The Challenge
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How might we improve maternal health with mobile technologies for low-income countries?
Winning concept
Free Maternity Camps
The idea is to send medical teams from a base hospital to remote areas where moms-to-be will be examined by doctors. The concept of the maternity camps is inspired by Aravind's free eye camps in India. The camps are organized with the help of the community. Camps are held on a fixed day of the month.The local community advertises for the camp in the vicinity- in front of i.e. temples, mosks, churches, at wedding ceremonies (events/places where lots of people join) using posters, loudspeaker announcements, and pamphlets. The midwives/health care workers from the community go door-to-door advertising as they know best in which households the expecting moms are.
UPDATE: The community could engage aid backpackers (as suggested by Estudio6 in the concept "The Aid Backpacker"), who talk to the community to find where pregnant women live. They go door-to-door to personally talk to the women and their family members to convince them to join the free maternity camp. The aid backpackers should have a fairly good idea how many people to expect during such a camp, so that proper place could be found and proper preparation could be done.
The aid backpackers gather data as they visit the expecting moms. They register the expecting moms using a simple questionnaire on a mobile phone - name, age, location, pregnancy stage, previous child deaths, # of children, birth intervals, blood pressure etc. Nokia Data Gathering Application or MoTeCH could be used as a data gather platform as its current version is centered around pregnancy. The data is sent to a base hospital where it will be process and classified.
This will allow the base hospital to prepare how many specialist, health workers, equipments, they will require for the camp. This will replace the data gathering session which will lead to an increase of time in the other two sessions.
Following the Groupon model, suggested by Haiyan, when the aid backpackers register enough women in a certian community, the camp will go to them.
The local community finds a place (could be a local health center or a local school), organizes health care workers and volunteers, who do a lot of the preparation work as registration of moms-to-be, and basic examinations.
TARGET GROUP
Women who have just got married, moms-to-be, young mothers and family members- husbands/mothers-in-law, close friends of the family of the expecting mom; women who traditionally help women give birth with no medical education.
HOW COULD A MOM-TO-BE-CAMP WORK?
- Educational session- Women and young girls are shown a movie and given a booklet/stack of plastic cards with visuals that gives basis information to the expecting mom about reproductive health, family planning, how to take pre-natal care, information about the labor and brief post-natal information. Sensitive for the community issue could be addressed (such as girls as welcomed as boys). Women share positive experiences with the community (help they received from the community, happy with the stay in the hospital, felt better after taking some nutritional supplements, etc.)
- Examination session: doctors conduct the actual exams with the use of i.e. mobile ultrasound. The exam data is stored on the mobile phones that the midwives/HCW/aid backpackers have used to register the women. The midwives/HCWs/aid backpackers accompany the women through the exam process and capture the data as the doctor examines them. The data gathering platform is integrated with server side software.
Women who require further exams will be taken by bus to the next hospital.
- Follow ups: all follow ups from the camps are done by the midwives/HCW who continue to monitor the expecting mothers and communicate to the doctors from the base hospital. The aid backpackers work together with the midwives from the community on the follow-ups- revisits, finding emergencies, notifying midwives for upcoming deliveries in the community.
UPDATE: Build from "Eat Well, Be Well"- As part of the educational session, we imagine a session during the maternity camp called "Eat Well, Be Well". The expecting moms and the family members will be explained what food to prepare (spinach, beans, peas, lentils, eggs, etc.) and why. The local community that helps organizing the camp, will engage women from the community to prepare a nutritious lunch that will be served during that day to the expecting moms.
How to sustain this?-> One possible way might be to use the free maternity camp as a place to sign up a sub group of women in the local community to continue providing nutritious meals to pregnant women on a daily basis. This sub group could assemble on rotation at the home of one of the pregnant women to prepare food in bulk quantity for all pregnant women in the area. This way the pregnant woman gets to learn and practice hygiene and healthy food prep and the boys of the community recruited as aid backpackers could deliver these lunch boxes to the homes of all the pregnant women in the area.
How to finance the "moms-to-be lunches"? -> One option could be to collect small amount of money from all pregnant women and then buy the necessary products for the lunch.
Another option could be that part financing is obtained through an external program that raises funds from the global community for this purpose.
UPDATE: Build on "The aid backpackers": the aid backpackers play an important role throughout the 1) data gathering phase, 2) the examination phase, 3) medical follow ups for the women in the community, 4) lunch distribution. I can imagine that they go through a simple training where they learn how to use the tool on the mobile to collect data, they learn how to measure basic vitals.
INCENTIVES: as there is certain opportunity cost for coming to such a camp (women and their family members coming to the camp cannot work on that day), incentives could be offered to the expecting moms and their family members- i.e. 1 kg of lentils for the mom-to-be + 1 bottle cooking oil as suggested by Mokeira (for a member of the household who accompanies her to the camp).
One option the aid-backpackers: the aid backpackers are given air-time as a reward for helping the community (i.e. per registered pregnant woman or per healthy mom and baby.) Another option could be that the aid-backpackers sell some basic hygenic products and nutrition supplements, as suggested by Stacy Klingbeil.
ECOSYSTEM:
- A network of hospitals committed to conduct such camps.
- Local community health centers, local volunteers, local aid backpackers
- Local midwives
COSTS:
- NGOs help for the publicity; camp set up
- Costs for sending health professionals to conduct the exams
A one day camp with 300 patients (benchmark: Aravind’s eye-care clinic) costs about 6700INR (~150USD) – Source: C.K. Prahalad, The Fortune at the Bottom of the Pyramid
WHAT COULD SUCH CAMPS ACHIEVE?
- Influence health seeking behavior
- Community participation
- Bringing maternal health care to the rural areas
- Educating girls to become midwives and boys to engage as aid-backpackers, following the practice of Aravind's eye clinics. (Every year Aravind's clinics recruit 100 girls from villages who are educated for most of the routine patients' exams; this has a huge impact and seems a scalable solution.)
COULD SUCH CAMPS BE FUN?
- A performance/dance event/puppet show could be shown at the end of the camp, so that women leave with a smile. This will stick with young girls for a long time and hopefully, this will be a story to tell to the other girls in the village.
ADVANTAGES:
- decentralized approach, leveraging the local community resources- midwives, volunteers, local entertainment (street art)
- exponential effect through spreading the word in the community
- incentives for participation
- standard mobile application for data gathering
- bringing maternal health to areas that otherwise remain "unreachable"
DISADVANTAGES:
- highly dependent on the local communities, local infrastructure
- dependent on committments from hospitals and doctors from the hospitals who agree to conduct the exams
Concept Builds
- Incentives for the aid backpackers to participate could be additional air time they get per registered expecting mom (source of the idea: http://bostonreview.net/BR35.6/eagle.php)
COSTS: Costs for educating the midwives to use Nokia Data Gathering (or openXdata or similar software that is collect basic data and register the expecting mom) to conduct the data collection and make updates later on.
Builds from the "Aid Backpacker" and "Eat Well Be Well" are directly embedded in the concept description.
How could this work in a low-literacy context?
The questionnaires could use visuals to capture the answers as well as multiple choice questions.
Virtual Team
Kirk Soderstrom; Sarah Bird; Vincent Cheng; Haiyan Zhang; Robyn Sneeringer; Radhika Mehta Tandon; Estudio 6, Columbia; Mokeira Masita-Mwangi
What is the minimum level of mobile technology needed for this concept?
Mobile phones for the midwives/HCW. Nokia DataGathering: http://www.nokia.com/corporate-responsibility/society/nokia-data-gathering/english
Which partners could help realise and deliver this solution?
- Oxfam
- Nokia
- Mobile operators
- NGOs
Evaluation Results 14 people have evaluated this
1
Does this concept have the potential to save lives related to maternal health in the poorest and most marginalized communities?
| A great deal of potential | |
| Some potential | |
| Not a lot of potential |
2
How realizable do you think this concept can be? Think about the real issues faced by low-income communities, such as literacy challenges, affordability of devices and tools, usage costs.
| It's very realizable | |
| There are some hurdles to realization | |
| This concept is not realistic |
3
How much does this concept leverage resources and partners in existing low-income communities? Thus enhancing positive aspects of the way things work in the community as opposed to taking away what is a valued way of working and living in the community.
| This concept works harmoniously with existing resources and partners | |
| This concept does not work against existing resources and partners | |
| This concept conflicts with existing resources and partners |
4
Can this concept become self-sustaining and even provide some livelihood value add to the community?
| This concept could become a self-sustaining business for locals | |
| This concept still needs some work before it is self-sustaining | |
| This concept is not self-sustaining at all |
5
Will this concept work in low-tech & low-connectivity environments?
| This concept is very well suited to low-tech and low-connectivity environments | |
| This concept needs to be evaluated for technology feasibility | |
| This concept may be too high-tech for low-income communities |
Downloads
maternity camps- a diagram: http___openideo.com_open_maternal-health_concepting_the-aid-backpacker_gallery_mapa-estudio.pdf
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