Several reports have shown that every day about1500 women die from pregnancy or childbirth-related complications. A total of 99% of all maternal deaths occur in developing countries, where 85% of the population lives. Although there are intra and inter regional variations in the reasons for such high maternal mortality rates in these countries, lack of access to good quality midwifery services appears to be a universal problem. Data shows that on average, 62% of women in developing countries receive assistance from a skilled health worker when giving birth. Even in the presence of trained midwives, however, many women do not use services because they do not like how care is provided or because the health services are not delivering high-quality care.
Studies have also shown that most maternal deaths are avoidable simply because most of the health care solutions in preventing or managing the complications of maternal mortality are well established. The leading causes of maternal mortality common to all developing countries include severe bleeding (mostly bleeding postpartum), infections (also mostly soon after delivery), hypertensive disorders in pregnancy (eclampsia) and obstructed labor. In addition to this, complications after unsafe abortion cause 13% of maternal deaths. It has been stated that about 80% of maternal deaths are due to these causes. Other indirect causes that constitute 20% of maternal death are diseases that complicate pregnancy or are worsened by pregnancy, such as malaria, anemia and HIV. Since all of the above mentioned complications are not predictable, all women need care from skilled health professionals, especially at birth, when access to good quality treatment services can make the difference between life and death.
The main objective of this project is therefore to create educational opportunities for midwives in the world's poorest countries with high maternal and child mortality rates. The project will primarily focus on incorporating information and communication technology to improve overall maternal health in one of the poorest countries in sub-Saharan Africa hard-hit by an extremely high rate of maternal mortality (1,107 per 100,000 live births)- the Sudan. Several studies including one conducted by the World Bank have established a positive correlation between improved information and communication technology and accessibility. For example, in Ghana the use of a low-cost portable technology such as cell phones played a pivotal role resulting dramatic decline in maternal deaths.
This project will focus on providing a low-cost, low-power robust laptops to midwives in Sudan. Certainly, providing midwives with a sturdy, low-cost, low-power, connected laptop will create an environment where by midwives are engaged in a collaborative, self-empowered learning and communication. When midwives have access to this type of tool they can get engaged in the most up-to-date state of the art about midwifery. They can learn, share, create, and collaborate among themselves. In this manner, they become connected not only to each other but also to the world. This will empower midwives in developing countries to have access to new information giving them an opportunity to develop and share their skills, access to vast amounts of information, connect with each other as well as with other parts of the world. This will have a significant contribution towards the development of highly qualified practitioners of midwifery and improved primary healthcare services.
Using a similar approach used in “One laptop per child” (i.e. the XO laptops), the idea is to introduce midwives with a specially designed to provide an engaging wireless network. These laptops connected to others nearby automatically will have a significant contribution in sharing information. Midwives in the nearby health facilities can permanently be connected to chat, sharing information on the local network or web. Like the XO laptops these can be designed to be charged by solar or mechanical power or through special bulk-chargers making the use of these laptops easier for midwives in a community to connect to one another almost anywhere. This will also create a new learning environment beyond the walls of classrooms.
The recent surge in availability of information technology such as mobile phones and internet access in Africa has prompted considerable enthusiasm regarding the use of these technologies for various activities. Many countries in Africa are successfully implementing the use information technology for almost everything from marketing and e-commerce to tracking crop diseases and reminding HIV/AIDS and tuberculosis patients to take their medicine. In the Sudan, the use of information technology has become very important and can be characterized as one of the fastest growing innovations not only in Africa but worldwide. Reports indicate that over 80 % of Sudan’s one million square mile is covered with wireless telephone services. Major cities such as Khartoum, Medani, Port Sudan and Juba are well covered by Third Generation (3G) internet services. These conditions provide an ideal environment for a successful implementation of one laptop per midwife project in the Sudan.
Ohio University in collaboration with Ahfad University for Women in Sudan is currently in the process of a capacity building program in the area of maternal and child health in Sudan. Ahfad University for Women in Omdurman, Sudan will be the leading international partner for this project. The institute has over a 100 year history of education for girls and women in Sudan. Over the past few years the institute has developed special emphasis on health issues, particularly women's health in the entire Sudan, including Darfur and the South, and has had years of project work and student participation in and from those two regions. One aspect of the collaborative capacity building program constitutes the development of innovative instructional technology for MCH training such as interactive video and web-based conferencing, web-based training, computer-based training, and audio conferencing. The existence of this collaborative project provides an ideal environment for a successful implementation of the one laptop for child project. The presence of a network of literate midwives who work closely with faculty and staff at Ahfad will also play an important role in facilitating the implementation of this project. Faculty and Staff at Ahfad University for Women will be the major stakeholders in the development and provision of training on the use of the laptops. Subsequently, those trained midwives will be responsible in providing training to their colleagues. Such a collaborative effort will not only improve the current maternal mortality rates but will also play a significant role in improvement in the quality of MCH care and MCH data reporting.