time frame and others won’t.
3. Understand the need for customization.
One size for all won’t work, and it is important you have a digital tool that can be adapted to the targeted context—this goes for the language and content, as well as the visuals. This also gives the critical ownership indicated above. However, there is still a lot to leverage from a universal package, ensuring that you don’t have to start over when you wish to apply your tool in a different context.
We build our work on an 80% standardized package and customize 20% to fit local contexts and requirements. We find that a lot of our content can be replicated across different contexts. It is a huge advantage to have a standardized package that can easily be updated and that builds on global evidence and best practices. A robust platform and operating model also make it possible to respond quickly to new clinical needs or contexts.
Your tool might not need the same ratio in terms of standardization versus customization. Building a robust digital platform is a huge investment, and in order to go beyond the pilot stage, the need for customization and the operating model to accommodate this need should be assessed up front.
Technology is not a magic bullet, but when we apply it in an intelligent manner, it can make a huge difference. Let’s use it, and let’s use it wisely, to train more midwives better, advance maternal healthcare services and build back stronger overall after the pandemic.