Nigeria: A Dual Approach - Tackling Maternal Deaths in Southern Nigeria Using Technology and Birth Kits

HelpMum’s founder Abiodun Adereni says delivery of clean birth kits to women in rural areas will help in tackling maternal and infant mortality.
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When Abiodun Adereni founded HelpMum two years ago, his dream was to provide basic health information to pregnant women and to help tackle maternal and infant mortality in Nigeria. Now, faced with the harsh reality of decreasing maternal and child mortality in the country, Adereni feels much more work needs to be done to achieve this dream.

Across Nigeria, pregnant women die due to poor access to quality care, while children die from vaccine preventable diseases. According to a 2015 report by the United Nations, Nigeria is one of the most dangerous places to give birth and contributes to 19 percent of maternal deaths in the world. Annually, according to the report, Nigeria records a total of 58, 000 maternal deaths. Additionally, the United Nations Children Fund (UNICEF) says Nigeria has the world's second highest number of deaths in children under five, losing around 2,700 children every day. This means around 120 children died for every 1, 000 live births in 2016. Although this ratio is an improvement from 2003 when 200 children died for every 1, 000 births, every life that is lost still matters especially as most of them are preventable. Only one out of three babies born in Nigeria, is delivered in a health facility. HelpMum is working to help reduce maternal and infant mortality by giving pregnant women and nursing mothers in underserved communities birth kits that will help them when they are giving birth.

Saving the Lives of Mothers and Babies

"HelpMum started in 2017 and uses the power of mobile technology and low-cost birth kits to tackle maternal and infant mortality," said Adereni. From initially carrying out rural outreach programmes to provide health services, the organization transitioned to the distribution of clean birth kits; the use of a Vaccination Tracking System (VTS) to send SMS reminders to women about vaccination; and training of Traditional Birth Attendants (TBAs) to help women where access to healthcare is limited.

By providing clean and affordable birth kits to women in rural areas and underserved communities in Lagos State and other states like Oyo, Ondo and Osun in the Southwest, HelpMum aims to help tackle maternal and child mortality in Nigeria.

"Pregnant women are notified through an automated system of their dates for antenatal and vaccination and the need to take their child to a local hospital or clinic for immunisation," Adereni said. This system saves them from missing antenatal and immunisation appointments at the hospitals.

Setting up the VTS is free and easy to navigate. When a visitor logs on to the website, an online registration form pops up where new users fill in their details. So far, the online automated VTS has 11,230 registered nursing mothers who receive prompt reminders about their children's vaccination schedule via SMS. The platform also uses indigenous languages to connect directly with the women through phone calls. Since inception, HelpMum has reached 16,000 pregnant women and nursing mothers. The organisation also leverages on social media to get more people to register on the platform and encourages donors to donate clean birth kits to women for safe and hygienic delivery.

"The antenatal care reminders are very important because most of the things that lead to the death of a baby during delivery can be detected during antenatal care" Tolu Abinbade, the medical director at HelpMum said. "We also counsel the women on why they should not be scared to go to health facilities for delivery," she added.

The birth kits tackle maternal and infant mortality by helping to prevent infection during delivery. So far, according to the organisation, all the women that have used the birth kit have not had any post-partum infection and continue to give great feedback.

The affordable birth kits sell for N2000 and includes 10 maternity pads, one delivery mat, two sterilised gloves, antiseptic soap, methylated spirit and disinfectants. Other contents are a pack of gauze, cotton wool, scalpel blade, and other equipment that helps pregnant women during delivery and prevents avoidable deaths caused by infection or lack of birthing equipment. However, since most of the women in the rural areas are from poor communities and can barely afford the kits, donors and organisations buy the birth kits in large quantities and give them to pregnant women. HelpMum serves as an intermediary to deliver the kits to pregnant women in rural areas across the country. Last year, Rotary International in Lagos State procured the kits for distribution to 25 pregnant women. The platform has also received some global recognition and grants to help them scale up their reach and impact, such as the Google Impact Challenge grant of $250,000, the United Nations Conference on Trade and Development (UNCTAD) grant of $5,000 and another grant from the Pollination Project.

Allaying Mothers' Fears

The Helpmum team's work doesn't end with ensuring women have safe and hygienic deliveries. They also try to ensure that new mothers present their babies for immunisation by using the VTS to send SMS reminders to mothers to take their babies for immunisation. In addition, they call up the women to remind them a day before the date for their child's immunisation. That way, "we are tackling maternal mortality with our kits and also tackling child mortality with our vaccination tracking system because if a child is vaccinated, he or she will be protected from vaccine-preventable diseases," Adereni said.

Prior to delivery, Kamal Samira, 22, was overwhelmed with fear associated with childbirth because of stories she heard of pregnant women and their babies dying. Her fears were allayed when she encountered the HelpMum team and received their birthing kit.

"They were very useful to me during delivery," Samira says. "Before my delivery, I was very scared but when we were given the kits, they told us that it will help us during delivery especially in preventing infection."

On April 7, 2019, Samira gave birth to her baby girl, Suweiba at a local hospital in Bodija community where she lives. "I didn't have any issues during delivery and the doctors said my baby is doing fine. I will use the kit next time." Samira said.

Abdulazeez Opeyemi heard about HelpMum at the health centre in Bodija when the team from the organisation came for sensitisation and distribution. She used the kits when she gave birth to her baby in May 2019 and now recommends it to other women living in her neighbourhood.

Sustaining Momentum

This year, HelpMum hopes to meet a target of reaching 60, 000 women in rural communities by extending to over ten states in the country with high maternal mortality rates. Adereni and his team also plan to replicate the model in six African countries in the next five years and have started talks in Kenya and Ghana -- countries with maternal and infant mortality issues like Nigeria. But charity, they say, begins at home and they know this.

"Before we go to other African countries, we are looking at having a strong physical presence in the northern part of Nigeria and we are already working towards that" Adereni said.

Adereni says partnerships where federal or state governments procure these kits in large quantities, select local communities where they will be distributed, and HelpMum serving as an intermediary to reach the women, will go a long way in tackling maternal mortality.

"If we really want to solve maternal and child mortality in Nigeria, I think a lot of people should get involved because this is a huge problem." he said. But getting this support and partnership has been a major challenge for the HelpMum team. Adereni believes their work will be a lot easier and have more impact if the government provides more support to social enterprises proffering solutions to local issues. They still have big dreams, despite these challenges. The team aims to make HelpMum Africa's leading mobile healthcare service provider before 2020 and to contribute significantly to creating a world without maternal and infant deaths.

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