A closely monitored pregnancy is something taken very much for granted when you live in a city. Scheduled ultrasounds ensure you will get to see your child at various intervals during the gestation period, and healthcare specialists are on hand to ensure that everything runs smoothly.
In remote parts of the world, however, that isn’t the case: Women often don’t lay eyes on their child until he or she is born. Sadly, many women don’t get to see their child alive at all.
Rising Maternal Mortality
The maternal mortality rate in Indonesia remains among the highest in Southeast Asia, with 190 maternal deaths per 100,000 live births. The maternal mortality rate actually rose under the UN’s Millennium Development Goals – the precursor to the Sustainable Development Goals – from 227 to 359 per 100,000 live births between 2007 and 2012.
This problem is largely attributed to a continuing lack of access to quality healthcare for expectant mothers. Deaths occur with births handled by traditional birth attendants rather than by medically trained healthcare professionals, according to the World Health Organization.
Indonesia today is awash with new technologies and innovations. It has a population of 250 million people and health solutions now lie in the palm of their hands: the mobile phone. By 2018 Indonesia will surpass 100 million active smartphone users, becoming the fourth-largest user population behind China, India and the US, respectively.
A recent InMobi analysis showed that Indonesia is one of the top places for developing apps and that it has one of the fastest growing app markets in the world.
A Scalable Telehealth Platform
Last year Philips partnered with Bunda Medical Center in Padang, West Sumatra, one of the leading hospitals in Indonesia in the area of pregnancy, to address problems during antenatal care using the Philips Mobile Obstetrics Monitoring (MOM) solution. This partnership was a collaboration between Bundamedik, the city government of Padang, the Ministry of Health and Philips Healthcare to address increasing concern with maternal mortality in Indonesia.
We developed a pilot program that leveraged this huge mobile penetration to improve maternal health. We developed a scalable telehealth platform that can be adapted to suit specific rural and urban needs, using a mobile phone application.
The app enables midwives to build a relevant health profile of pregnant women by collecting data from physical examinations and tests and local nursing clinics, or even at the soon to-be mother’s home. Data is uploaded from the app onto the central Mobile Obstetrical Monitoring server, allowing obstetricians and gynecologists to remotely monitor patients from hospitals or home.
The doctors can review the data collected from the antenatal visits and determine if a pregnancy might be high risk, in which case immediate care can be provided.
Increasing High Risk Detection
A pilot study of 656 pregnant women in Padang assessed the use of MOM to facilitate a public-private partnership of midwives and obstetricians and gynecologists (OB-GYNs) with regard to five aspects:
- The ability to improve the detection of high-risk pregnancies
- Appropriate and timely referral of very high-risk pregnancies to an appropriate healthcare center
- Remote monitoring by OB-GYNs of high-risk pregnancies facilitated by home visits of midwives
- Patient engagement in antenatal (prenatal) services
- Improved skills and knowledge of midwives
The results were impressive: Detection of very high-risk pregnancies increased by three times during the 2014 pilot study and zero maternal deaths were recorded thanks to identification, timely referral and management using the MOM solution. There was also a 99% reduction in anemia from the first to the third trimester through enhanced patient management.
One woman in the study was pregnant with twins, which is usually a difficult proposition without proper monitoring and scans. Through the use of Visiq ultrasound, integrated with the MOM application, we were able to see that the position of one of the twins would make delivery very risky. Philips is now in active discussions with Bunda to become a clinical partner for the MOM solution.
Most pregnant women in rural villages have never seen their baby during the pregnancy, and MOM helps them enjoy the same medical access as if they were living in a bigger town. They feel more confident as a result, knowing that the pregnancy is being carefully monitored daily by a doctor and a midwife.