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“If You Are Alive Today, Thank a Midwife”: How Mobile Phones Can Increase Skilled Birth Attendance

By: Ida Marie Boas, Program Manager, Maternity Foundation

A few weeks ago, my colleague and I sat in the car in Accra, Ghana on our way to a stakeholder meeting with several professional midwives to introduce our Safe Delivery App, a new mobile training tool for skilled birth attendants. Together with our fellow colleagues, we sat in the hot and dusty car and discussed the day’s meetings and expectations. In front us was a car with a bumper sticker that read, “If you are alive today, thank a midwife.” Immediately, I turned to my colleague who is a midwife, and I thanked her with a smile.

For those of us living in countries with easy access to a skilled midwife during pregnancy and delivery, we tend to take maternal and newborn health care for granted. This is not the case in many countries across sub-Saharan Africa. Every day, over 800 women die from causes related to pregnancy or childbirth. According to the World Health Organization, 99% of these deaths occur in developing countries, particularly among women living in poorer rural communities. Every year, 5 million babies in the developing world die before reaching their first birthday. Skilled care during pregnancy and childbirth could save the lives of countless women and their newborn children.

Imagine this scenario: You are a midwife stationed alone in a remote health clinic in rural Ghana. A young man comes in carrying his wife who has clear convulsions and is unconscious. She is 35 weeks pregnant with their first child. The man is terrified and looks to you desperately for help. You want to do everything in your power to save the woman’s life, but with limited training and clinical experience, you feel powerless.

Without proper training and practice, midwives cannot provide high quality maternal and newborn care. Maternal mortality has afflicted women across the globe for millennia. Fortunately, unlike our ancestors, we now have access to technologies with the potential to prevent maternal deaths. Maternity Foundation’s Safe Delivery App aims to enhance midwives’ skills and knowledge in order to improve the quality of care women receive. The Safe Delivery App is a mobile health training tool that provides midwives working in remote, low-resource settings with access to evidence-based clinical guidelines and animated instructions, helping them to prevent and manage obstetric emergencies.

A randomized controlled trial evaluating the effectiveness of the Safe Delivery App in Ethiopia yielded promising results: Compared to the control group, the skill scores of health care workers who used the app increased by 80% from baseline to 6 months and 107% from baseline to 12 months. Knowledge scores also significantly improved among workers using the app.

While the Safe Delivery App does not address all barriers—transportation challenges and weak referral systems, for example—its success in expanding health workers’ skills and knowledge is highly relevant in low-income settings where quality of care is challenged by a lack of continuing education. The use of technologies such as the Safe Delivery App can help midwives prevent major causes of maternal and neonatal death, not just in Ghana but in many other developing countries as well. Midwives have the potential to be crucial change agents, but we must ensure that they have the resources they need. I will continue to thank all of the midwives I meet for the amazing work they do for mothers and babies.

Learn more about the Maternity Foundation based in Denmark.

Explore how mhealth strategies can help improve maternal health.

Read another perspective on how midwives can help reduce maternal mortality.

Categories: Contributor Posts Maternal Health Quality of Maternal Health Care

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