First Advisory and Real-Time Health Surveillance to Reduce Maternal Mortality Using Mobile Technology

Abstract

Maternal mortality is death of any woman while pregnant or 42 completed days during post partum period. Maternal Mortality Rates (MMRs) measures the risk of dying from pregnancy. This is expressed as number of deaths per 100000 births. According to Patel et al[1] 70.69 % of maternal deaths within 24 hours of admission in the hospital are due to geographic conditions, lack of qualified medical attention, delayed referral and late intervention. Therefore a vast majority of these deaths are preventable [2]. Our current study involves developing a “risk assessment method” [Fig. 1] based on a simple health scoring scheme [3], [4]. Using this method we can provide first advisory and referral services to patients in rural and far flung areas through health workers working in sub centres, PHCs and CHCs [Fig. 2]. These services are delivered through SMS [5] or WAP [6]. Similar scoring schemes have already been tested for its efficacy in Indian conditions on 490 mothers [4]. The previous scoring schemes lacked the transport variable which is important as around 56.67% patients die within 6 hours of admission in the hospital, thereby highlighting the necessity of quick transport [7]. Thus we refined the existing model by adding a transport variable. When we introduced this system in Phringia Block of Kandhamal District, Orissa, India in the form of printed manuals, we saw 100% decline in MMR [Table 1] over a period of two years. The scoring scheme being one of the factors behind it but the specific impact of it was not quantitatively measured. Total risk scores (calculated from Table 2) and associated risk category are 0-2 (Low), 3-5 (Moderate), >6(High). Based on risk category relevant advisory are provided [8].