Closing the Capacity Gap in Saving Lives at Birth

While the rate of infant and maternal mortality from preventable causes has continued to decline over the last several years, the current statistics are still mind-numbing. In Africa alone, around quarter of a million women die every year due to preventable pregnancy related causes. The number of children dying due to stillbirth, infection or asphyxia soon after birth is even higher. So while the change in the positive direction is coming, it is unacceptably slow. Chief among the challenges in reducing maternal and infant mortality is the lack of competent local and technical capacity for health care delivery and scale up of best practices.

For a moment, now let us shift our attention from these sobering statistics to something more positive. Over the last five years, online education and collaborative e-learning have started to reshape higher education landscape around the globe. With the success of Khan Academy and collaborative ventures (like EdX) coming out of prestigious academic institutions, high quality education can now reach the most distant corners of the world. Enrollment for online courses routinely reaches a hundred thousand or more per course. This positive change is not only welcoming because it allows traditional and non-traditional students to take high-quality courses, it also enables a truly global learning. It is now possible for a nurse in rural Cambodia to take a course from a lecturer in Cambridge and a farmer's daughter in Botswana can now learn from a Professor in Berkeley.

So what does this have to do with saving lives of mothers and babies? Well, I would argue that one of the biggest bottlenecks in meeting on-the-ground challenges in saving lives at birth is the lack of competent and qualified individuals who are capable of providing onsite care. The logistical and financial challenges in training and building capacity can often be prohibitive. While there have been some efforts to use videos for training and for public service messages, a set of interactive, coherent, and rigorous courses for building local technical capacity have been lacking.

So how do we close the technical capacity gap in saving moms and babies using e-learning? For that we have to look at existing resources and opportunities. A key resource available in the developing world is a cell phone that has already become a vital tool in providing healthcare through mHealth endeavors. That said, online education and collaborative learning approaches in building technical capacity to save lives at birth are a relatively new concept. With cell phone coverage and use growing at an exponential rate in all parts of the world, including Africa, there is a tremendous opportunity for institutions to create platforms, programs and solutions that will allow the front-line health workers to be trained in best practices for maternal and child health.

It is important to note that to date, online education consortia have focused largely on higher education and have provided little technical training in the context of public health. However, I believe that providing rigorous certificate courses through interactive online learning and using appropriate and necessary quality control mechanisms will make a tremendous impact in training quality health workers.

I am cognizant of the many challenges that face us on this road. Quality control and context appropriate content are important issues that cannot be overlooked. However, these challenges can be addressed through a global partnership of technical experts, public health professionals and experienced on the ground staff.

E-learning mechanisms will also be instrumental in meeting one of the biggest challenges in healthcare delivery: scale-up of delivery and sharing of best practices. Peer-to-peer and collaborative learning, as well as continuous access to archival videos and text based training will reduce the barriers to scaling and will create an automatic and continuously improving process. A repository of best practices will allow quicker adoption and adaptation. In addition, I believe that these mechanisms will create a more integrated global public health community, create better assessment tools and above all foster innovation, locally and globally.

Finally, I strongly believe that these approaches, interfaced with community based efforts will engage and inspire the youth to create new and exciting platforms for innovation, bring together local institutions of higher learning and create a strong sense of community empowerment.

I have always believed that all game changing solutions are inherently multidisciplinary. Learning from higher education, using the tools of information technology and applying them to public health may prove to be the most potent of solutions to permanently end preventable maternal and child mortality.