WHO develops electronic solution to child, maternal deaths

Conducts study in Nigeria, Uganda on 10,000 pregnant women

The World Health Organisation (WHO) has developed an electronic solution using hospital-based study on 10,000 pregnant women in Nigeria and Uganda to reduce the high labour-related child and maternal death rate in sub-Saharan Africa.

The software, an electronic health solution, tagged Simplified, Effective, Labour Monitoring-to-Action (SELMA) tool, would be built into mobile phones, tablets and other mobile devices. It promises to enhance the capacity of less skilled persons working in rural areas but does not replace the expertise of a specialist.

WHO BOLD Research Group was led by João Paulo Souza, a Medical Officer at the WHO Department of Reproductive Health and Research, and a professor of Social Medicine at the Ribeirão Preto Medical School, University of São Paulo, Brazil.

Other members of the team include Prof. Olufemi T. Oladapo, a medical officer at the Department of Reproductive Health and Research, WHO Geneva, Switzerland; Dr. Bukola Fawole, an obstetrician/gynaecologist in the Department of Obstetrics and Gynaecology, University College Hospital (UCH), Ibadan, Oyo State and Dr. Livia Oliveira-Ciabati of the University of Sao Paulo.

The team, at a study dissemination meeting in Abuja, said they would have the test version ready by November 2016, which would be used in a large study next year.

Souza told The Guardian: “In November, we will release it for testing, and we hope by the end of next year, it will be ready for public use.”

He said the tool also promises to identify the essential elements of intra-partum monitoring that trigger the decision to use interventions aimed at preventing poor labour outcomes that usually lead to the death of mother and child.

Intra-partum is the period from the onset of labour to the end of the third stage of labour.

Also, Fawole said: “The software is a product of SELMA. SELMA was a study that was conducted and that software has come about because we have input the data of over 10,000 deliveries from Nigeria and Uganda into that special design software which then acts as an artificial intelligence and so for everywoman that presents in the hospital in labour, the health care provider only needs to input the data of that woman and the data that already exist in that software enables the software to identify similar women who have been managed before.

“The benefits of the software is such that hopefully when the suggestions are taken, it will reduce adverse outcomes in both the mothers and the babies and we look forward to the implementation of this software when it eventually comes out.”

Oladapo on his own said: “The development of the SELMA algorithm and tool is part of the BOLD project, a larger initiative with the overall goal of reducing adverse maternal and infant outcomes resulting from labour complications through research, design and implementation of innovative tools. The BOLD project also includes the development of a passport for Safer Birth (PSB, another tool being developed as part of the BOLD project). The BOLD project has a qualitative, formative research component that will feed into the final development of SELMA at the implementation phase. In the future, the findings from this project may contribute to WHO guidelines on intrapartum care.

“As most pregnancy-related deaths and morbidities are clustered around the time of childbirth, quality of care during this period is critical to the survival of pregnant women and their babies. Despite the wide acceptance of partograph as the central tool to optimise labour outcomes for over 40 years, its use has not successfully improved outcomes in many settings for several reasons. There are also increasing questions about the validity and applicability of its central feature to all women regardless of their labour characteristics.”