Tackling Indian Maternal Deaths By Smartphone

India leads the world in annual maternal deaths. Technology firms are pairing with the government’s village health program to work with rural women.

By Shoba Narayan,Contributor /March 23, 2014

A commuter talks on a mobile phone in New Delhi, July 17, 2013. In bustling New Delhi, technology firms are pairing with the government’s village health program to work with rural women.

Altaf Qadri/AP/File


Subhi Quraishi believes that the solution to the high maternal mortality rates that have dogged women in rural India starts with a mobile phone.

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Standing in his bustling New Delhi offices, Mr. Quraishi shows off the mobile lifeline channel that his software firm has developed to send nuggets of information to rural users. The app uses rhymes, songs, and interactive games to spread maternal health tips and rudimentary but crucial information.

India leads the world in annual maternal deaths, according to a 2013 report by the advocacy group Save the Children. The report notes that in rural India especially in states like Uttar Pradesh and Bihar poor sanitation and malnutrition are rampant and women often give birth in the filthiest area of the house. Newborns are placed on dirt floors and breast-feeding is discouraged under the notion that it will debilitate the mothers health.

India has made progress on its millennium development goal to lower maternal mortality rates to 109 deaths per 100,000 births by 2015. It has cut the rate by 42 percent from 1990, when maternal deaths stood at 457 per every 100,000 births, but the United Nations says rates havent dropped quickly enough for India to meet its target by 2015.

ZMQ Software, the firm founded by Qurashi and his brother Hilmi, developed the lifetime channel in 2003. It aims to apply the skills of Indias fast growing technology and healthcare sectors to the problem and reaches 500,000 women. The information is sent through visual and sound-based reminders from the companys server to the users mobile phone, bypassing the Internet.

Once a woman registers herself on our system, and she is pregnant, she will get information every week pertaining to her week of pregnancy, Quraishi says. It sends timely information about immunization schedules for her children and pregnancy information for her.

As the number ofmobile phone users in India explodes (the country has the second largest number of mobile phones in use, below China and above the US), more women in rural locations have access to the technology.Programs like Qurashis are growing. He now competes againstfirms like DimagiandBBC Media Action, who offer similar platforms. Yet there are still vast challenges to overcome, including many women off the grid, skepticism of modern practices, and government policies that health care experts say are inadequate.

Pairing with government volunteers

ZMQ, along with a handful of other Indian technology companies, is working with ASHAs or Accredited Social Health Activists, government-sponsored volunteers who are at the forefront of Indias battle against maternal and infant death.

The program, whose name means ‘hope’ in Hindi, is roughly similar to the community health workers or barefoot doctors of China, Iran, and Bangladesh. Instituted by the Indian government in 2005 with a goal of establishing at least one ASHA per village, there are currently about 900,000 of them. The program consists of village-based volunteers who get small monetary incentives when they achieve outcomes like ensuring that a pregnant woman delivers in a hospital.

ZMQ works with ASHAs by sending their lifetime channel information to the pregnant women and to the ASHAs working with them.

What do you need for delivery?

Anita Kumari is an ASHA worker in rural Bihar, one of the poorest Indian states. She works in Sigriyawan, a small village two hours outside the states capital. She monitors the women and children in her charge and visits the homes of pregnant women regularly.

Hina Kumari, one of her charges, is in her seventh month of her first pregnancy. She lives in a thatched hut without running water or electricity with her in-laws. Chickens and a pig run around the mud floors of the single room hut. Anita asks her to repeat all the things she needs before her delivery next month. “Clean sheet of cloth, clean blade, clean water in a clean bottle, clean change of clothes for me and thenewborn baby, Hina recites.

Anita uses her mobile phone and a health booklet to send reminders to herself and her charges about what health service is due to whom and when.

Evaluating success

Despite the enthusiasm for harnessing new technology, a daunting challenge still remains. India’s progress has been slow and many rural women remain disconnected from technology or urban best practices.

Developing apps will only do so much, says Professor Mathew George from the Center for Public Health at the Tata Institute of Social Sciences in Mumbai, who has argued in papers that Indias high maternal and infant mortality rates are in part due to the failure of the state to ensure public health functions like nutrition and sanitation for the state.

Technology by itself will not work until the structures are in place to support it, he says.

The ASHA program has its critics too. They say that it only addresses some of the causes of the maternal mortality rate and operates in much of a vacuum. There are multiple programs running with little coordination at the district, state or central level,” says Rama Baru, a professor of health policy at Jawaharlal Nehru University in New Delhi.

Quraishi acknowledges the criticism, but maintains that using technology for a step-by-step start to the problem is a good place to start. Eventually, he hopes to add other lifeline material to the app, including English lessons.


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  1. Reply

    Where To Get Health Fitness Tips? Hello friends let me know where you can get health fitness tips. I have recently read blog related health and fitness and I found it helpful. I am looking for more same king of blog which I have read before. Please you may take a review and suggest me more. Thanks!

    Blog: healthfitnesstipszone.blogspot.com

    1. Reply

      Health and fitness centers are more in numbers where you can be trained to keep up your good health in good way. Inspite of visiting the Gym or health and fitness centers many a time, people are not able to maintain good health. Therefore one should maintain their daily diet along with the good exercise, by doing this you can maintain good health.

  2. Reply

    Send Me The Health Tips?

    1. Reply

      Many people take for granted very simple ways to healthy living and eating. Our foods are full of toxins, chemicals and preservatives so when you eat try to think natural which is the best way to know your eating right.

      If we go back thousands of years when man had no supermarkets and no packaged goods but just simple food then we can relate that to how we should be eating in the 21st century. Back then man would eat food straight from the fruit trees, vegetables that have no chemicals in the soil and free of pesticide spray. Men and women would have been much healthier as they would have also had to work hard to gather their food and we all know that exercise is a vital part of healthy living.

      Instead of buying your vegetables from the supermarket which are usually full of chemicals and pesticides consider taking a visit to your small local fresh fruit & vegetable store. Not all of these small fresh fruit & vegetable stores are are that much better as many of them still buy their stock from the same growers as the supermarket chains. The best way to judge if the produce is free from toxins & chemicals is to take it in your hand and take a look at the produce. Study the leafs in greens, do they have a look of been nearly perfect and pest free? If the leaves looks like they have had some harmless insects nibbling at the leaves then thats a good sign the produce has not been sprayed. Do the tomatoes looks pale and without blemishes? If so they have been grown in a hothouse artificially. You are the best judge, use your own discretion and ask the shop keeper directly if the produce is organic and free of sprays & chemicals.

      You can also find particular sections in supermarkets & fresh fruit & vegetable stores that cater especially for organic foods which is probably one of the best guarantees that the food is free of toxins. You can also find fresh fruit & vegetable stores that only sell organic foods which is usually the best places to buy.

      Eggs are another food source that can be unhealthy to eat due to the chickens bred in cages and they get no exercise and the eggs contain traces of chemicals from the artificially produced eggs. The eggs also have less natural vitamins, minerals and proteins so we don’t get the full benefits of what natural eggs would normally contain. To be assured your eggs are going to be good for you then buy farm range eggs that are organically grown.

      How many of us buy white sugar or use white sugar when buying a drink from a café? Most likely over 80% of us… Instead of having white sugar which is very bad for our health when too much of it is consumed, buy raw sugar which is less refined or even better use honey to sweeten your drinks and food. Honey is a very healthy food but make sure you buy it unfiltered and honey that has not gone through any processing or heating. The best place to buy honey is straight from the owners of bee hives. If you do have to buy your honey from a store then look for a dark natural color with traces of honey comb and read the label.

      Another over consumed everyday food source is salt, apparently most people eat 2 sacks of salt a year more than they need. That is an awful lot of salt but its in nearly every packaged food and nearly all foods from your local restaurant, cafés or fast food outlet. Aways insist on salt free food when buying from these places and most restaurant & cafés will be happy to prepare a special dish free of salt for you although at a slightly higher price but it’s well worth it. We all need some salt but not so much, only use natural sea salt or kelp in our meals and do so moderately.

    • Hg
    • March 25, 2014

    Do These Health Tips Actually Work? 1 apple / day – no doctor
    1 lemon / day – no fat
    1 cup of milk / day – no bone problems
    3 ltrs water / day – no diseases…

    Also what are some losing weight health tips?

    1. Reply

      No, these health ‘tips’ are actually myths. It’s all very healthy to do that, but no.

      To lose weight, all you can really do is exercise more and eat healthy and try to keep your calories at around 1600 a day. It’s good to drink homemade lemonade that tastes pretty sour and not sweetened very much- it’s good for your metabolism. Tea is good, fruits and vegetables are good. It’s a great time to get active because it’s summer and you’ll sweat more, which is awesome for your body to flush out toxins and such. I like making fruit smoothies and adding spinach or kale (you can’t taste it and it’s so good for your body- not to mention filling). When you snack during the day, only snack on ‘raw’ foods like fruits and vegetables, or maybe a few almonds.

      Good luck!

  3. Reply

    What Are General Health Tips? What type of diet, how much sleep, how much exercise, etc.

    don’t tell me it depends on the individual because i’m looking for general tips for everyone

    1. Reply

      8 hours of sleep each day minimum

      play ball or sport 3 times a week. you can also go to a gym and do some cardio [run or bicycle]. or go to a swimming pool. what i suggest is get a subscription to a local gym. that means you will go there every week.

      stay away from sugars, animal fat, or industrial food. eat lean foods : beef, turkey, chicken, brown rice, pasta, fruits, vegetables, olive oil. reduce coffee amount. get as much as fresh water as possible. that means bring a bottle of water with you all times.

      of course, if you smoke, it is the good moment to try stopping. let people know about your goals. if you drink hard alcohol, stop also. however, red and white wine is good for you so a glass once in a while is great, for these parties.

      eat slowly. if you eat too fast, try to appreciate what you eat.

      go to the countryside every 6 months.

      stay clean and shower everyday.

      laugh. smile. jump. play like a kid every once in a while.

      have true relationships [true, scientific research shows that peace of mind is healthy for the body too]

      added today 17th: go to dentist every 6 months, and do a general health check with a doctor every year

      final point: scientific research shows that the only way to live longer is to eat less everyday [meaning you need to have that light hungry feeling after a meal] and sexual abstinence. I am not sure everyone wants that though, it is sure monks live longer, but it is “healthier” to live life at its fullest

  4. Reply

    Tips For Shopping For Health Insurance?? I have no clue about shopping for health insurance but i just go married so they kicked me off of my mom’s… any advice would be greatly appreciated!!! I’m gonna need something with maternity and dental anyone have any good policies or companies you recommend?

    1. Reply

      The best way to attain health insurance is through employment.Buying individual health policies are not only expensive but they also have limitations that larger groups don’t have.Blue Cross Blue Shield has an open enrollment every year for individual policies but the deductible is extremely high around $2500-$3000 yearly.If you buy insurance through an employer they not only pay half the premium the yearly deductible is a lot lower $250-$500 yearly.There are allot of companies out there that say they offer health insurance but it falls short of adequate coverage.The true tell tale to any policy is its exclusions.You should always read the exclusions before buying any insurance product.There are a few companies that underwrite true major medical policies.Blue Cross Blue Shield,Aetna and United Health Care are Three of the largest most reputable insurers.Make certain for the coverage you are looking for you are buying a Major Medical Policy and not anything else.Do not fall for Aflac or an accident plan as Medical.Do not fall for the Hospital Indemnity plan either.If you look at the three companies I mentioned you should find what you need at a premium of course.

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