India has one of the worst indices from around the world in terms of maternal and neonatal deaths. About 6.4 lakh babies die every year within the first 28 days of birth, and it is estimated that about 44,000 women die annually in India due to pregnancy-related causes.
In such a situation, it becomes essential to not just develop strong guidelines focusing on the quality of perinatal care, but build a chain of care that increases access to and use of skilled care during pregnancy, birth and the postpartum period.
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This is where Maatritva comes in.
Maatritva is a mobile platform for health workers to deliver maternal health services. It helps in screening, identifying, and tracking high-risk pregnant women and ensures that there is continuous care before birth for both the mother and the child.
When and how was Maatritva founded?
Maatritva started as an internship project at the Digital Impact Square, a TCS Foundation innovation Centre in Nashik, in March 2016.
The team, comprising of Pritesh Agrawal (who eventually left), Abhishek Verma, and Garima Dosar. Abhishek Verma, was given the challenge to reduce maternal mortality and morbidity.
“We found that most of these maternal deaths occurred in high-risk pregnancies. By the time it is identified, and the risk is gauged, it is already too late to manage the complication,” says Abhishek.
The founders then identified lack of infrastructure along with the right methods and protocols with regards to ante-natal care as one of the main reasons for maternal and neonatal deaths.
Hence, they decided to build a platform that could help in identifying a high-risk pregnancy.
To identify the different parameters, they consulted with health practitioners and specialists like gynaecologists and neonatologists.
The real challenge was to come up with parameters which could be monitored on the ground as this is crucial and helps in timely detection.
“We finalised 25 key parameters after doing a lot of research and multiple consultations. Some of these include the pregnant woman’s geographical profile, previous pregnancy history, family medical history, while, the current vitals measured regularly throughout the pregnancy,” explains Abhishek.
It took them about eight months to come up with the initial prototype, following which they conducted a successful pilot in Trimbakeshwar in Nashik, with the help of the government health department and the Zila Parishad health department.
Maatritva was officially launched in May 2017 registered under the company Preleaf Technology Pvt Ltd.
“In August 2017, we started operations in five talukas (out of the 15) in Nashik district and gradually scaled up our operations in all the 15 talukas. Meanwhile, we also worked on a new version of the software.”
How it works
The Maatritva system functions in two parts.
One is in the form of a mobile app which is easily downloadable by the health practitioner. This app has the 25 different parameters in the form of a checklist that the health practitioner needs to keep in mind during a check-up involving the pregnant mother. These parameters include blood sugar levels, haemoglobin levels
The second part is the online dashboard where the health records of the women are stored for analysis, reference and reporting. The government health administration uses the dashboard and make for data collection on pregnant women from the entire district. This helps them to plan accordingly in terms of conducting checkups, supplying medicines, holding health camps, etc.
Since the medical history of the woman is recorded from the beginning stages of her pregnancy and fed to the system, it helps as a reference for health practitioners in different blocks in case the woman has travelled to her mother’s home, which is a common activity in the rural areas.
In case of emergencies too if the woman needs to be referred to a PHC or the central hospital, the doctors treating the woman can access her medical history.
Poonam Gaikawad, 26, is an auxiliary nurse based in the Sinnar district in Maharashtra. She has been working at a Primary Health Care (PHC) sub-centre close to eight years now after completing a one-year training course in Ahmednagar.
Since the past 1.5, Poonam says that thanks to the app, she doesn’t miss out on anything while performing checkups at the clinic.
“I spend almost 20 minutes with each woman and keep track of all their records. We keep a track on the haemoglobin levels, and there are sonography reports for each month, along with other tests. This has been made possible by a checklist provided by Maatritva,” she says.
“After we started referring to the Maatritva checklist, we have been detecting high-risk pregnancies much earlier now than before,” she adds.
Jyoti Awad, 25, also a resident of Sinnar taluka in Nashik district in Maharashtra. She is nine months pregnant and visits a health centre in Paste every first Monday and Friday in a month.
She regularly goes for her ante-natal care visits because she feels that every aspect of her health and her child’s health is taken care of by the health practitioner.
“They test my sugar levels, blood pressure, and even spend time understanding the family history of diseases. At one point, my haemoglobin levels were deficient, but they gave me medication, and I am better now,” she says.
Poonam, admits that the women have been regularly visiting the clinics after they realised that this thorough checkup is not only necessary but also beneficial for them.
“Sometimes, we have to visit pregnant women in remote rural areas where there is low network connectivity. However, we don’t have to worry about the internet because the app works seamlessly regardless. Once we reach an area with good connectivity, the data we have fed earlier in the app gets synced,” she says.
Abhishek clarifies that Maatritva in no way provides any clinical or diagnostic services. What they do provide, however, is support in terms of running operations related to the Maatritva app on the ground, on-call support and help in data analysing. They also help in organising Antenatal care (ANC) sessions, defining the process and the mechanism to properly conduct an ANC session on the ground.
About 60,000 pregnant women have been screened, and their medical histories followed up on using this platform.
“I see the app as a collaborative effort with the health practitioners who are instrumental in ensuring that it is useful. Its success involves monitoring, vigilance, informed reporting, regular follow up and more,” emphasises Abhishek. He believes that integrated systems can be affordable and provide quality service.
Now, the team wants to expand beyond Nashik and spread to other states in the country.
“We aim to create a robust health care ecosystem not just in the sphere of antenatal care but other health domains too,” he says signing off.
(Edited by Gayatri Mishra)