For many women in rural India, both postnatal and antenatal care are all but non-existent. Healthcare facilities are often out of reach. This alone is a significant contributing factor to both maternal and neonatal deaths in India, which is among the highest in the world. Could the minds of India’s start-ups begin to alleviate the issue?
India has a neonatal mortality rate (NMR) of 25.4 deaths per 1,000 live births, according to UNICEF reports on neonatal mortality. This equates to 600,000 newborn deaths in the country every year, more than any other country.
The issue is difficult to address due to the multitude of causative factors behind these deaths. Infections or complications during the pregnancy may be lethal. They may also require immediate medical attention. In these cases lack of contact with a doctor, even remotely, may put the mother and child at risk.
A unique start-up, created by M Senthil Kumar, a tech worker based in Madurai has set out to address this issue. The creation of the start-up is a kit — named SaveMom — that can monitor several vital health parameters of pregnant women in remote rural villages, all the while sending the data back as a live feed to the relevant health professionals.
What does the kit include?
The kit has already been tested on around 1,400 pregnant women across 25 remote villages between Ooty in Tamil Nadu and Wayanad in Kerala. The pilot project was undertaken over eighteen months beginning in 2017 and had the support of a number of local NGOs.
The kit includes a number of measurement devices intended for regular check ups by local nurses and health workers as well as a wearable device that can be worn around the neck.
The wearable device monitors day-to-day activities such as the amount of time sleeping, steps taken, calculations of calories burnt as well as daily nutrition. Colour-coded signals from the device then give simple instructions to the wearer as a reminder to take supplements or when to set meal times.
More complex measurements are undertaken through a tablet intended for use by a local health worker. As with many Indian start-ups intended for use throughout rural India, the tablet will make use of cloud data storage to allow the sharing of data between the local health workers and the appropriate medical professionals.
The more in-depth assessments undertaken include temperature, blood-glucose level, iron levels, pulse rates and blood-oxygen saturation levels. Using these figures the doctors the data was sent to were able to provide a greater evaluation of the health of the women who were being assessed.
Were the kits successful?
The AI involved in processing the data was shown to be highly successful in identifying those women who were deemed to be at most risk. This is an important factor in assessing how to proceed with treatment, particularly in the situation where treatment centres were often a considerable distance away. By showing which of the women needed more in-depth attention than a local medical practitioner could provide, the system was successful in referring those who needed immediate attention to the correct medical body.
Swati Negi from Amrita Serve NGO served as the local health coordinator for the test run. She noted that the nutritional assessments were of particular use because it allowed nutritional supplements tailored to the individual to be delivered to the village.
This aspect of the programme identified a key underlying issue that is one of the most concerning factors in rural health that affects neonatal and maternal mortality rates — malnutrition.
Kumar noted that in some villages, the proportion of pregnant women suffering from malnutrition was sometimes in excess of ninety percent. Many of these women were also found to be suffering from anaemia.
For this piece of information to be uncovered already places a significant degree of value in Kumar’s start-up. Malnutrition in both pregnant women and children can lead to possible fatalities during the pregnancy, as well as considerable lifelong effects in the child.
Stunting due to malnutrition, as well as the resultant neurodevelopmental deficits can have a heavy impact on a child’s upbringing and education. This in turn can set them back in terms of employment prospects leading to a life of poverty in which malnutrition may be a lifelong ordeal.
Such results may not have been uncovered without the start-up, as many of these women will not have opted to seek out medical intervention for malnutrition. The data could, if properly utilised, could set out a framework to begin interventions — such as those used in the trial with nutritional supplements — to begin to rectify the high rates of neonatal mortality in India’s rural communities.