IT as support for reduced maternal mortality in developing countries

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Every day approximately 800 women in the world die from causes related to pregnancy and childbirth. 99% of these women live in a developing country. The slow development in reducing maternal mortality is explained by limited access to healthcare and medically educated people. For people living in the countryside it is often a long distance on foot on very poor roads to get medical help.

– The pregnant women in development countries are mainly supported by volunteers since there are usually not enough professionally trained people around, especially in rural areas, says Hawa Nyende.

Hawa is a PhD student in the BRIGHT project, a collaboration between the University of Gothenburg, Chalmers University of Technology, and two universities in Uganda. That means that she spends half her time as a doctoral student at the Department of Applied IT at the University of Gothenburg and half her time at her home university, Makerere University in Uganda.

Information technology can counter long distances to medical support

As a PhD student Hawa soon started to look more closely at the role information technology could play in improving the situation of pregnant mothers in developing countries. The number of mobile phones is increasing rapidly in the sub-Saharan regions for example, which could make it possible to reduce the distances to medical advice and support. Hawa has among other things been looking at the possibility of using different apps.

Hawa has been collecting the main part of the data she uses in her research during her doctoral studies in Uganda. She has interviewed both hospital directors and health care workers, app developers, pregnant women, and volunteers in the countryside.

To map what can be most important to include in an app for pregnant women, Hawa have also been conducting a study in Sweden, one of the countries in the world with the lowest maternal mortality. Hawa has interviewed people from different categories in Swedish maternity care to find out how the IT-related support is structured in Sweden and how the midwifes and other staff in the maternity health care use it in their everyday work.

– An optimal IT support is partly about predicting risks, but also very much about getting advice and support when a “normal” pregnancy suddenly takes an unexpected turn.

The fact that no pregnancy is predictable is one of the objections to the kind of IT systems which are mainly focused on trying to chart possible risk pregnancies. All pregnant women can be at risk throughout pregnancy, delivery and puerperium, regardless of categorization. In the situations when a pregnancy not has followed the expected plan, the IT systems focusing on prediction have not been of much help.

Co-creation, a way to share important information

– Apart from the information technology itself, I am also very interested in how the technology needs to be designed to be as beneficial as possible for the users, Hawa says. I have been studying processes of value co-creation, which is about actively seeking and sharing knowledge, instead of passively awaiting the advice of the often very few experts available. How do we extend the information processes to the people involved, to the pregnant women and to the local midwives?

Half the doctoral time in Sweden and half in Uganda

Hawa Nyende thinks the idea of spending half her PhD education in Gothenburg and half the time in Uganda has been working well so far.

– Changing environment and having supervisors from both universities provide good opportunities to link research and practice. The PhD education in Sweden is more structured as I see it. You are also more exposed to the research area, as you continuously discuss and share ideas with researchers of similar research interests. Altogether this means that I find it easier to progress in my research this way.

– But of course I miss my family during my time in Sweden. I have three children in Uganda, two 11-year-old twins and a four-year-old. It has been hard to be away from them for so long, but my family are happy for me and very understanding. They really want me to do this, even if it means that I am away most of the time.

Back to Uganda after the PhD defence

One of the main goals of the collaboration between the universities in Uganda and Sweden is to increase the number of teachers with a PhD degree within the ICT area in Uganda. That means that the newly graduated doctors from the project will be able to educate new doctoral students in their home country when they are back. Through the collaboration, the number of teachers in the field can grow quickly in a short period of time.

– Before I started as a doctoral student, I was a teacher at Makerere University, my home university in Uganda, Hawa says. After my doctorate, I will return to Uganda where I will continue teaching, but of course also devote myself to further research and be a part of the education of new doctoral students. I have put a lot of time and energy into my research, but I find it very interesting and I look forward to continuing my work!

Text: Catharina Jerkbrant