Frequently asked questions
What is The Safe Delivery App?
The Safe Delivery App is a smartphone application that provides skilled birth attendants with instant access to clinical guidelines on Basic Emergency Obstetric and Neonatal Care (BEmONC). The App leverages the growing ubiquity of mobile phones to provide life-saving information and guidance. With the support of MSD for Mothers and the Bill & Melinda Gates Foundation, the App was developed and validated in a co-operation between Maternity Foundation and leading experts within mHealth from the Universities of Copenhagen and Southern Denmark. The impact is continuously documented on a global scale.
Who developed the Safe Delivery App?
The App is developed by Maternity Foundation, University of Southern Denmark and University of Copenhagen. It is produced by Visikon.
What is Maternity Foundation?
Maternity Foundation is a Danish development organization that aims to reduce maternal and newborn mortality in developing countries. With the vision ‘No woman should die giving life’, Maternity Foundation works to empower and mobilize women to seek care, to build capacity of and train health practitioners to ensure that more women give birth with skilled birth attendance. In our own Maternal and Newborn Health Program in Ethiopia, we work with local partners in the capacity building of health care workers and empowering the community to seek care.
Maternity Foundation has established itself as a recognized player in the mobile health field with innovative solutions such as The Safe Delivery App and a SMS service (LUCY) for pregnant women in Ethiopia.
The Safe Delivery App
What does the App contain?
The App is based on the most recent WHO clinical guidelines on Basic Emergency Obstetric and Neonatal Care (2016) and features 10 clinical modules featured in animated instruction videos, action cards, drug list, practical procedures, and an intuitive learning module “My Learning” which is currently under development.
How can I use the App?
The App can be used to train and instruct skilled birth attendants in Basic Emergency Obstetric and Neonatal Care. It can be used in pre-service, in-service trainings, and as an in-practice job aid. The App is not a stand-alone tool, but can be used as part of programs to strengthen and support maternal and newborn health interventions. However, the opportunities for applying the App are many and cross-cutting in the continuum of training from pre-service to in-service.
How can I get the App?
App Store: The App can be downloaded for iPhones and iPads.
Google Play: The App can be downloaded for devices using Android.
Find link to downloads here.
How much does the App cost?
The App is free for download.
Costs will naturally occur related to implementation such as trainings and/or administration similar to other project implementations.
Does the App work without Internet?
Yes. It is not a requirement to have internet connection to view the videos and other features of the App once it has been downloaded. In other words, internet is only needed upon download.
Can I download the App without Internet?
Yes. In settings with no or weak internet connectivity the App can be pre-installed to the devices by downloading it as an APK file and transferred from a computer directly to the phone/tablet or via Bluetooth between two phones. However, you will need internet for the initial download. Contact the mHealth Competency Center for more information and support.
Do I need to turn on the GPS?
Maternity Foundation collects data on the App’s usage. This helps us achieve knowledge about user patterns to improve the App according to user needs. We therefor ask everybody using the App to kindly share their GPS location.
Where is the App currently being used?
The App is currently used in more than 40 countries and rolled-out in partnership with Ministries of Health, UN agencies, professional organizations and non-governmental organizations with focus on low- and middle-income countries. Maternity Foundation’s mHealth Competency Center based in Copenhagen supports partners with implementation tools and resources, adaptive learning methods and trainings. The Competency Center consolidates and disseminates learnings and results across the different implementation settings and contexts. See more in Cases and Results.
In which languages is the App currently available?
The App is currently available for Ethiopia (English and Oromiffa), Lao PDR (Lao), India (Hindi), South Africa (English), French and Tanzania (English). Translations for Myanmar (Burmese), Bangladesh (Bengali) and a thorough update of the French version are underway.
What content does the App cover?
The App covers basic emergency obstetric and newborn care (BEmONC) which is defined as seven essential medical interventions, or ‘signal functions,’ that prevent and treat the major causes of maternal and newborn morbidity and mortality. In addition, the App covers related subjects of infection prevention, active management of third stage of labour, and newborn management.
The 10 clinical themes including the 7 BEmONC signal functions covered in the App are:
- Infection Prevention
- Post Abortion Care (Removal of retained products of conception)
- Hypertension (Anticonvulsants for treatment of eclampsia and preeclampsia)
- Active Management of Third Stage of Labour
- Prolonged Labour (Assisted or instrumental vaginal delivery)
- Post Partum Haemorrhage (Uterotonic drugs (e.g. oxytocin) administered for postpartum hemorrhage)
- Manual Removal of Placenta
- Maternal Sepsis (Antibiotics to prevent puerperal infection)
- Neonatal Resuscitation (Neonatal resuscitation with bag and mask)
- Newborn Management
Who reviewed the content of the App?
The App was reviewed by a panel of leading, international experts within maternal and neonatal health and mHealth, and has undergone a systematic clinical review process in 2016 for a global update based on the newest WHO guidelines.
Is it possible to add new content to the App?
No, not as a starting point. As Basic Emergency Obstetric and Neonatal Care is a specific set of medical interventions based on global guidelines, Maternity Foundation and the university partners will maintain this focus. This way, we ensure that skilled birth attendants can quickly navigate in the App’s features and access in emergency situations. However, Maternity Foundation has developed an animated instructive film on Female Genital Mutilation (FGM) which is available in English and can be added to the App.
Can the App be adapted to my context?
Maternity Foundation collaborates with organizations and Ministries with resources to translate and adapt the App into local languages and country versions.
The most recent WHO content alignment is crucial to the integrity of our App and to setting a high standard of care for women. Nevertheless, we recognize that causes of maternal and neonatal mortality and thus that protocols and treatments vary from setting to setting. Maternity Foundation is therefore willing to discuss with ministries and departments of health how to make our content relevant and impactful for specific settings and in-line with national protocols.
How can I partner with Maternity Foundation?
A partnership can take many forms depending on specific setting, feasibility and local needs. We partner with organizations, departments and ministries in several different ways e.g. as remote support, training facilitator or implementing partner. Please contact our Competency Center to know more about how we can support your organization in the implementation of the App in your region.
Can I use the videos only in my training?
We believe that there are many elements of the App that are useful to incorporate into Basic Emergency Obstetric and Neonatal Care training, depending on your need and setting. We are happy to provide examples and think through this with you. However, if you decide you want to use the videos only, we are open to dialogue with you about this and are open to providing them depending on the circumstances and with clear understanding of copy right and usage agreements.
Can I co-brand the App?
We do not permit logos of partners to be displayed in the App. The only branding currently is in the “About” button, to recognize the work of those who developed the App. We want to keep the App non-branded so it is universally applicable and accessible to all who use it; potential exceptions are in the case of the national ministry of health for national scale-up.
Does Maternity Foundation provide smartphones?
Maternity Foundation does not purchase and/or provide smartphones for organizations. This must be planned and budgeted for by the implementing partner designed for the specific project.
Does Maternity Foundation provide funding for implementation and/or research?
Implementing the App is and should be low cost. The App is free for download, and as long as the relevant technical infrastructure is in place – either the skilled birth attendants have their own smart phone or tablet or the clinic/program provides a smart phone or tablet – costs for use and implementation are low.
The Competency Center provides support to partners in the form of training resources and staff time. We do not have the ability in most cases to provide funding or technical hardware.
However, the Competency Center may dialogue with partners on applying to co-funding, and prioritizes utilizing any funding that may be available for use in high-impact implementations of the App at nationally led scale.
Research and Monitoring & Evaluation
Is there evidence that the App has impact?
Yes. With the support of MSD for Mothers, four films of the App (Active Management of Third Stage Labor, Post Partum Hemorrhage, Manual Removal of Placenta, and Neonatal Resuscitation) were tested in a one-year randomized controlled trial in 78 facilities in Ethiopia in 2014 to assess the impact on health workers’ life-saving skills and knowledge. Key results revealed a significant increase in the skills and knowledge level of the health workers using App, e.g.: at 12 months health workers ability to handle post-partum hemorrhage (PPH) and to resuscitate a newborn (NR) more than doubled. Read the research paper at JAMA Pediatrics.
Can the Competency Center assist in M&E and data collection?
Yes. Maternity Foundation believes that to achieve impact, reach scale and sustainability with the App, we must work in close collaboration with countries, partners from all sectors and the wider development community. Therefore, we are naturally keen on sharing Global Learning on the use of the App with potential partners and support implementation research.
Maternity Foundation’s Competency Center, based in Copenhagen, supports implementing organizations to help ensure scalable, impactful and sustainable implementation of the App in their respective project and/or countries. The implementation research conducted and data from the usage of the App is compiled and analyzed by the Competency Center. This information is leveraged to create a knowledge bank of implementation best practices that serves as the foundation of the services and support provided.
Moreover, the Competency Center has developed an M&E framework with a wide range of quantitative and qualitative methodological approaches to assess the impact of the App in a specific setting. We are happy to share these resources with partners and interested parties.
Does the Competency Center collect data from the App and can I access it?
Yes. To assess the health workers’ progress, the App contains two testing modules. One tests the health workers’ confidence level before and after using the App, and another tests the health worker’s level of knowledge. Furthermore, the use of the App and its different functions are tracked and combined with GPS coordinates so it is possible to track the use of the App wherever in the world it is located. The Competency Center monitors usage data and can offer partners a consolidation of reports.
How does the Competency Center collect qualitative and quantitative data?
The Competency Center conducts a knowledge assessment in form of a questionnaire at baseline and at follow-up which is based on clinical case scenarios. Skills assessment in form of Objective Structured Assessment of Technical Skills (OSATS) is available upon request. The OSATS gives health workers scenarios they are then asked to manage in form of a role-play to show what they would do in the actual clinical situation, using what they find available during the assessment. The OSATS, however, is only conducted in projects where time and resources are allocated for this.
Furthermore, the Competency Center has formulated different data collection and method guides such as interviews and focus groups on usage, perception and integration and level of acceptance of the App with health care workers; interviews of if the App was used during delivery (from clients). These resources can be shared with partners and interested parties.