In the ninth year since it was launched in 2014 by the Department of Health, in partnership with Reach Digital Health, MomConnect is a groundbreaking digital health initiative aimed at providing pregnant women with prenatal, during and post-natal information as well as prioritising maternal and child health using mobile phones.
MomConnect now offers users an accurate, accessible symptom-checking service. Provided by Ada Health, the technology will further enable women and mothers to better understand their healthcare needs and care options, and has the potential to reach as many as one million active MomConnect users across South Africa, with wider integration possibilities in South Africa and other countries.
According to a World Health Organisation (WHO) report, a woman dies every two minutes due to pregnancy or childbirth, and around 70% of all maternal deaths are in sub-Saharan Africa.1 The same report found that women aged 15 and above in low-income countries have a 1 in 49 chance of dying from maternal causes versus high-income countries where the chance is 1 in 5,300. According to the CDC, most causes of maternal death are preventable, so recognising warning signs and ensuring access to timely, quality care can save lives.2
South African health systems are overburdened and dealing with a critical shortage of healthcare workers in hospitals, with a ratio of 0.8 doctors to every 1,000 patients in 2022 3, compounding the fallout from the Covid-19 pandemic. A recent study found that technology could be key to better health outcomes for maternal care by relieving the burden on healthcare systems and improving health equity and accessibility in low-and-lower-middle income countries.4
Integrating Ada’s AI-powered symptom assessment technology into the existing MomConnect platform 5 will further help to address these issues. MomConnect users can now better understand their symptoms by answering a series of questions based on validated AI protocols in the system, and based on their responses, will be navigated to appropriate and available human-centred services and support.
Ada’s medical knowledge covers an industry-leading range of symptoms and conditions, while the platform itself highly prioritises user safety and accuracy and is designed to be as inclusive as possible. The new service can be accessed by users via the MomConnect HelpDesk available on WhatsApp, a first-of-type integration for Ada.
A preliminary evaluation with almost 1,000 MomConnect users from across South Africa 6 showed that 99.94% of respondents knew what to do about their health query one week after using Ada. Over 50% of those who received treatment were not planning to seek care before using the service and subsequently changed their care-seeking decision after completing an assessment. It also shows that Ada’s assessment effectively guides participants to potentially life-saving care. Of those directed to emergency care following an Ada assessment, 55% of mothers that ended up in emergency care were not intending to do so prior to an assessment. The evaluation found that 96% of users considered it easy or very easy to check their symptoms, and 98% considered the medical information provided by Ada useful.
Users involved in the evaluation identified that Ada had helped them understand and take appropriate action on a wide range of health issues, including newly detected cases of hypertension and infections, both highlighted by the WHO as among the main causes of maternal mortality7, as well as meningitis, miscarriage, urinary tract infection (UTI), vitamin deficiency, postnatal depression, fever, allergy, intrauterine growth restriction (IUGR) and labour. The majority of mothers seeking care after using Ada received treatment in the form of new medication, hospital admission, or even surgery. In these scenarios, care journeys with better awareness and earlier intervention can significantly improve maternal and child health outcomes.
One MomConnect user commented that the Ada symptom-checker had helped her to understand her health and seek care, saying she was diagnosed with “high blood pressure that almost lead to the decision of C-section at 7 months (premature) luckily, I seek help before it late, thanks to mom connect and symptoms checker [sic]”.
To ensure equity and accessibility, Ada’s symptom assessment language capabilities have been tailored to support how South Africans describe their symptoms, and the reading level of Ada’s medical knowledge adapted to support lower literacy users without compromising accuracy. Ada’s condition models and AI reasoning engine have also been optimised to enable more accurate assessments of the most common maternal and paediatric symptoms and conditions in the region. Thanks to its mobile accessibility and ease of use, the initiative has seen particularly strong usage in rural areas with very low access to care, such as Limpopo, and uptake in areas of significantly higher maternal mortality rates such as the Free State.
From its modest beginnings as a text-only service, MomConnect has continued to evolve to meet the needs of its users. Today, in addition to MomConnect’s invaluable SMS messaging service, it has a seamless integration with popular messaging service WhatsApp which significantly expanded its reach, allowing the programme to provide even more comprehensive and accessible real-time support for pregnant women throughout their journey to motherhood.
The new integration of Ada, partially funded by The Rockefeller Foundation as part of its Precision Public Health strategy, will further accelerate the uptake of proven healthcare interventions, which mothers learn about, contributing to their positive health journey.
Debbie Rogers, CEO of Reach Digital Health: “The need to provide accessible, regular, and accurate healthcare guidance at a time when mothers and children need it most has never been more urgent. Integrating Ada’s intelligent health technology with the MomConnect mobile platform has the potential to build on the South African National Department Of Health’s aims of providing more equitable care and improving the health outcomes in the region.”
Hila Azadzoy, managing director of Ada’s Global Health Initiative: “Technology has the power to improve maternal health outcomes by improving access to relevant advice for new and expectant mothers while bolstering existing health systems by alleviating pressure on health services. Ada’s AI-powered symptom assessment platform has been adapted to local linguistic, cultural, and healthcare requirements to make it accessible to as many individuals as possible, and we’re pleased to be able to rapidly deploy this new service through our collaboration with Reach Digital Health and The Rockefeller Foundation.”
Naveen Rao, MD, senior vice president of health at The Rockefeller Foundation: “Safeguarding the health and well-being of women and children should always be prioritised, and even more so during a health crisis. Technology offers us an opportunity to reach the most vulnerable with essential health services, and The Rockefeller Foundation is proud to support Ada and Reach Digital Health’s innovative approach to making this a reality in South Africa.”
References
1. www.who.int/news/item/23-02-2023-a-woman-dies-every-two-minutes-due-to-pregnancy
-or-childbirth--un-agencies
2. https://www.cdc.gov/hearher/pregnancy-related-deaths/index.html
3. www.iol.co.za/mercury/news/shortage-of-healthcare-workers-threatening-sas-health-syst
em-ab02f296-8b8d-4857-8b5a-871e701ef955
4. www.nibib.nih.gov/virtual-workshop-technology-to-improve-maternal-health/summary-wo
rkshop-discussion
5. www.health.gov.za/momconnect/
6. Preliminary findings from the ‘SAFEMOM’ Monitoring & Evaluation study (2023)
conducted by researchers from Ada Health and Reach Digital (formerly Praekelt.org)
together with local research agencies and an independent panel of physicians.
7. www.who.int/news-room/fact-sheets/detail/maternal-mortality
