The WONDER App Improves Maternal Mortality Rate in India


BIG SKY, Montana — Maternal health has long been one of the measures reflecting the overall development of a nation. India is one of the countries that struggle with high maternal mortality rates. The most recent available data shows that the maternal mortality rate in India is 113 deaths per 100,000 live births. Nearly two-thirds of all maternal deaths in India link to severe bleeding, high blood pressure, post-childbirth infections and birth complications. However, many of these deaths are largely preventable.

Maternal Health in India

Maternal deaths in India are positively declining, with 2,500 more mothers saved in 2018 in comparison to 2016. However, pregnancy-related complications are the number one cause of death for Indian females between 15 and 19. This is because their young ages increase their risk of complications. Additionally, child brides are less likely to receive proper medical treatment while pregnant.

The government is giving more attention to maternal health. The maternal mortality rate in India has improved significantly in the last 20 years. Unfortunately, there is a large gap in health coverage between wealthy and low-income individuals and those residing in urban versus rural areas. The economic status of the patient often affects access to healthcare.

Gynecologist Narmadha Kuppuswami

Narmadha Kuppuswami has been a practicing gynecologist and obstetrician for more than 40 years and currently practices in the United States. Several continuous days of being on call left Kuppuswami exhausted and unable to make a quick decision in an urgent medical situation. Her physical depletion meant she could not recall a specific dosage. She then realized how many critical steps there are in maternal care and how a mobile app could help healthcare providers better handle emergency maternal situations.

Kuppuswami developed the Women’s Obstetrical Neonatal Death Evaluation and Reduction (WONDER) app with low and middle-level healthcare workers in mind. WONDER’s mission is to make pregnancy safe for women all across the globe and reduce preventable maternal deaths. The WONDER app utilizes innovative technological solutions to improve obstetric care for all women regardless of socioeconomic status or location. Kuppuswami’s app has directly impacted the maternal mortality rate in India.

How the WONDER App Works

  • Comprehensive Health Data Collection. The medical history, lab results and vital signs of the patient must be entered into the app. Low and middle-income level healthcare workers enter this vital information into the app when the patient is first seen. This information includes blood pressure, oxygen levels, temperature, pulse and family history.
  • Detecting Abnormalities. If any of the information inputted is abnormal, the app uses an algorithm to identify such abnormalities and alert the healthcare worker that the patient is high risk.
  • Detailed Medical Instructions. The app provides detailed instructions to a healthcare worker in the case of normal parameters. This eliminates the risk of missing any vital steps in the maternal healthcare process. Most maternal deaths are preventable and these step-by-step instructions provide healthcare workers with the confidence to provide adequate and up-to-date obstetric care.
  • Other Maternal Healthcare Features. The WONDER app can also link to a WONDER electronic health system in order to improve a hospital’s medical responsiveness in an emergency situation. Furthermore, midwives can use a WONDER Kit when doing prenatal home visits. The kit contains biometric tools to measure vital parameters.

The Success of the WONDER App in India

The WONDER app was used to assist 65,000 patients in Darbhanga. The app flagged 4.5% of the patients seen. This alert means the person needs urgent medical care at a medical facility. These particular patients were transported to a hospital immediately.

Using telehealth technology, doctors at the facility were notified while critical patients were in transport, allowing for doctors to prepare the necessary medical supplies before the patient’s arrival.

Due to the success of the app in Darbhanga, there are plans to launch the app in other districts too. The ultimate hope is to reach all states of India and further reduce the maternal mortality rate in India. The WONDER app is regularly upgraded. Some of the upgrades accommodate circumstances of COVID-19 as well as areas impacted by natural disasters.

Poverty and Maternal Health

The U.N. Sustainable Development Goal 3 set out an ambitious goal of “reducing the global MMR to less than 70 per 100,000 births, with no country having a maternal mortality rate of more than twice the global average” by 2030. The main way to combat maternal mortality is to address inequalities in access and quality of maternal medicine and care. The WONDER app is directly impacting and improving access to obstetric care regardless of socioeconomic status. In essence, the WONDER app is contributing to the declining maternal mortality rate in India.

Tatiana Nelson
Photo: Flickr


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