Description
Introduction: Global maternal and newborn health is a source of significant healthcare disparity across the world. Maternal and neonatal mortality is largely preventable with appropriate and timely interventions. We at WONDER believe that leveraging modern digital technology, ensuring equitable access, engaging communities, and including social and environmental determinants of health is a reasonable approach. Rather than looking at technology as a limitation, we should engage and take advantage of the opportunities of digital health platforms for common good to save the lives of mother and children.
Methodology: WONDER (Women’s Obstetrical, Neonatal, Death, Evaluation & Reduction) Maternal (MEOWS) and Newborn Early Warning (NEWS) Digital Platform has a powerful algorithm with an alert system and telehealth. This patient centric approach aims to improve maternal and newborn outcomes using low-mid level providers at the frontline in locations with limited healthcare resources. The low-mid level providers act as primary health providers and register patients, collect detailed medical & obstetric histories, record vital signs and symptoms. Each provider receives clinical and technology training and a WONDER kit with biometric devices like BP apparatus. When abnormal values are entered, the system generates alerts based on severity, provides treatment guidelines, and enables the provider to use telehealth and communicate with doctors for further care. We have partnered with UNICEF, Care India, and Jeevika (NGOs) to implement this program.
Results: We have one published study and two ongoing programs spanning three districts across two states in India.
The published study involved care at the labor wards in 5 PHCs and 3 district headquarters hospitals over a period of 2 years. A total of 15184 mothers in labor were monitored by wonder application where MMR decreased by 50%., prevented in-hospital eclampsia by 91% and met the required time of action of 30-60 minutes to initiate treatment in 95% of the time.
First ongoing study involves >230,000 mothers in 18 PHCs with ANMs as front-line antenatal care providers with the following results over a two-year period:
o First trimester registration increased by 26.4%,
o Four antenatal visits ↑ by 24.9%,
o Iron & folic acid supplementation ↑ by 15.45%,
o Institutional deliveries increased by 22.7%.
o Anemia decreased 9.8%,
The second ongoing program involves self-help women providing Home Based Newborn Care using Wonder Newborn application (NEWS). About 40 providers covered 222 villages, following 2294 babies with 9291 visits. A total of 794 sick children were identified. A total of 237 babies with red alerts were referred to tertiary care, 557 babies with yellow alerts were referred to doctor’s care at PHCs. Examples of the referrals were: sepsis-12, pneumonia-51, diarrhea-35, seizures-32, and poor weight gain -48 and others.
Conclusion: WONDER digital platform, is an efficient way of providing patient centered seamless continuum of care to mothers and their newborns using trained community health workers that is economical, dependable, scalable, and sustainable without disturbing the existing health system.
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