In this dynamic realm of health care innovation, our health landscape is being reshaped by a multitude of digital interventions. From registers to health surveillance systems, from telehealth solutions to mobile applications, these innovations are revolutionizing how we approach reproductive maternal, newborn, and child health. They offer us a profound opportunity to enhance access to care, optimize utilization and post our coordination among diverse healthcare providers. Yet, as we navigate this exciting transformation, it's important to recognize the complexity that lies ahead, especially in low and middle income countries where challenges emerged in designing digital health technologies tailored to the unique context of each community.
To discuss this topic further, EMPHNET held a webinar titled “Digital Health for Reproductive, Maternal, and Child Health” on Tuesday, August 15, 2023 as part of its WEBi Series.
The 90-minute session was conducted by five subject experts in the field namely: the Director of the Institute of Community and Public Health at Birzeit University, Dr. Maysa Nemer, the Associate Professor in Global Health at Karolinska Institute, Prof. Ziad El-Khatib, the Professor at the Department of Health Management and Policy in the Faculty of Medicine at Jordan University of Science and Technology (JUST), Prof. Mohammad Alyahya, the Research Specialist at EMPHNET, Dr. Mirwais Amiri, and the Policy Officer at Privacy International, Ms. Sarah Simms. Furthermore, the session was moderated by the Director of the Center of Excellence for Applied Epidemiology at EMPHNET, Prof. Yousef Khader.
In her presentation titled “The State of Digital Health for Reproduction, Maternal, and Child Health in Palestine: Exploring the Issue Around Governance, Maturity, Privacy, and Human Rights”, Dr. Maysa Nemer expressed gratitude for the opportunity of setting the stage to discuss the state of digital health in productive maternal and child health in Palestine. Furthermore, she highlighted the collaborative research project that brought together Birzeit University, Jordan University of Science and Technology, Privacy International, the University of Oslo, and the International Development Research Center (IDRC).
Within this context, Dr. Maysa acknowledged the global acceleration of digital technology in healthcare, specifically emphasizing its application in maternal and child health services. She elaborated on interventions like health surveillance systems, telehealth, and mobile applications.
Emphasizing the gradual transformation of Palestine's healthcare system into a digitalized model, she proceeded to delve into various digital initiatives meticulously designed to elevate healthcare access and delivery. This comprehensive approach encompassed health information systems, registries, health surveillance, and mobile applications such as Nabdh Al Hayat (نبض الحياة) and e-MCH applications. Furthermore, Dr. Maysa elaborated on the imperative for a robust regulatory framework, a pressing need accompanying the burgeoning rise of digital health initiatives. This regulatory emphasis pertained particularly to safeguarding the privacy and security of personal data, an essential prerequisite for effectively realizing their potential.
Her presentation underscored the development of a maternity assessment tool as a means to gauge the progress of digital personal data initiatives within reproductive maternal and child services. This tool evaluated various dimensions, including digital maturity, governance, privacy, gender, and human rights.
To conclude her presentation, Dr. Maysa pointed out that despite advancements, notable challenges persisted. These challenges ranged from limited resources and infrastructure constraints to privacy and security concerns, compounded by cultural factors. She highlighted the paramount significance of addressing gender equality and human rights within digital health initiatives, and she emphasized the necessity for comprehensive policies, active stakeholder engagement, and robust governance structures to ensure their efficacious implementation and sustainable continuity.
In his presentation titled “Overview on the Digitilization of Children Immunization- The Children Immunization App (CIMA)”, Prof. Ziad El-Khatib highlighted the need to resume routine immunization activities after the disruptions caused by the pandemic, while also underscoring the cost-effectiveness of immunization programs. Dr. El-Khatib acknowledged the profound life transition of becoming a parent, a journey that spans from pregnancy to childbirth. Building on these concerns, the Children Immunization App emerged. The App aims to educate parents about the significance of vaccines, and it offers timely vaccination schedule reminders, thus replacing the traditional handwritten yellow card that often confuses parents with its symbols. Intriguingly, the App was created using a multi-faceted approach. It addresses misinformation, especially prevalent during the pandemic, that create challenges for parents to distinguish between truth from falsehood. The Children Immunization App offers a comprehensive solution to these challenges.
He stated that the App's impact is far-reaching. It effectively educates parents and enhances vaccination awareness. The CIMA App ventured into real-world testing, initially in the Zaatari refugee camp. It has expanded its reach to Rwanda, Japan, and Cameroon, offering clinics a dynamic platform for programmatic vaccination monitoring. He further explained that the CIMA App has emerged as an innovative means to empower clinics. By offering an overview of vaccination trends, identifying defaulters, and even presenting geographical vaccination maps, it is set to revolutionize immunization tracking. An automated SMS feature ensures that parents, regardless of their device, receive timely reminders and cyclical health education messages, further enhancing its holistic impact. He further added that this App's influence spans nurse and health worker training, offering updated insights and enhancing vaccine understanding. Empowering clinics through visual insights, the App tracks vaccination trends and defaulters, fostering informed choices. Driven by a participatory framework, the App's collaborative development builds trust, exemplified by successful partnerships in Jordan and Cameroon.
Prof. Mohammad Al-Yahya's presentation titled “Jordan Stillbirths and Neonatal Deaths Surveillance System”, unveiled an innovative system, strategically aimed at measuring and addressing the burden of perinatal mortality. This comprehensive platform seamlessly integrates data collection, mortality rate adjustments, and a meticulous exploration of causative factors. Notably, the system's profound value surfaces in its capacity to judiciously allocate health resources, prioritize immediate interventions, and propel research endeavors. In the exposition, Prof. Al-Yahya explained that the distinct features of the system were unveiled, with a strong focus on its ability to amass individual-level data, thereby offering profound insights into the trajectory of mortality patterns. He stated that what sets this system apart is its method of employing registered births as denominators. This inherently bolsters the precision of crude mortality rates.
Impressively, the practical application of this system within Jordan's principal healthcare institutions showcased its seamless integration, allowing medical practitioners to input data, attribute causes of death, and seamlessly navigate through an array of pertinent indicators. With the aid of a dedicated website and a user-centric interface, the system's adoption was rendered even more streamlined. Intriguingly, the matrix component emerged as a standout feature, aiding in the identification of preventable deaths while simultaneously suggesting targeted interventions. An evaluation conducted by healthcare professionals resoundingly affirmed the system's efficacy, its transparency, user-friendliness, and stringent privacy provisions.
In a resonating conclusion, Prof. Al-Yahya presented the system's potential for expansion, foreseeing its application to maternal mortality and morbidity data. This holistic vision underlines its cost-effectiveness and positive contribution to the landscape of healthcare reporting, firmly positioning it as a transformative force in healthcare intervention strategies.
In an informative presentation titled “The Harmonized Reproductive Health Registry (hRHR) to Improve Maternal and Child Health: Jordan’s Experience”, Dr. Mirwais Amiri introduced the Harmonized Reproductive Health Registry (hRHR) initiative, a collaborative effort funded by IDRC, aimed at enhancing maternal and child health in Jordan. The project addressed the challenge of data fragmentation by streamlining data collection techniques to improve health outcomes. The background highlighted the lack of harmonization among various data platforms, leading to resource wastage and hindered collaboration. Dr. Amiri further stated the transformational potential of transitioning from paper-based data collection to electronic systems, pinpointing the challenges of staff familiarity and the need for capacity development. The implementation phase of this project encompassed coordination strengthening, platform establishment, and gender integration into indicators. Notably, the project was successfully piloted in Mafraq, North of Jordan, a strategically chosen region due to its population size and diverse healthcare needs. The midpoint and endpoint evaluations confirmed the project's positive outcomes, influencing the Technical Steering Committee's recommendation for hRHR ‘s expansion across different regions. Dr. Amiri also revealed plans for publishing evidence and scaling up the project, with IDRC's continued support playing a pivotal role. This initiative signifies a crucial step toward a more efficient and effective healthcare system in Jordan.
In a thought-provoking presentation titled “Data and Technology in Reproductive Healthcare: Exploring the Privacy and Human Rights Implications”, Ms. Sarah Simms discussed Privacy International's perspective on digital health and its intersection with human rights, particularly in the realm of reproductive rights. As an NGO headquartered in London, Privacy International collaborates globally to advocate for legal and technological measures safeguarding people's data against exploitation. Ms. Simms explained the rapid rise of digital health systems and their potential impact on human rights, emphasizing the implications beyond mere data protection compliance. The ongoing COVID-19 pandemic accelerated the deployment of digital health technologies, uncovering complexities related to privacy, security, dignity, and discrimination. These transformations, while beneficial, can also manifest as vehicles for power imbalance and control, spanning surveillance to market dominance. The integration of human rights principles, such as participation, non-discrimination, transparency, and accountability, was proposed as a necessary framework for assessing digital health initiatives comprehensively.
Ms. Simms shared Privacy International's research findings, focusing on menstrual tracking Apps like Maya. These Apps, though designed for health management, often exhibited data sharing practices that compromised privacy and consent. Following Privacy International's advocacy, significant improvements were observed in App policies and practices, impacting millions of users positively. The presentation concluded by advocating for human rights-based due diligence throughout the lifecycle of digital health initiatives, including rigorous impact assessments, accountability mechanisms for both governments and the private sector, accessible grievance procedures, and heightened awareness within the health sector. This comprehensive approach is envisioned as essential for a balanced and equitable integration of digital health technologies within the framework of human rights.
Following the presentations, Prof. Yousef Khader facilitated the Q&A session, where participants and panelists engaged in the discussion. He then concluded the session by thanking the speakers and the attendees for their participation.
A total of 167 participants attended the webinar, deeming it another success in the EMPHNET WEBi Series.