1. health and fitness

Press information, April 2015
New Danish app saves mothers’ lives
On 22 April, The Safe Delivery App ‒ a ground-breaking mobile training tool that can save the
lives of mothers and newborn babies during pregnancy and childbirth in Africa ‒ will be
launched at an event in Copenhagen attended by HRH The Crown Princess Mary of Denmark.
The app has been developed by the Danish organization Maternity Foundation in collaboration
with researchers from the University of Copenhagen and the University of Southern Denmark.
New research results show that The Safe Delivery App can significantly increase the ability of
birth attendants to save lives.
Every year, 289,000 women and more than 5 million newborns die as a result of complications in
pregnancy or childbirth. Of these deaths, 99% are in developing countries. Globally, maternal mortality
thus represents the health area with the greatest inequality. The vast majority of deaths could be avoided
if the women in question had the support of a skilled birth attendant.
The Safe Delivery App builds on the rapid proliferation of mobile telephony in Africa, where there are
already more than 600 million mobile phone users. Mobile technology is paving the way for innovative
solutions to global health problems that can be difficult to address due to geographical distance and lack
of training.
The Safe Delivery App features animated videos that provide instruction for health workers in developing
countries in handling childbirth complications, for example if the mother begins to bleed after giving birth
or the newborn is not breathing. The videos, available both in English and local languages, can be used
irrespective of poor literacy skills and language barriers. The Safe Delivery App therefore has significant
and scalable potential to reach health workers in rural districts, where it is normally costly and difficult to
provide conventional training programs.
The Safe Delivery App has recently undergone a clinical trial in Ethiopia. The final results will be published
at the end of 2015, but data show that the app can significantly increase the ability of a health worker to
prevent life-threatening childbirth complications.
The ability of health workers to handle postnatal bleeding and to resuscitate a newborn more than
doubled after 12 months of using the app. The biggest improvement in skills occurred among health
workers on the periphery of the healthcare system, i.e. at remote outposts where the starting point was
lowest and the need for training consequently highest. It is also noteworthy that the skills continued to
Maternity Foundation • Sortedam Dossering 81 • DK-2100 Copenhagen • [email protected] • www.maternity.dk
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improve throughout the 12-month period, indicating that the app is able to continuously maintain and
improve the level of skills.
The final version of The Safe Delivery App will be made available for free to the health sector and NGOs in
developing countries. In partnership with these major players, the app will be thoroughly tested and
evaluated when it is rolled out across sub-Saharan Africa in order to continuously gather data and best
practice on the results and usability of the app. So far, partnerships have been entered into with the
Danish Red Cross and Marie Stopes International, which will use the app in their health programs in
Guinea and Tanzania respectively. In both countries, The Safe Delivery App will initially be implemented in
a single region, with a subsequent nationwide rollout in the coming years.
The Safe Delivery App will be launched on 22 April in Copenhagen as part of the celebration of Maternity
Foundation’s 10-year anniversary. HRH The Crown Princess Mary of Denmark, a patron of Maternity
Foundation and a passionate champion of women’s health rights, will attend the event.
The development and testing of the app have been financed by MSD for Mothers, The Obel Family
Foundation and an international crowdfunding campaign on Indiegogo. The company Visikon has
produced The Safe Delivery App.
Further details can be found in the fact box in the following pages.
For more information and/or an interview with Maternity Foundation and the researchers behind The Safe
Delivery App, please contact:
Lise Knudsen, communications officer: [email protected]/+45 22 11 70 52.
Anna Frellsen, CEO: [email protected]/+45 22 78 84 81.
Maternity Foundation • Sortedam Dossering 81 • DK-2100 Copenhagen • [email protected] • www.maternity.dk
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Facts:
About maternal mortality
Every year, 289,000 women and more than 5 million newborns die as a result of complications in pregnancy or
childbirth. Of these deaths, 99% are in developing countries. Globally, maternal mortality thus represents the
health area with the greatest inequality. On a worldwide level, maternal mortality is a leading cause of
children becoming orphaned.
The causes of maternal mortality are many and complex, but UNFPA believes the vast majority of deaths could
be prevented if mothers had the support of a skilled birth attendant during pregnancy and childbirth.
However, every year 40 million women give birth without such professional support. In Ethiopia, only 10% of
women give birth with the support of a skilled birth attendant.
Maternal mortality has almost halved since 1990, which represents major progress. Nevertheless, there is still
a long way to go to achieve the UN Millennium Goal of a 75% reduction in maternal mortality by 2015, and the
progress that has been made is extremely unequally distributed. In some African countries, there has been no
progress at all, and developments are often not reaching vulnerable and disadvantaged groups.
About The Safe Delivery App
Within a few years, there will be more mobile phone subscriptions than people on the planet. It is estimated
that 65-70% of sub-Saharan Africans have access to a mobile phone and that the number of users will continue
to grow exponentially. In 2019, the number of mobile phone users in Africa with internet access will be 20
times higher than today.
The Safe Delivery App takes its starting point in the proliferation of mobile phone telephony in Africa and aims
to overcome one of the biggest barriers to preventing maternal mortality: a lack of trained childbirth support.
The app is a ground-breaking mobile training tool that is being developed in a collaboration between
Maternity Foundation, the University of Copenhagen and the University of Southern Denmark. It
communicates visually through short animated instructional videos and is available in both English and local
languages, which means it can be used irrespective of poor literacy skills or language barriers. The app makes
it possible to reach health workers in rural districts who are normally difficult to reach with traditional training
programs, thus increasing the qualifications of the health workers. The app will also include drug and practical
procedure lists, push messages and testing options.
The Safe Delivery App provides guidance on the handling of all acute childbirth complications based on
international guidelines from WHO (the World Health Organization), ALSO (International Advanced Life
Maternity Foundation • Sortedam Dossering 81 • DK-2100 Copenhagen • [email protected] • www.maternity.dk
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Support in Obstetrics), FIGO (the International Federation of Gynecology and Obstetrics), RCOG (the Royal
College of Obstetricians and Gynaecologists), and ACOG (the American Congress of Obstetricians and
Gynecologists).
The development of the app has been financed by MSD for Mothers, The Obel Family Foundation and an
international crowdfunding campaign on Indiegogo, which in fall 2014 raised more than USD 50,000. The
company Visikon has produced The Safe Delivery App.
About the research study
The Safe Delivery App was tested in a clinical trial in Ethiopia in 2013-2014. The project tested the ability of
129 health workers to handle life-threatening childbirth complications in mothers and newborns after 0, 6 and
12 months. At baseline, the ability to handle postnatal bleeding and neonatal resuscitation was lacking, with
only 20-25% of the important actions during these interventions being carried out during the initial test.
The ability of the health workers to handle postnatal bleeding and to resuscitate a newborn had more than
doubled after 12 months of using the app. The results indicate that The Safe Delivery App is an effective tool
for improving – and maintaining – the quality of childbirth support in developing countries.
About Maternity Foundation
Maternity Foundation is a Danish development organization that has been working since 2005 to save the lives
of women and babies threatened by complications in pregnancy and childbirth. Our vision is: “No women
should die giving life.”
Obstetrician Henriette Svarre Nielsen founded Maternity Foundation in 2005 together with five other Danish
women. In 10 years, Maternity Foundation has grown into a professional organization that has become an
internationally important player in the fight against maternal mortality.
Since 2005, more than 380,000 family members have received Maternity Foundation’s mother-child health
training and 19,000 women have been given access to safe childbirth at Maternity’s affiliated hospitals and
health clinics in Ethiopia.
The number of births at Maternity’s affiliated health facilities has increased by 155% since 2010.
Maternity Foundation focuses in particular on the training and capacity building of health workers in
developing countries and on the development of new, innovative initiatives such as The Safe Delivery App.
Inspired by the business world in general and the consultancy branch specifically, Maternity Foundation takes
Maternity Foundation • Sortedam Dossering 81 • DK-2100 Copenhagen • [email protected] • www.maternity.dk
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an entrepreneur-oriented and partnership-based approach to development work. CEO Anna Frellsen was
formerly a partner at KPMG and worked for a number of years at McKinsey.
HRH The Crown Princess Mary of Denmark agreed to become patron of Maternity Foundation in 2010.
About the researchers behind The Safe Delivery App
The development and testing of The Safe Delivery App are being carried out in collaboration with doctors and
researchers from the leading academic institutions within mHealth (health promotion through mobile phones)
and global development: the University of Copenhagen’s School of Global Health and the University of
Southern Denmark.
The two researchers behind The Safe Delivery App are Dr Stine Lund and Dr Bjarke Lund Sørensen.
Stine Lund is a doctor in the Department of Paediatrics at the Copenhagen University Hospital and holds a PhD
from the University of Copenhagen. She is one of the leading experts in the development of mHealth tools and
programs for developing countries. In Tanzania, she founded Wired Mothers, an mHealth tool that connects
pregnant women to the healthcare system through SMS services. The Wired Mothers system is also being
tested as part of Maternity Foundation’s program in Ethiopia.
Bjarke Lund Sørensen is a doctor and PhD specialized in the quality assurance of acute childbirth care and
neonatal care in low- and middle-income countries, including through the teaching and adjustment of
Advanced Life Support in Obstetrics (ALSO) in sub-Saharan Africa and with Doctors Without Borders.
Bjarke Lund Sørensen works in the Department of Obstetrics and Gynaecology at Odense University Hospital
and is an associate professor at the University of Southern Denmark. The latter university prioritizes research
in reproductive health in low- and middle-income countries and hosts the Centre for Innovative Medical
Technology, the leading institution for the development of mHealth strategies.
Maternity Foundation • Sortedam Dossering 81 • DK-2100 Copenhagen • [email protected] • www.maternity.dk
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