A Case for App Development in Combating Maternal and Child Health Mortality in Developing Countries.

The bond between a mother and child transcends culture, race, religion and economic power. A mother would protect her child with all her strength. The progress therefore of any wise nation rests on how it treats its ‘Mothers and Children’. It is no surprise that the millennium development goals on child and maternal health follow each other, that is, goals 4 and 5. These goals aim to reduce under-5 mortality rates by two-thirds, reduce maternal mortality ratio by three quarters between 1990 and 2015 and achieve universal access to reproductive health by 2015. The global burden shows that 6.9million children under the age of five and about 287,000 mothers die from preventable causes yearly. Although there has been a 47% improvement in maternal mortality from 1990, a mother living in sub-Saharan Africa is 300 times more likely to die in pregnancy or childbirth than her counterpart in industrialised countries, this health indicator accounts for the largest difference between the poor and rich countries. At least 20% of the burden of disease in children below the age of 5 is related to poor maternal health and nutrition, as well as quality of care at delivery and during the new-born period. A motherless child is ten times more likely to die within two years of mothers’ death. The recent report by UNICEF shows that the rate of decline in child mortality is still insufficient to meet MDG4 target in sub-Saharan Africa and South Asia regions, which account 81 percent of global child mortality.

Despite these gloomy figures, there seems to be a light at the end of the tunnel. This light is being powered by mhealth (mobile health). The global mobile phone subscriptions hit a whopping 6.8 billion in 2012 with developing nations accounting for 5.2 billion. There has been an exponential growth rate of use of mobile phones in developing countries since its introduction in the early 2000’s. The use of mobile devices have become ubiquitous across the world. The developing nations although playing ‘catch-up’ are doing a great job the closing the mobile technology gap.  More recently, reports have showed that smartphones have increased their sale in Africa, edging out features phones. The figures show a 51% sale of smartphones over feature phones, with a projected growth of up to 85% by 2017. This growth is in no small part due to the activities of mobile phone giants like Windows/Nokia, Android/Samsung, Blackberry, iOS/Apple in developing nations. The growth of smartphones in developing nations have seen a concomitant growth in the use of mobile web in the last twelve months. Africa’s mobile web use doubled between 2012 and 2013 from 11.3% to 23.7% respectively. It also showed that about 25% of all web access from across the African continent came from mobile phones.

With the growth of mobile technology in developing nations in the past decade, it is little surprise to see various mhealth initiatives springing up in these countries. The major sponsors and funders of mhealth projects and initiatives in developing countries are Non-profit Organisations, the Government of the country and donor Organisations. This follows the usual trend of sponsorship on health projects in developing nations. There is low funding and support in research and academic projects relating to mhealth projects in developing nations.

The most used feature in a mobile phone in tackling maternal and child health is the SMS and voice calls. Mhealth initiatives and projects across developing nation’s use these features because they are cheaper, easy to use, consume less data, do not need advanced broadband internet connective. There is also little technical know-how involved in using these functions unlike the use and development of mobile apps. However, with the recent growth and sales of smartphones in developing countries this trend is expected to change sooner rather than later.

Smartphones have a major role in reducing maternal and child health figures in low and middle income nations. With its functions including SMS, voice call, video-call, app, internet and GPS, smartphones are equipped and ready to bring down maternal and child health rates in developing countries. The number of mhealth apps specifically geared towards fighting maternal and child health aren’t so much in the various app stores and markets. Although there are some new apps developed suited to combating maternal and child health, like the mobile ultrasound app developed by the Mobisante team, the smartphone based quantitative diagnostic solution by i-calQ, and the recently developed anaemia detecting app. This problem is not as a lack of app developers (although there are not so much of them in developing nations as compared to the more developed countries), but from the lack of awareness of the massive role mobile devices and in extension mhealth has to play in their health. As a medical personnel and tech savvy individual, I recently had the chance of interacting with some app developers and heads of technology companies across my country (Nigeria). The problem was not the TOTAL lack of technical know-how amongst the developers in general programing, but the lack of ‘support’.

This lack of support includes; lack of technical knowledge, medical and public health knowledge, little or no financial support, no regulatory bodies that guides health app development in the country and the list goes on. These problems generally apply in most developing nations across the world. In developed countries where medical personnel’s and app developers form teams for app development, various competitions to encourage app development and also have regulatory bodies like the U.S Food and Drug Administration taking mhealth into its strides. This has greatly improved health app development in these developed nations. 

Most of the strategies needed in attaining millennium development goals four and five have already been put on ground by experts. These strategies include the child survival strategy, integrated management of childhood illnesses, promotion of antennal care and postnatal care etcetera. Therefore, mobile app development as a tool in combating maternal and child health mortality should inculcate these strategies. Marrying the functions of feature phones and some of the key aspects of each of these strategies have largely been successful in many mhealth initiatives. However, inculcating one or two of these strategies as a whole into mobile devices (smartphones and tabs) as apps will greatly help to reduce maternal and child mortality rate.

The need therefore for the provision of supports and scaling-up needed in the development of mobile health apps to tackle maternal and child health mortality rates in developing countries cannot be over-emphasized. With proper support of these mobile app development, will not only tackle maternal and child health mortality rates, but will also help reduce the surge of preventable diseases in Africa and developing countries as a whole.