Maternal health technology encompasses tools and techniques used to improve maternal health outcomes, particularly during pregnancy, delivery, and postpartum period. Technology adoption and implementation has been uneven, with access stratified by geography and wealth.
Prenatal ultrasound represents important technology for identifying complications and monitoring fetal development. Ultrasound can detect fetal abnormalities, assess placental position, estimate gestational age, and identify multiple pregnancies. However, ultrasound availability is limited to urban centers and wealthier private facilities. Rural areas often lack ultrasound, forcing pregnant women with suspected complications to travel to urban centers for imaging.
Fetal monitoring during labor using cardiotocography (CTG) detects fetal distress, allowing timely intervention to prevent perinatal death. However, CTG machines are expensive and require trained operators. Most government facilities in rural areas lack CTG, limiting ability to detect and respond to fetal compromise.
Partograph, a simple paper-based tool for monitoring labor progress, is low-cost but requires training and discipline to use correctly. Implementation in government facilities has been inconsistent; some facilities use partograph routinely while others do not, creating variable quality of labor management.
Blood pressure monitoring technology for detecting preeclampsia (a dangerous complication) should be standard, but automated BP monitors are often non-functional or unavailable in resource-limited facilities. Manual BP monitoring is possible but inconsistently performed.
Testing for gestational diabetes requires blood glucose testing capacity. Many rural antenatal clinics lack testing capability, missing opportunity for identifying and managing gestational diabetes that increases maternal and fetal risk.
Anemia screening through hemoglobin testing identifies iron deficiency affecting maternal health and fetal development. While blood testing is possible at most facilities, results are often not acted upon with iron supplementation.
Partum management technology includes access to uterotonic drugs (particularly oxytocin) for managing uterine atony, the leading cause of postpartum hemorrhage death. Oxytocin availability is variable; some facilities have reliable supply while others do not.
Vacuum delivery and forceps delivery are operative interventions for prolonged or obstructed labor. These require trained operators and specialized equipment. Many rural facilities lack these tools, necessitating cesarean delivery for delivery complications. Some women experience delays in receiving cesarean due to lack of surgeon availability.
Cesarean delivery technology and capability is critical for managing dangerous complications. However, cesarean availability is concentrated in major referral centers; many lower-level facilities cannot perform cesarean. Access to timely cesarean is a major determinant of maternal and perinatal survival.
Anesthesia for cesarean requires skilled anesthesiologists or trained anesthesia technicians. Anesthesia shortages limit capacity to perform surgical deliveries safely.
Blood transfusion capability for managing hemorrhage requires blood screening, typing, and transfusion service. Government blood banks face challenges with blood supply reliability. Some facilities lack blood or type-matched blood is unavailable, limiting capacity to manage severe hemorrhage.
Postpartum hemorrhage management requires rapid access to drugs (ergot alkaloids, oxytocin), IV fluids, and transfusion capability. Technology and supplies for managing hemorrhage are sometimes inadequate in lower-level facilities.
Infection prevention technology includes sterilization capability and infection control supplies. Poor sterilization increases risks of infection after delivery. Some facilities lack basic infection control supplies.
Antibiotics for preventing and treating postpartum infection are essential. Availability of antibiotics in government facilities is sometimes limited due to stockouts.
Newborn resuscitation equipment and training are critical for managing asphyxiated newborns. Bag-mask ventilation equipment and trained personnel should be available at all deliveries, but many rural facilities lack equipment or trained personnel.
Newborn temperature management is important for preventing hypothermia in newborns, which increases morbidity. However, many facilities lack heated infant care spaces.
Neonatal intensive care technology for managing premature or ill newborns is limited to major referral hospitals. Neonatal units are few and often inadequately staffed and equipped.
Kangaroo mother care, skin-to-skin contact for temperature regulation and bonding, is a low-technology, high-impact intervention for premature infants. Implementation in maternity units is variable.
Technology for maternal health monitoring and surveillance, including electronic health records tracking pregnancy outcomes, is underdeveloped. This limits ability to identify problems and improve care.
Mobile health technology for maternal health has been introduced in some areas, including SMS reminders for antenatal visits and facility delivery. However, adoption and sustainability have been limited.
See Also
Ultrasound Prenatal Care Maternal Mortality Reduction Neonatal Mortality Rates Hospital Infrastructure Standards Medical Equipment Supplies Rural Healthcare Access Healthcare Technology Innovation
Sources
- Kenya Ministry of Health Maternal Health Strategy 2015-2020, https://www.health.go.ke/
- WHO Guidelines for Management of Complications of Pregnancy and Childbirth (2015), https://www.who.int/publications/
- Campbell, O. M., et al. (2016). Maternal health and the sustainable development goals: A baseline for post-2015 accountability. Lancet, 387(10032). https://doi.org/10.1016/S0140-6736(15)00851-8