Nepal’s reduction in maternal mortality is one of the major success stories hailing from the World Health Organizations’ Millennium Development Goals. In 1990, Nepal suffered 790 maternal mortalities per 100,000 live births. By 2013, that number dropped an astonishing 76% to 190 maternal mortalities per 100,000 live births.
While this progress is no doubt phenomenal, much of it occurred in urban areas. About 90% of Nepali women living in urban areas had at least one care visit prior to birth, and 79% had their births attended by skilled health personnel. The experience of rural Nepali women was much different, where only 56% of women had at least one care visit prior to birth and only 37% of women had births attended by skilled health personnel. Simply put, there aren’t enough traditional resources available to provide rural Nepali women with adequate maternal care.
Amakomaya, or “Mothers Love,” has developed a mHealth platform intended to fill this void. It not only maximizes the efficiency of health providers in rural areas, but also provides educational material to pregnant women who would have no access to it otherwise.
Providing Education
Early marriage is a common occurrence in Nepal. While the legal age to marry in Nepal is 20, the median age of first marriage for women aged 20-49 is just 17.2. In rural settings, many of these young women lack access to any sort family planning or maternal health education. Amakomaya intends to provide these at risk women with a variety of educational materials via an Android based mobile phone application (available here). Mobile penetration in Nepal is over 83%, and a large portion of the population have access to a smartphone.
Additionally, where smartphone resources are unavailable, Amakomaya is donating smartphones to Female Community Health Volunteers (FHCV’s). These volunteers will register pregnant women in their local communities for the Amakomaya program, and distribute the programs content.
Once a user registers for the app, she will begin to receive educational materials tailored to her phase of pregnancy. These materials come in the form of audio, video, and text content, and are all provided in Nepali. It educates the user on what is physically occurring during her pregnancy, what she can expect, and steps she can take to improve her health, and the health of her child. The entirety of the program can be downloaded from the Amakomaya website here.
Another critical driver for the success of the Amakomaya program is that at week 28 of pregnancy, the entire family is incorporated. The material is shared with the pregnant woman’s husband, involving him directly in her care.
Amakomaya for Medical Professionals
In addition to educating pregnant women, Amakomaya also increases the efficiency of care offered by healthcare professionals in rural areas. Any advantage that a provider can gain is of serious import in Nepal, where there are only .29 healthcare workers per 1,000 people. This doesn’t come close to the WHO’s guideline of 2.3 healthcare providers per 1,000 for basic lifesaving care.
Healthcare workers who are registered for Amakomaya can view data regarding the number of pregnant women in their local populations, as well as how far along they are in their pregnancies. This data is gathered when women register for Amakomaya, as the program asks for the date of their last menstrual cycle. It allows rural healthcare workers to adequately prepare for upcoming births by notifying them as local women approach their anticipated due dates.
So far almost 1,000 pregnant women have registered for Amakomaya in 15 different health posts, with plans for expansion. While the program can’t substitute for in person care, it can provide rural Nepalese women with the information they need to properly educate themselves about their pregnancies.
