Mumbai,  20 September – The article by Shraddha Kothari, Manager, Intellecap  titled, ‘From Local Manufacturing to Digital Tech: How African Organizations are Pivoting to Support Maternal and Child Health During COVID-19’ was featured in Next Billion.

This article is part of NextBillion’s series “Recovery 2021,” which explores how businesses, development initiatives and the communities they serve in low- and middle-income countries are building greater resilience for a post-pandemic future.

Sub-Saharan Africa has witnessed a sustained improvement in maternal and child health outcomes in the last two decades. The maternal mortality ratio in the region has declined from 870 per 100,000 births in 2000 to 534 per 100,000 births in 2017. However, despite this impressive progress, the region still has the highest neonatal mortality rate in the world, with 27 deaths per 1,000 live births in 2019. It also accounts for over two-thirds of all maternal deaths worldwide.

The ongoing COVID-19 pandemic has stressed global healthcare systems and reduced the availability of medical services across the board — and maternal, newborn and child health services are no exception. There has been a notable reduction in the utilization of these services in sub-Saharan Africa, as measures such as curfews and lockdowns have been used to curb the spread of the pandemic across the region, affecting how women seek and access health facilities in these countries.

In Liberia, for instance, the number of women who attended the recommended medical visits during pregnancy dropped by 18%, while the number of women seeking to initiate medical care during pregnancy fell by 16% in Nigeria. In Uganda, a study found that women’s attendance at antenatal services dropped by 26%. In addition, the study also noted a rise in: adverse pregnancy outcomes for Caesarean sections (5%), haemorrhages related to pregnancy (51%), stillbirths (31%), low-birth-weight (162%) and premature infant births (400%). Similarly, in Ethiopia the pandemic affected the utilization of reproductive, maternal and newborn healthcare services, worsening both maternal and perinatal outcomes.

This has, unfortunately, led to a further increase in maternal mortality in various African countries. Consequently, it is imperative to recalibrate and scale models that can prevent the further deterioration of maternal and child outcomes in the region’s already-strained healthcare systems. There have been some organizations that have done just that, benefitting from a reduction in their immediate supply chain vulnerability and also attaining long-term economic and environmental benefits. Below, we’ll explore a few of these organizations’ pandemic responses, and discuss what other healthcare providers can learn from them.

DEVELOPING LOCAL MANUFACTURING TO OVERCOME SUPPLY CHAIN CHALLENGES

The Safe Motherhood Alliance, a for-profit social enterprise in Zambia, sells low-cost delivery kits to expectant mothers for a safer birth experience. As a result of the pandemic’s disruptions in the global supply chain, the enterprise pivoted its model and commenced manufacturing the products that it was struggling to source through its usual suppliers. It has developed the local manufacturing capacity to produce some of the items — such as sanitary napkins and face masks — that were needed for its delivery kits. Moreover, it has leveraged locally available materials, like the fibres of banana skins, to make sanitary napkins, allowing it to produce them at a fraction of the cost of importing them.

When the Safe Motherhood Alliance reaches full production, it will be able to sell these sanitary napkins to other relevant groups, such as adolescent girls. Overall, leveraging local manufacturing and available materials will not only enable the enterprise to support safer births at a lower cost, but it will also allow it to expand its customer base.

ADAPTING TECH-BASED MATERNAL AND CHILD HEALTH SOLUTIONS

In recent years, organizations have deployed several technology-based solutions to support improved health outcomes for maternal and child health in sub-Saharan Africa. As a result of the pandemic, some of these health-focused organizations have refined their models and formulated partnerships to support expectant mothers. For instance, Child.org, an NGO in Kenya that focuses on improving global child health partnered with MamaTips, a non-profit maternal health organization that has developed a mobile subscription service. The partnership enables Child.org to provide essential information to expectant mothers via SMS texts, in the absence of the face-to-face meetings that were a part of its delivery mechanism. Such partnerships can be effective in scaling existing programs focused on maternal and child well-being, even beyond the pandemic.

Another digital platform, MomCare, increased its offerings to expectant mothers during the pandemic. It provided women in Kenya with details on facilities that could be accessed despite the curfew, and also connected them to transport services so they could access these facilities. MomCare’s mobile phone-based application enables the staff at healthcare facilities to track the progress of expectant mothers digitally and in real-time.

Similarly, in Nigeria, the digital health enterprise mDoc expanded its scope of services to meet the pandemic-fueled increase in demand for digital health services by expectant mothers. This for-profit enterprise hired more coaches and deepened the support offered to these women. Given the limited access to health care facilities, the enterprise refined its curriculum and modified its processes to provide these expectant mothers with further guidance on clinical care and support to manage pregnancy-related health issues like high blood pressure.

These examples demonstrate that there is significant potential to leverage and integrate technology-based health solutions in the region — not only to provide care during the pandemic but also to improve and scale existing health service delivery and support services for expectant mothers.

COVID-19 has already worsened maternal and child health outcomes in sub-Saharan Africa. As the crisis gradually abates it will be critical to evaluate, adapt and scale health service delivery models and support service programs to prevent — and ideally, reverse — any further loss of the previous gains made in maternal and child health outcomes across the region.