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Jun How Ooi1, Rosediani Muhamad1, Rosnani Zakaria1, Nik Rosmawati Nik Husain2, Siti Azrin Ab Hamid3, Maryam Mohd Zulkifli1, Zainab Mat Yudin4, Imran Ahmad1, and Nur Suhaila Idris1


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## **Reversing COVID-19 Effects: An mHealth Tool that Empowers Women to Improve Maternal Health and Maternity Care**

**Sandra Orcí Gutiérrez1,2,3, Sara Arce Sánchez**³ **, and Antoine Flahault**¹

<sup>1</sup> Institute of Global Health, University of Geneva, Switzerland 2WHO Collaborating Centre for Knowledge Translation and Health Technology Assessment in Health Equity, Bruyère Research Institute, University of Ottawa, Canada 3Global Health Research Center, Global Health Booster, Geneva, Switzerland

COVID-19 has caused a setback in achieving the maternal mortality target established in the Sustainable Development Goals. Women's empowerment is an internationally supported human-rights policy to improve maternity care and decrease maternal mortality. This research aimed to find an integrated solution to encourage women's participation and provide an integral evaluation of maternity care in Guerrero, Mexico. Three major objectives were pursued: conceptualization, testing, and local adaptation. For conceptualization, interdisciplinary research was conducted, and a prototype was designed. For testing, focus groups, interviews, and expert consultation were done in three target groups: women, health professionals, and public health leaders. For local adaptation, surveys were translated from English to Spanish according to WHO methodology and adapted to Guerrero's local context. In this phase, 358 women were surveyed with the support of 29 social workers, health professionals, and administrative staff. The integrated prototype was programmed and will be piloted in a future phase. An mHealth transdisciplinary tool with a women-centered approach would enable the environment to promote women's empowerment and health professionals' participation and operationalize global standards to improve maternity care quality. To achieve this, a tool that includes woman-reported outcomes was designed. Decreasing preventable maternal deaths requires the participation of all healthcare stakeholders: women, health professionals, social workers, community leaders, and public health authorities. A platform with a global health perspective will allow learning from different stakeholders and identify improvement areas for healthcare facilities. Four main challenges were found: cultural and institutional change, low literacy levels, connectivity, and COVID-19 restrictions. An integral evaluation tool to improve maternity care should have a woman-centered approach that empowers women by improving their skills for self-care during pregnancy and postpartum and ensuring their participation in maternity care programs. This tool should collect data from women and measure it routinely. An mHealth tool is a cost-effective solution that will empower women to improve maternal health.

Social workers also felt empowered

#### Authors

Sandra Orcí Gutiérrez1,2,3, Sara Arce Sánchez3, and Antoine Flahault1

1 Institute of Global Health, University of Geneva, Switzerland

2 WHO Collaborating Centre for Knowledge Translation and Health Technology Assessment in Health Equity, Bruyère Research Institute, University of Ottawa, Canada

3 Global Health Research Center, Global Health Booster, Geneva, Switzerland

#### Decreasing Preventable Maternal Deaths Requires the Participation of All Healthcare Stakeholders

#### Transdisciplinary Approach for Maternity Care Improvement

A women -centered qualitative management tool was designed, and includes:


COVID-19 has caused a setback in achieving the maternal mortality target established in the Sustainable Development Goals.

Due to COVID-19, Mexico has had a 60% increase in maternal deaths since 2019.

Guerrero is one of the most vulnerable states in Mexico: 68% of its population does not have enough income to afford the basic products to survive [1]. The maternal mortality ratio increased from 59.1 in 2019 to 72.4 in 2020 [2].

Human rights for maternity care. Women's empowerment is an internationally supported human rights policy to improve maternity care and decrease maternal mortality.

Promoting women's participation in maternity care. The project aimed to find an integrated solution to encourage women's participation to provide a complete and integral evaluation for maternity care in Guerrero, Mexico.

#### Methods:


#### Empowering women, empowering social workers

An integral evaluation tool to improve maternity care should have a woman- centered approach that empowers women by:


An mHealth tool is a cost-effective solution that will empower women and social workers to improve maternal health.

*Confidence in taking care of the baby:*

*"I think it's a question that leaves me thinking since I'm a new mother and I hadn't thought of what to do."*

*Anxiety at childbirth:*

*"It is an adequate question. They care for what we feel in the moment."*

*Breastfeeding intention:*

*"It's interesting [the question] because it helps appreciate breastfeeding even before [giving birth]".*

*Surveyed mothers in Guerrero, Mexico.*

### References

Allen Repko, Interdisciplinary Research: Process and Theory, University of Indiana (SAGE Publications, 2008).


The application of the survey made women reflect on their condition and made them feel they were well cared for.
