A six-page report published in September by the established UK medical journal Lancet provided some shocking figures about maternal mortality in India. It revealed that in 2015, there were more than 45,000 deaths related to pregnancy and childbirth in the country. This figure accounts for 15% of such casualties worldwide. A crippling lack of maternal health care services and skilled birth attendants has lead to India missing its millennium development goal of reducing the maternal mortality rate by three-quarters.
Luckily, one organisation based in Mumbai has been working to help vulnerable mothers who don’t have access to immediate healthcare. A start-up called Care NX was launched in 2013 by an NGO called Science for Society. They noticed that high-risk pregnancies are the leading cause of maternal mortality in India. And early medical intervention could bring down this risk greatly.
Malhar Khakaria, Head of Business Development at Care NX, told The Better India that their motto is, “early diagnosis, early intervention and early counselling.”
Shantanu Pathak and Aditya Kulkarni, who run Science for Society in Mumbai, started Care NX in 2013. Shantanu’s pregnant sister lived in a rural area and had to reach out to a friend studying to be a doctor in Mumbai city for all queries related to her pregnancy. From her experience, Shantanu realised that women in villages are more often than usual deprived of quality healthcare. Malhar says, “Three important things had to be done – the first was to bridge the access to standard health care, the second was to empower healthcare workers to reach pregnant mothers multiple times so that they could conduct tests, and the third was to detect high risk pregnancies during the first and second trimesters.”
They developed a technology called CareMother, which comprises three different components – Medical Kit, Mobile Application and Web Application.
The medical kit is made up of seven diagnostic devices, which include a digital stethoscope, blood pressure meter, urine analyser, glucometer, etc. The assigned health worker carries this medical kit so he/she can provide doorstep testing and diagnosis. The results of the test are entered directly into the mobile application, which alerts the health worker of high risk factors if they are present. Gynaecologists in a nearby health centre use the web application. Malhar says, “A gynaecologist/doctor needs to be associated with the health worker because in case there any major complications, it is not in the health worker’s capacity to provide accurate consultation.”
The CareMother kit is a lot less costly than standard tests, Malhar says. “A standard test in a hospital would cost you around Rs. 400 and this is not inclusive of the transportation cost. Another cost that people don’t take account for is that a woman has to take a day off from work to go to the lab and get these tests done. Regular checkups for women in remote areas, where the closest labs are more than 10-15 kilometres away, are extremely expensive and time consuming. Since we take our testing equipment to their doorsteps and provide antenatal care, we are able to cut many of these costs. The government mandates four tests per pregnancy but we conduct at least eight.”
Since health workers are such an integral part of Care NX’s programmes, how do they reach out to them and train them? Malhar says, “Typically, we provide antenatal care to mothers by selling our software to health implementing agencies. These could be hospitals, clinics, NGOs, or even government bodies. These agencies have already trained these health workers and have an efficient task force in place.”
Care NX’s target group is pregnant woman in dire need of medical counselling in rural areas. So how do the doctors counsel them or examine the test results in areas where there is no/limited internet connectivity?
“The mobile app given to each health worker can work on offline mode; it does not require a steady internet connection. The data from the tests is transferred to the doctors automatically through Cloud from the health workers’ apps, whenever they can access any internet connection,” says Malhar.
In the two years since Care NX was launched, it has managed to create a major impact on the health of pregnant women in the country. The organisation launched three projects in Maharashtra during its pilot run, and identified 55 % of the cases where mothers were likely to have high-risk pregnancies. In comparison, the public health system set in place by the state government was able to identify only 21% of such cases.
Their first project was implemented in Mumbai in collaboration with Doctors for You, an organisation that extends medical support to marginalised sections of society, and UN Habitat. Malhar says the project was very successful: “We were approached by 793 mothers in the past year, whereas the public health system was able to reach only 120 mothers from 2014-2015; this tells us that if we just increase the outreach of these medical services, so many more people can benefit from them.”
Their second pilot project was conducted in collaboration with the Hedgewar hospital based in Aurangabad. The hospital had mobile vans with expensive equipment reaching out to pregnant women, and the operation cost for this setup was very high. Their expenses were reduced by half when Care NX offered to help them by extending technological support.
With an immense amount of dedication, this group of social workers, medical health professionals and business developers hope to reach out to at least one million pregnant women over the next year.
If you want to help pregnant mothers in rural India receive timely medical attention and prevent deaths related to high risks –
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