“Try not to move so much during this next contraction so I can take your COVID-19 sample” was one of the phrases I had not planned on hearing prior to March 2020 as I was preparing for the birth of my first child in June. Neither was my midwife asking me six weeks post-partum “Can you adjust your phone so we can begin your breast exam over zoom?” or “Now lie on your back and push fingers under your belly button to see if we can determine the size of your diastasis recti…virtually” while I fumbled with my phone. We both laughed while we tried to make the best of the situation at hand, which would have been impossible for both of us to picture just months earlier.
Being pregnant, giving birth, and becoming a working mom during COVID-19 has been a bumpy ride, but one of the silver linings for those of us lucky to have access to digital interventions is the flexibility and comfort they have brought in a very uncertain time. Without digital tools, I would have been completely isolated from friends and family, limited my access to healthcare for myself and the baby, and a mindful return to telework would have been impossible.
Once the pandemic hit, I was truly impressed by how my providers introduced new and harnessed existing digital tools to ensure continuity of my care. Within a period of less than two weeks, I had received clear guidance regarding when I would be seen in person and when I would be seen remotely and had a digital blood pressure monitor and scale which I used to share data with my care team. This device proved critical, as my blood pressure became elevated during the last few weeks of my pregnancy and allowed me to be connected to my care team from the comfort of my kitchen.
Many of my providers also started to work from home for their own safety, but they still had access to my health information due to the use of electronic health records. Using a personal health record system allowed me to communicate with my care team, ask questions, and receive lab results on my phone. Private and secure mental health services were available to me through the click of a button and remote check-in tools allowed me to stay in my car while filling out paperwork from my cellphone as I waited for the waiting room to clear at the pediatrician’s office to reduce exposure.
These are clear example of how digital health interventions can create value. Of course, not all services worked well virtually; my virtual village couldn’t help with night feedings and I needed hands-on support from a lactation consultant to get my baby to latch, but digital tools can augment and complement the in-person services; according to the CDC, telehealth visits increased 50% in the first quarter of 2020 in the US. This shift is much more than just downloading an app, it is, rather, a reflection of how much we can digitally transform health services when people, processes, and technology are aligned.
Beyond the virtual village: building resilient digital health systems for LAC with and for women
Although access to healthcare in the LAC region has generally increased, we know that access to basic services like prenatal care varies by income and location and care, in general, is more limited for populations that are disadvantaged because of their gender, ethnicity, or disability. Pregnancy is also more dangerous during public health emergencies; the Ebola outbreak restricted access to family planning, prenatal care and hospital births, and researchers estimate that COVID-19 could cause anywhere from an 8.3–38.6% increase in maternal deaths per month, across 118 LMIC countries. Telehealth can improve women’s reproductive health and many countries in LAC are using it to expand access. These tools may play an important role in the mental health crisis we are also facing; the pandemic has caused dramatic increases (29% to 72%) in the anxiety of pregnant women and new moms, and as women represent 70% of the health and social care workforce worldwide, many are suffering from anxiety, depression, and burnout due to the crisis.
Digital interventions can be a powerful tool for LAC, but we must make intentional choices to ensure that our digital health transformations are inclusive, equitable, and don’t leave women behind. We need to identify and correct data bias against women such as the ones I experienced during my pregnancy. Prior to COVID-19, women were frustrated and exhausted from designing workarounds to systems that weren’t designed for their needs. As we move forward, we need to ensure that our investments are creating value for women. The only way we can do that is to design our digital transformations with women and prioritize the problems women want solved.
In honor or international women’s month, you can join IDB by recognizing the digital health leaders in the Americas, nominating women digital health champions here.
Estimada Jennifer.
Una de las herramientas de salud digital para las futuras madres es https://www.text4baby.org/ implementada por Voxiva desde hace más de 1 década y que ha sido muy útil para madres de ascendencia latina en los EEUU. en su autocuidado de su embarazo con mensajes educativos personalizados y recordatorios vía SMS
En Perú, con el apoyo de USAID, en el 2009/2010, Voxiva también inició una implementación similar, que lamentablemente por cuestiones políticas no pudo continuar.
Previamente, entre 2003-2005, en una región de la selva de Perú, Ucayali, se implementó la plataforma multicanal de salud digital “NACER” enfocada a mejorar la salud materno-neonatal, incluyendo los aspectos de referencias de gestantes, medicamentos e insumos.
Saludos
Juan