BLOG: Empowering healthcare professionals to detect gestational diabetes in India through the Safe Delivery+ approach
By Julie Strøyer Rasmussen, Head of Programme Development and Support; Dr. Bhaskar Sen, Programme Officer-GDM and Disha Agarwalla Monitoring and Evaluation Manager
For millions of women in rural India, pregnancy brings more than the anticipation of motherhood. It also comes with significant challenges in accessing essential healthcare in their communities, and travels to hospitals further way can be daunting in remote villages, where public transport is few and far between.
As a result, many pregnant women miss out on important screenings, including those for gestational diabetes mellitus (GDM), a condition that can have serious consequences if left undiagnosed and untreated.
As part of a World Diabetes Foundation-funded project, led by the Maternity Foundation in collaboration with the Government of India, healthcare professionals in Madhya Pradesh are now being empowered with the essential knowledge and confidence to effectively manage GDM at district and village level. Additionally, the project aims to strengthen supply chain management and ensure that GDM screening and care become part of routine maternal care.
Such projects are crucial, as uncontrolled GDM can result in significant complications for both mother and baby. It heightens the risk of pregnancy complications, premature birth, and delivery-related issues. Additionally, both mother and child face an elevated risk of developing type 2 diabetes later in life.
Each year, GDM affects approximately four million live births in India (Sahu et al., 2021). The country introduced universal screening for GDM in 2014 as part of its national guidelines. However, implementation remains inconsistent due to a shortage of trained healthcare professionals, supply chain gaps, and limited awareness at the community level. Strengthening the integration of GDM screening, diagnosis, and treatment into routine antenatal care is vital to improving maternal and newborn health outcomes.
Leveraging technology for better maternal care
A central component of the project aimed at improving GDM care in Madhya Pradesh is the Maternity Foundation’s digital tool, the Safe Delivery App. Originally designed to assist nurses and midwives in managing birth and responding to complications, the Safe Delivery App has expanded its scope to include a preventative approach, with a dedicated module on gestational diabetes.
Tailored to the Indian context and aligned with the latest Government of India guidelines, the App works offline once downloaded and offers learning resources in multiple languages. These include videos, step-by-step instructions, practical procedures, drug lists, and action cards—making it highly accessible and practical for use in rural and low-connectivity settings.
One nurse-midwife shared her experience:
“I find it very easy to learn new concepts using the App’s audio-visual format. The videos are in Hindi, and the App is simple to navigate. I can revisit the lessons and take self-tests to ensure I understand everything correctly.”
Stories like these highlight how digital tools are reshaping maternal healthcare in India. So far, 150,000 healthcare professionals have used the App in India and the GDM module is for now available in Hindi and English.
Beyond serving as a job aid and tool for professional learning and training, the Safe Delivery App is being utilised in innovative ways to educate pregnant women who may be at risk of or diagnosed with GDM. Healthcare professionals play instructional videos while women wait for their Oral Glucose Tolerance Test (OGTT) results, providing them with important information on medical nutrition therapy and self-care. This not only empowers expectant mothers with vital knowledge about GDM but also encourages them to stay at the health centre until their test results are ready, ensuring timely diagnosis and follow-up care.
Combining technology with training
In combination with the new app module on GDM, Maternity Foundation conducts targeted training sessions in selected aspirational districts of Madhya Pradesh to ensure that healthcare professionals have the skills needed to screen, diagnose, and manage GDM effectively. The training also highlights the importance of postnatal follow-up and ongoing care, improving long-term health outcomes for both mothers and babies.
Using a training-of-trainers approach, Maternity Foundation has built the capacity of 67 trainers across two aspirational districts in Madhya Pradesh. These trainers are now equipping healthcare professionals with essential GDM screening and management skills, reaching 719 healthcare professionals to date. During the training sessions, participants are introduced to the Safe Delivery App, which they actively use in training and are encouraged to adopt as a self-learning tool beyond the sessions.
Improving GDM care at the local level
The project is already making a difference in improving the quality of GDM services in underserved districts.
A visit to a Village Health and Nutrition Day in Tendukera, Damoh district, highlighted the positive impact of decentralising antenatal care services. Pregnant women expressed relief at being able to receive OGTT testing and antenatal services close to home.
One expectant mother, in her second pregnancy, recalled the difficulties of travelling to a district hospital for diabetes testing during her first pregnancy:
“This time, I could get the test done right here in my village, without the stress of a long journey.”
At a Sub health centre (HWC-AAM) in Sailbara, Damoh trained healthcare professionals demonstrated confidence in conducting GDM testing and using the Safe Delivery App. Their improved ability to diagnose and manage GDM is already leading to better patient outcomes by ensuring that no woman is left without the care she needs.
Join the Conversation
How do you see technology transforming maternal healthcare in underserved communities? Have you encountered digital tools that are improving healthcare delivery? What are your thoughts on how to provide quality GDM care to women in remote and fragile areas? Share your experiences with us at mail@maternity.dk
To learn more about the Safe Delivery App and its impact, visit www.safedelivery.org.
