Abiodun Adereni

Abiodun is leveraging technology to expand the effectiveness of midwives’ work and services in health care centers in rural communities reducing infant and maternal mortality rates in Nigeria.

In many rural communities in Nigeria, health care access for child delivery is difficult and characterized by ill-equipped facilities and unhygienic tools giving rise to increasing maternal and child mortality rates. In the face of this, Abiodun is leveraging technology and empowering midwives to provide better access to maternal childcare as a way of reducing infant and maternal mortality. Through his AI-powered Vaccination Tracker, Abiodun is able to map children who have not received the required vaccination doses, offer the mothers of these children alternatives to obtain them according to AI-generated best logistical options, and simultaneously, he collects detailed data that feeds back into additional developments of the app and the overall service, for example, sending notifications to mothers before vaccinations are due.

Furthermore, he has acknowledged the relevance of midwives to his work due to the lack of functional primary healthcare centers in rural communities and he is partnering with them to strengthen their operations in these communities by upscaling their delivery homes to more modern and hygienic standards which he is calling Digital Health Cafes as replacements of conventional non-functional primary healthcare centers. The Digital Health Cafes are operated by the midwives with support from Abiodun, providing them with modern equipment, clean birth kits, internet infrastructure and e-learning tablets designed to improve their knowledge and practice for delivering better services.

Nigeria is facing a grave healthcare crisis, particularly in maternal and child health. According to a 2016 report by the World Health Organization (WHO), Nigeria has one of the highest rates of maternal mortality in the world, accounting for 14% of all maternal deaths. Over 32% of these deaths occur in South-western Nigeria, including deaths of children under the age of five. This situation is largely due to pre-existing medical conditions that go undiagnosed and untreated, inadequate health supplies, inadequate sanitation and hygiene, illiteracy, and poor health-seeking behavior of women.

Despite having over 20,000 primary health care centers (PHCs) across the country, they are largely non-functional and lack basic resources, leaving women with no other option than to seek care from untrained traditional birth attendants and midwives who have learned from tradition and old family doctrines rather than professional medical training. These traditional birth attendants and midwives use outdated, unsterile tools and unorthodox practices such as using the same blade or knife to cut the umbilical cord of all women that patronizes them, which often leads to the high prevalence or transmission of infectious diseases and neonatal infections, resulting in maternal-child mortality.

Moreover, to curb the mass exodus of medical personnel leaving the country, the government deployed thousands of Community Health Workers (CHWs) to provide care in remote, and rural communities. However, their effectiveness is hampered by disconnection from the formal health system, inadequate training, lack of equipment, and supervision. Nigeria also contributes to 30% of the staggering 23 million unimmunized children under five globally. And vaccine-preventable diseases such as tuberculosis, measles, and pneumonia are responsible for one in eight child deaths before their fifth birthday. Nigeria continues to report an alarming under-five mortality rate of 132 per 1,000 live births, which is far exceeding the SDG 3.2.1 target of 25 per 1,000 live births. Data shows that Nigeria is among the top five countries worldwide with the highest number of zero-dose children, alongside India, Pakistan, Ethiopia, and the Democratic Republic of the Congo.

In Nigeria, around 10 million children each year miss out on their recommended vaccinations by their first birthday, with over 7 million of them receiving their first basic vaccination at birth but not completing the rest of the course by the recommended age. The government's efforts to increase routine immunization coverage and reduce under-five mortality have had limited success over the past decade, largely due to limited access to vaccinations. Although, these vaccines are procured through the Gavi Alliance and are provided free in government-run hospitals. These hospitals give vaccination paper cards to mothers to track their vaccine uptake, however, many mothers are either unaware of the importance, misplace the paper cards, or are unable to travel to obtain these vaccines resulting in missed vaccination dates. Due to the low vaccine uptake and insufficient distribution systems, a significant number of vaccines go unused and expire, leading to wastage. As a result, Nigeria is among the top countries with the highest levels of vaccine wastage caused by expiration and vaccine inefficacy. This is a concerning issue as it not only represents a waste of resources but also means that fewer people are protected against vaccine-preventable diseases. This crisis is not unique to Nigeria alone as it extends to many other African countries.

To reach as many women as possible, Abiodun and his team use a multi-pronged approach. Firstly, they map out the local traditional birth attendants and midwives who hold significant influence in the communities. Then, they form partnerships with them. These midwives take responsibility for ensuring that Clean Birth Kits are provided to pregnant women in rural areas who visit their birthing homes for delivery. By collaborating with these midwives and conducting advocacy campaigns with them periodically, Abiodun has increased the confidence of pregnant women in the hygienic and sterilized nature of the midwives' processes and tools.

Through his learning arrangement with the midwives, Abiodun works to reinforce their knowledge through the provision of tablet computers pre-loaded with 20 videos of what to do in aiding pregnant women during birth. As a result of this learning partnership with the local midwives, Abiodun has helped them reduce maternal deaths by 50%. It is worthy of note that the videos are recorded in the Yoruba language for easy use by the midwives, and they don’t require an internet connection. However, to facilitate more spread of their content, Abiodun and his team are also developing versions of the videos subtitled in pidgin English and some major Nigerian languages for a start.

In addition to the above, HelpMum – Abiodun’s nonprofit organization targeted at improving maternal and child health using the power of mobile technology and low-cost innovation – developed a vaccination tracker that registers mothers with newborns and sends reminders to them on the dates to take their newborns to hospitals for vaccination. So far, the vaccination tracker has increased vaccination uptake by 45%. The tracker has a QR code for easy downloading and setup.

For some women in the rural communities where Abiodun’s work is situated, the vaccination tracker is not enough due to factors such as distance to the hospitals for the vaccination, cost of transportation to the centers, or simply not considering timely vaccinations as important. On the heels of this, through a partnership with Google, Abiodun and his team developed an AI component to the vaccination tracker they called “AI Adviser”. The “Adviser” uses the registration data of the mothers on the vaccination tracker to advise HelpMum on the best cause of action to be taken for rural women based on their geographical location, and distance to the nearest active healthcare facility. The Adviser does this using four optional parameters depending on what fits each situation. The options include:
1. Delivering the vaccines to the mothers
2. Providing a travel voucher for the mothers to come with the child
3. Pickup and drop-off for the mother and child
4. Additional phone calls to ascertain the situation of the mother and child.

As part of its strategy, HelpMum gathers and analyzes data through their different platforms to validate and learn from their work and consolidate robust research. Using this data, they are able to identify and incorporate new and emerging maternal and newborn potential complications which they in turn add to the learning videos on their tabs for their partner midwives. Abiodun and his team also use this data to analyze government expenditure on health and make recommendations for the government to include their vaccination tracker as a mandatory hospital offering for post-natal mothers across the nation. For instance, in Oyo state, Nigeria, Abiodun and his team have access to the 721 primary healthcare centers in the state, and data of 90,000 plus mothers registered in the tracker.

Abiodun is also strengthening and reinforcing his engagement with the midwives by renovating, converting, and upscaling their delivery homes to what Abiodun has called Digital Health Cafes, to emphasize the introduction of digital tools to enhance midwives’ work. These new versions of delivery homes are as familiar to rural communities as cafes, since well-known midwives are their owners. The cafes replace the non-functional primary healthcare centers in the rural communities and traditional birth homes, usually run in an unhygienic manner, and are designed with modern hospital beds and sanitary tools to help women deliver their babies in safe and hygienic environments. In addition to this, Abiodun and his team equipped midwives with tablets and installed internet facilities in the café to remotely connect the health workers to doctors, and ambulance services when there are emergencies that cannot be handled by the midwives in the cafes. To date, Abiodun has recorded a 50% reduction in maternal mortality in his areas of operation, which extends to over 200 rural communities.

He plans to scale up to 30 Digital Health Cafes in 3 years in Nigeria through partnerships with state ministries of health and the National Primary Health Care Development Agency. In addition to the partnership with the Oyo state government and Osun state government in Nigeria, HelpMum has partnered with Google, Patrick J McGovern Foundation, and Facebook (Meta) to continuously improve their vaccination tracker and AI Adviser, expand their coverage across Nigeria, reach more pregnant women with their innovation, setup more digital health cafes, and improve immunization outcomes across Nigeria, and West Africa.

In conclusion, Abiodun and his team are working on making the code for both the Vaccination tracker and AI Adviser open source for easy replication across Africa to improve vaccine uptake across the continent.

Abiodun was born in Ibadan, Southwest Nigeria, into a middle-class family. While growing up, his mother instilled in him the importance of helping others without expecting anything in return. His mother would encourage him to give alms, take up voluntary work at church and be responsible stewards in the community they lived in, and this shaped his perspective on life.

Abiodun studied veterinary medicine and wanted to go to communities to sensitize them on zoonotic diseases animal-to-human transmission. During the sensitization with communities, he discovered that the bigger problem was the lack of basic primary care services, particularly maternal and child health. Women in rural communities resorted to untrained midwives and traditional birth attendants for childbirth, which was detrimental to their health and resulted in needless deaths. Abiodun felt heartbroken by the practices he observed in these communities. To tackle this problem, Abiodun founded HelpMum, an organization dedicated to reducing maternal and infant mortality in Nigeria. He persisted in his efforts to combat maternal and infant mortality and in 2017 his work was recognized with a $1000 grant by Western Union to distribute clean birth kits to 100 mothers in a rural community in Oyo State. The project was a success, and he was able to secure a second grant to reach another 100 mothers.

Shortly after, Abiodun won a $250,000 grant from the Google Impact Challenge, along with a team of Google engineers who helped build the vaccination tracker. He also won $5,000 from the United Nations in Geneva, after sharing his presentation on Combating Maternal and Infant Mortality in Africa, using HelpMum as a case-study. Despite facing numerous challenges, Abiodun continued to work tirelessly to improve maternal and infant health in rural communities.