India has witnessed notable progress in reducing maternal mortality, marked by significant declines in absolute numbers. However, this positive trend is overshadowed by the troubling expansion of health access disparities. Maternal health indicators highlight a stark contrast of over 40% between states, underscoring a notable divergence.
Particularly alarming is the substantially elevated risk of maternal mortality among pregnant women from marginalized communities, underscoring the tragic impact of preventable deaths. These distressing outcomes serve as a poignant reminder of the deep-seated health equity disparities that persist in India.
With the pervasive growth of digital technologies globally, healthcare systems are actively integrating digital health solutions to bolster capacity, quality, and resilience. However, the success of this integration relies on the widespread adoption of digital innovations across different health equity stratifiers, including location, gender, and socioeconomic class (SEC).
Unfortunately, the positive effects of digitally-driven health advancements are not uniformly distributed, leaving marginalized populations frequently excluded from the accessibility of these transformative digital health innovations.
In India, the government has taken proactive measures to strengthen healthcare systems and ensure equitable access to health services. A crucial aspect of this effort is the ongoing expansion of Universal Health Coverage, currently reaching 63% of the population. With a specific emphasis on maternal health, the government has launched multiple initiatives dedicated to providing comprehensive and cost-free healthcare to every woman and newborn.
Furthermore, the Digital India campaign has been instrumental in promoting health equity by fostering the widespread integration of digital technologies and leading initiatives to ensure digital access for marginalized communities.
In various industries, such as e-commerce and communications, the private sector has successfully embraced equity investments to align with business goals, including gaining access to new consumer populations, differentiating themselves in the market, and developing more robust solutions. Simultaneously, there has been a focus on social impact goals, leading to the establishment of a positive brand reputation. Applying a similar approach to investing in health equity could yield comparable benefits.
From wellness apps fostering health literacy to AI-based screening tools simplifying risk triage, digital innovations led by the private sector have the potential to reshape healthcare comprehensively. By envisioning a broader form of healthcare that addresses quality, access, and affordability, these innovations not only contribute to improved health outcomes but also offer financial benefits to key stakeholders. This dual impact aligns with the private sector’s ability to drive positive change while achieving strategic business objectives.
Building with a health equity lens: Lessons from TfH
Avegen Health’s “Together for Her Health” (TfH), a digital maternal health initiative backed by MSD for Mothers, stands as a pioneering digital pregnancy platform empowering pregnant women in India to adopt healthy behaviours.
With over 2 million downloads, of which more than 80% originate from small towns and villages, TfH represents a scaled solution. It effectively enhances health literacy and promotes positive dietary behaviours among pregnant women.
TfH presents an actionable and scalable approach, serving as a model for equitably improving health access. Its success holds valuable insights that can guide the development of other digital health interventions.
Here’s a look at some of the key propositions of TfH.
1. The user-centric lens:
To gauge outreach across socioeconomic classes (SEC), TfH employs a machine learning model with a 70% accuracy rate in predicting users’ SEC. This model leverages the Relative Wealth Index by Meta along with additional digital proxies. Through this approach, TfH can enhance its reach and improve health access within low SEC segments. The use of targeted marketing campaigns and tailored service offerings, such as emphasizing government schemes for pregnant women from lower SEC backgrounds, is facilitated by this predictive model, allowing TfH to effectively address specific needs within different socioeconomic strata.
2: Be intentionally and obsessively inclusive:
Prioritizing inclusivity and avoiding exclusive design for early adopters is crucial to prevent non-inclusive product decisions that may worsen existing inequities. TfH remains committed to inclusivity by:
a) Offering content through various mediums such as audiovisual aids and diversified options like self-learning courses, virtual live workshops, and recorded videos.
b) Optimizing the app for low-end smartphones and conducting thorough testing with pregnant women who have recently adopted digital technology.
3: The diversity factor:
In the hiring process, Avegen Health emphasizes cultivating a team with a shared foundation of core values while also prioritizing diversity in lived experiences. The team maintains a 60:40 women-to-men ratio, recognizing that diverse teams not only fuel innovation and profitability but are also more effective in mitigating unintentional biases.
The company encourages cross-functional collaboration and nurtures an open, participatory culture. Each team member, regardless of their role, engages with pregnant women from diverse backgrounds and actively contributes to generating product ideas. This approach fosters inclusive, participatory innovation that extends beyond traditional job descriptions.
The Expert’s perspective:
On “The Evolution of Maternal Health Systems in India”, Nayan from Avegen Health remarks
“As a proponent of digital health, I envision a future that closes the digital divide through technology that is culturally aware and easily accessible. This future is constructed with diverse voices in mind, actively addressing inequities to enhance the pregnancy journey for everyone.”
Nayan also remarks that
“Digital Health Products (DHPs) possess the potential to empower expectant women by closing access gaps, anticipating risks, and shaping a more assured and predictable future for every pregnancy. The proactive nature of technology enables early intervention, averting emergencies and enhancing both maternal and neonatal outcomes. Imagine it as a vigilant guardian, consistently overseeing the well-being of both the mother and her child.”
In a similar vein, Mark Allyn observes that
“I anticipate a revolutionary shift with the rise of “Humble Tech,” seamlessly ingrained in the daily routines of expectant women from diverse socio-economic backgrounds. This technological advancement holds the power to redefine maternity care on a global scale, extending its transformative impact beyond the borders of India”.
The Road ahead:
The digital economy presents a unique chance to bring about a positive transformation in existing healthcare systems. Unleashing this potential requires recognizing that advancing health equity is not automatic; it necessitates intentional innovations from diverse teams capable of effectively navigating equity barriers. TfH’s methodology in constructing health equity stands as a practical model, offering insights on how other digital interventions can strategically enhance their influence on health equity.
Looking forward to witnessing the success and growth of maternal health equity in India being driven by TfH!
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