As the COVID-19 pandemic forced healthcare services to ramp up their digital operations to offer remote consultations, cooperation has been crucial. Countries quickly needed to adapt their digital infrastructure to facilitate or scale up contact tracing, case management, and commodity tracking, among other functions. The availability of digital public goods (DPGs) made that process less onerous as much of the work had already been done.
A DPG is open source software, open data, open Artificial Intelligence (AI) model, open standard, or open content that adheres to privacy and other applicable laws and best practices, does no harm, and helps attain the Sustainable Development Goals (SDGs).1 The Digital Public Goods Alliance (DPGA) is a multi-stakeholder initiative that established and maintains the DPG standard and DPG registry. It aims to increase the discovery, use of, and investment in digital public goods. UN Global Pulse has recently become a member of the DPGA, which means we will work collaboratively to advance digital public goods.
In our first collaboration, our team at UN Global Pulse in Finland is working with the DPGA to explore how DPGs can contribute to improvements in maternal and newborn health. Supported by the Government of Finland and UNICEF, this work aims to discover what innovations are already out there, what works well, and what lessons have been learned. More importantly perhaps, it will also seek to identify what a supportive ecosystem looks like and what needs to be in place to enable maternal and newborn health DPGs to scale up where they are needed most. This fits well with UN Global Pulse’s role in providing tools and technical assistance to lower the barriers to scaling.
According to the UN Secretary-General’s Roadmap for Digital Cooperation, digital public goods are “essential in unlocking the full potential of digital technologies and data to attain the Sustainable Development Goals, in particular for low- and middle-income countries.” Our work with the DPGA responds to the challenge of making DPGs more accessible and scalable by providing a practical framework in the field of maternal, newborn and child health.
Why is maternal and newborn health the focus of this work?
The COVID-19 pandemic has impacted everyone. Existing inequities in access to healthcare have been exacerbated by the pandemic, with maternal and infant services disrupted.2 Resources have been stretched, women were scared to attend appointments, and health facilities have been repurposed, resulting in direct and indirect consequences on maternal and newborn health.3
One analysis4 estimates the disruption to services as a result of the pandemic could result in 1,157,00 additional child deaths and 56,700 additional maternal deaths over six months. That means almost 6,500 children and 315 mothers will die every day. In addition to the 810 women who already die every single day as a result of their pregnancy.
Indirectly, the impacts of COVID-19 on pregnant women include increased anxiety and depression, domestic violence, and loss of income5, placing a disproportionate social and economic burden on women. In low-income countries specifically, the pandemic has resulted in reduced use of maternal, newborn and child healthcare services including prenatal care, contraception, and immunization. Women and their families lost confidence in healthcare services or felt prevented from attending due to lockdown restrictions. Additionally, healthcare providers advised some women not to attend facilities, with services moving to telehealth where possible.2 But not all localities had the infrastructure or resources to enable this switch from in-person to remote care.
Great strides have been made in recent years to prevent maternal deaths, which have globally been reduced by over a third, and stillbirths which have been cut in half, since 2000. We cannot let these gains fall away now, putting the SDGs further at risk of missing their targets because of the pandemic.
Over the years, many initiatives have been launched to encourage innovation in maternal and newborn health. It is something a lot of people are very passionate about. There is a sense there must be ways to prevent these avoidable deaths. And there are. But the solution needs to be broader than a few incredible new devices or some innovative training schemes for midwives. Basic infrastructure needs to be tackled. And that means digital infrastructure as well as running water and reliable electricity.
How can digital public goods help?
Some of the remote healthcare innovations adopted during the pandemic may fit the criteria of digital public goods (DPGs). Digital tools can drive change across the spectrum of maternal and newborn health. From national online birth registration, to healthcare worker professional development and support apps, to chatbots for pregnant women, remote diagnostic tools, tracking of infant vaccinations, and Artificial Intelligence (AI) to detect childhood malnutrition. Increased use of digital tools within maternal and newborn healthcare can connect all the parts of the system to enable safer care.
As we recover from the pandemic, building back better and striving for solutions to promote equity are our guiding principles. For mothers, infants and children, we can support positive change through digital public goods. Look out for further updates as the project progresses.
Visit the Digital Public Goods Alliance website to learn more about their work.
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1 https://digitalpublicgoods.net/who-we-are/
2 Chmielewska et al. (2021). Effects of the COVID-19 pandemic on maternal and perinatal outcomes: a systematic review and meta-analysis. Lancet Global Health, 9:e759-72.
3 Ahmed et al. (2021). The effect of COVID-19 on maternal newborn and child health (MNCH) services in Bangladesh, Nigeria and South Africa: call for a contextualised pandemic response in LMICs. International Journal for Equity in Health, 20:77.
4 Roberton et al. (2020). Early estimates of the indirect effects of the COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries: a modelling study. Lancet Glob Health (8:e901-08).
5 Kotlar et al. (2021). The impact of the COVID-19 pandemic on maternal and perinatal health: a scoping review. Reprod Health 18.
