BLOG: From Ethiopia to Everywhere – How an Evidence-Based App Tested in Ethiopia is Now Empowering Midwives Worldwide
By Mahtot Leykun Sisay
In my work at the intersection of global health and digital innovation, I’ve seen how geography can profoundly shape — and often limit — access to care and, ultimately, health outcomes. In many fragile or remote regions, midwives are too often left without the support or training they need to ensure safe deliveries for both mothers and newborns.
I joined Maternity Foundation because I believe in the transformative power of technology to rewrite the story of maternal health — and the need remains urgent. According to the latest UN report Trends in Maternal Mortality 2000-2023, a woman dies every two minutes from causes related to pregnancy or birth. For every death, another 20 to 30 women suffer birth injuries, infections or disabilities. Most of these outcomes are preventable — with access to quality care.
What I deeply admire about Maternity Foundation is how they’ve built and scaled up a digital tool that supports midwives in delivering safer births — even in low-resource settings where internet connectivity is limited.
The Birth of a Digital Lifeline
In 2015, Maternity Foundation, in collaboration with the Universities of Copenhagen and Southern Denmark, launched the Safe Delivery App — a mobile application offering clear, practical guidance and video instructions on how to deliver high-quality preventive, routine, and emergency care. Free of charge and functional offline once downloaded, the app puts life-saving knowledge directly into the hands of midwives and frontline health professionals — exactly when and where it’s needed most.
Since its launch, the Safe Delivery App has been used in over 60 low- and middle-income countries. Combined with the broader Safe Delivery+ programme, it has reached more than 455,000 healthcare professionals to date — advancing midwifery and improving maternal outcomes worldwide.
As a data and tech analyst, I’ve been especially inspired by the rigorous journey the Safe Delivery App has taken — from a local pilot to a global platform — and how data has been central to every step of that journey.
From Local Pilot to Global Platform
From the beginning, the creators of the Safe Delivery App were determined to evaluate it as rigorously as any medicine or vaccine. That’s why they launched a cluster randomized controlled trial (RCT) — the gold standard in medical research.
The first RCT study took place in five rural districts of West Wollega, Ethiopia. Some healthcare professionals used the Safe Delivery App, while others continued with standard care. The goal: determine whether the app could reduce perinatal deaths and improve knowledge and hands-on skills, especially for life-saving procedures.
The results were powerful. Across 73 health facilities, 176 healthcare professionals were trained and assessed on their management of two critical childbirth emergencies: postpartum hemorrhage (PPH) and neonatal resuscitation. The findings? Health care professionals who used the app demonstrated stronger skills, sharper knowledge, and greater confidence—and these improvements lasted for at least 12 months after adoption.
What began as a research study became the foundation for global scale-up. With clear evidence of impact, the Safe Delivery App earned the trust of national and international partners, as well as key donors.
Growing a Global Evidence Base
Since that first trial in Ethiopia, the evidence base has grown rapidly on impact of the Safe Delivery App and the accompanying training programme. By 2025, across 29 projects in 17 countries, monitoring showed measurable impact:
- 27% increase in knowledge
- 68% increase in skills
- 23% increase in confidence
On top of that, digital monitoring shows that the completion rate of the app’s MyLearning platform stands at 21.7% — one of the highest among free, open-access medical learning tools globally. Looking at retention, users stay engaged for an impressive 167 days on average, far exceeding most educational apps.
What’s Next for the Safe Delivery App?
The Safe Delivery App has already proven its impact — and its potential is only growing. Maternity Foundation is embedding the app into national education systems and integrating it into humanitarian and development projects worldwide together with partners.
The organisation is also exploring new frontiers:
- Piloting an AI-powered smartbot to offer faster support to midwives in real time
- Continuing to expand language options
- Adding additional modules focusing on preventive services, including: Perinatal mental health, Modern contraception, and Antenatal and postnatal care.
Proud to Be Part of the Journey
I’m proud to have joined Maternity Foundation and to support the continued evolution of the Safe Delivery App — expanding its features, its reach, and its impact. My role is to help ensure we keep measuring, learning, and improving every step of the way.
Ultimately, I hope my work can contribute to accelerating global efforts to reduce maternal mortality and morbidity — because every mother deserves a safe birth, and every midwife deserves the tools and knowledge to make that possible.
Explore the full library of impact studies and evidence behind the Safe Delivery App and programme here.
