Introduction of maymay app Dr Aung Aye Khine Senior Communications Officer, mHealth Population Services International/Myanmar Jun 20, 2016

“maymay” Myanmar’s First Maternal Health App

Myanmar Maternal Mortality Rate Maternal mortality ratio is the number of women who die from pregnancy-related causes while pregnant or within 42 days of pregnancy termination per 100,000 live births.  No. of deaths per 100,000 live births (2015) 2011 2012 2013 2015 Myanmar 201 195 189 178 Maternal death causes include hemorrhage, hypertension and infection. Sources: http://data.unicef.org/maternal-health/maternal-mortality, http://who/maternalmortalityratemyanmar, data.worldbank.org/indicator

Child Mortality Rate Under-five mortality rate is the probability per 1,000 that a newborn baby will die before reaching age five, if subject to age-specific mortality rates of the specified year. Sources: data.worldbank.org/indicator

Child Mortality Rate Under age 5 mortality rate per 1000 live births (2013) Maternal mortality rate and child mortality rate are some of the highest in the region. The majority of births take place outside of a professional medical facility. Limited access to health services and information persists. Malnutrition contributes to 60% of child deaths. Child death causes include respiratory infections and diarrhea, both of which are made worse by malnutrition. Breastfeeding, pneumonia and diarrhea treatment, ANC visits, and facility delivery are listed as missed opportunities for the delivery of child lifesaving interventions.

Many of these deaths could be prevented with knowledge and access to proper health information. Maternal mortality below the standards set by the United Nations. Maternal mortality rate and child mortality rate are some of the highest in the region. The majority of births take place outside of a professional medical facility. Limited access to health services and information persists. Malnutrition contributes to 60% of child deaths.

Use mobile to deliver maternal and child health information. Mobile Alliance for Maternal Action (MAMA) developed mobile maternal and child health messages. Content is based on WHO and UNICEF guidelines, and informed by a team of health experts. Messages are provided to partners free of charge and adapted for the local context. Bangladesh’s Aponjon program has over 1.15 million subscribers. MAMA Bangladesh Case Study: 75% of women and gatekeeper respondents reported that they now have the ability to take action to improve the health of the mother or baby as a result of the MAMA messages. MAMA was founded by USAID, Johnson & Johnson, United Nations Foundation, mHealth Alliance and BabyCenter India, Bangladesh, South Africa, Colombia some of the countries that have adapted the messages. Sources: http://aponjon.com.bd/, http://www.mobilemamaalliance.org/sites/default/files/BangladeshCaseStudy2014.pdf

Reducing maternal and neonatal mortality in Myanmar with maymay Mention EG $90k and USAID DIV $150k Koe Koe Tech Jun 20, 2016

WHO Health System Performance (191 countries) Woof.

Most Myanmar people are using Android smartphones, even rural people Everybody’s using smartphones in Myanmar! Maybe present theory of change here

What’s the solution? Our app, maymay A mobile and web platform where pregnant women and their partners and parents of children can: LEARN INFORMATION Before when during making important health decisions FIND QUALITY DOCTORS They can call and live chat with ORDER PRODUCTS Medicine, maternal and baby products to their door

Features of maymay Application Lesson Hospitals Baby Products Weekly Message Nutrition Mom Fashion Symptoms Viber, Messenger Doctor Locator Emergency Health Articles

Social Impact RCT running at Central Women Hospital (CWH) Intermediate Outcomes (WHO) – compared against baseline (in parenthesis) % of people who did 4 ANC visits (73%, DHS, MICS) % Facility-based births (33%, UNICEF) % babies exclusively breastfed for 1 year (24%, DHS, MICS) Ultimate Outcomes Reduce maternal mortality (200 deaths per 100,000 live births, MMIEG 2014) Reduce under-5 mortality (52 deaths per 1,000 live births, IGME 2013) Reductions of # of neonatal deaths (within first 28 days), # of all under-5 deaths, and % of under-5 deaths are neonatal (51%, MICS) Similar IVR initiatives have resulted in 20-30% improvements from baseline for 4+ antenatal clinic visits, facility-based births, exclusive breastfeeding.

Currently 30,000 monthly active users and adding 200-500 new users per day (every year 765,000 new pregnant women) Facebook has just launched maymay app on Free Basics this June to 20 million Myanmar people (zero-rated data use) – 1,000 daily active users after a week Note on how all of this results in massive data collection Patient side care Doctor side care Midwives, nurses Integration with DHIS2 Results in a completely connected data network

Distribution through PSI Sun clinic doctors and Save the Children midwives Distribution through MOH rural health centers and hospitals Telemedicine integration with mobile money and Facebook Messenger bot (boosts doctors incomes and saves patients money!) Purchases of high-quality, low-cost health products in the maymay app delivered by PSI & Living Goods rural sales agents to customers’ doors Looking to the future Patients: 30,000 monthly active users Currently adding 1,000 new users per day Free Basics: 20 million people will be added Connecting Patients to Doctors and Midwives Maymay telemedicine will allow appointments setups with clinic and hospital doctors, nurses, and rural midwives Transportation to health facilities Ratings of doctors, midwives, nurses (upward quality pressures) Doctor-to-doctor telemedicine and referrals Desk references for doctors, decision support More Content Save the Children on exclusive breastfeeding

Thank You 