Reducing maternal mortality is key to promoting population health. It is also a main priority of the UN General Assembly’s Sustainable Development Goals. And the reasons for concern are clear. Globally, 800 women and 6,500 infants die during pregnancy and birth every day. More than 94 percent of these deaths occur in low-and-middle-income countries (LMICs).

Specialized, high-quality health care during pregnancy and birth can often prevent maternal and infant deaths. Innovation is essential for improving care to support maternal and newborn health, particularly solutions centering health care workers. Yet despite recent gains in maternal and infant mortality, the COVID-19 pandemic has posed serious challenges to reaching the goal of less than 70 deaths per 100,000 live births.

Can technology help boost the odds of success? The Maternity Foundation – an international NGO – thinks it can. The foundation works to prevent maternal mortality, morbidity, and harm through digital health solutions, and educational programing to increase the capacity for specialized pregnancy care. The ubiquity of smartphones in LMICs has led the Maternity Foundation to develop the Safe Delivery smartphone application alongside partners at University of Copenhagen and University of Southern Denmark.

The Safe Delivery App aims to provide critical, life-saving information to midwives and birth attendants in these regions. Since the time of its development, it has been used in more than 40 countries and has reached more than 300,000 health care workers. This technology has proved especially important for health workers during the COVID-19 emergency response.

Visual aids and training modules for health workers on basic emergency obstetric and infant care are a key element of the application—providing them with immediate access to the most current clinical guidelines and practices in supporting pregnancy and childbirth. It also features key global languages and country-specific language versions. Best of all? The app is provided by the foundation for free to everyone, benefiting those who need it most.

Emergency preventative procedures, including infection prevention, post-abortion care, hypertension, post-partum hemorrhage, and newborn management, are the subject of modules within the app. The information is delivered to users through videos, action cards, practical procedures, drug lists, and MyLearning and feature videos with step-by-step instruction for procedures and the language and animations are specific to the country context. These tools also have varied levels of detail to reflect constraints on workers’ time.

The versatility and accessibility of the Safe Delivery App is particularly useful in supporting health care workers in LMICs, especially in increasing knowledge and improving care in non-emergency times as well as in emergency responses. That users do not need an internet connection to utilize the app once it is downloaded is also a key feature, increasing accessibility for health care workers in remote settings.

The potential for COVID-19 to create disruptions to maternal care led the Maternity Foundation to develop updated modules and conduct remote trainings focused on minimizing COVID-19 exposure for health care workers and their patients. More than 33,188 health workers globally received these trainings, and birth attendants who participated demonstrated a measured increase in COVID-19 related knowledge and confidence levels.

Users of the app have been enthusiastic about its impact. Anne Shuma, a senior nurse midwife in Tanzania who trained using the Safe Delivery App COVID-19 module, noted how the information helped mobilize providers in their health center “We have made a triage area and identified a place where suspected or confirmed mothers can be isolated. Being introduced to the app made us think ‘we need to prepare!’”

The need for skilled health care workers and increased support for programing which expands access to care remains, especially during the COVID-19 pandemic. While the Safe Delivery App is only one key tool among many to achieve these aims, the knowledge it gives to birth attendants—especially in LMICs— supports their efforts and helps reduce the high maternal and infant mortality and morbidity in these settings.

Read more

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• Taking a rights-based approach to women’s health offers policy solutions to reduce maternal mortality
• Gender inequality remains a challenge to expanding professional midwifery globally