GestAmor

The COVID-19 pandemic has affected everyone differently and has worsened existing gender inequalities to access to maternal health services. Being locked up, women have limited access to health care, which pose serious threats to face childbirth or complications. To improve access and quality of this services in the districts of North Lima, Peru, we are proposing the development of a mobile application called "GestAmor", low cost and easy access to the community on various platforms. GestAmor will help 1) To identify cases of possible pregnancies in order to have contact with a health professional and detect in a timely manner some risks. 2) It will help pregnant women to continue with their prenatal care in an adequate way to reduce complications and the risk of maternal mortality. 3) It will help provide maternal and child health support during the puerperium until the first month of life of the newborn.

During the Covid 19 pandemic, the Ministry of Health has directed its greatest effort towards this disease. Being maternal health care displaced and affected. In this framework, there is a prevalent public health problem that also deserves priority attention in Peru, and that is maternal mortality. According to the National Center for Epidemiology, Prevention and Control of Diseases, for the year 2018 there were 366 maternal deaths nationwide and a direct affection to the family and society.

A determining factor for this problem is access to health services and quality, timely and comprehensive care. From the first pregnancy stage, women do not have access to a pregnancy test and prenatal care, resulting in obstetric complications such as bleeding, which is the first cause of maternal, obstetric infections and complications, preventable from care. Due to the social isolation that the country has been going through for 90 days, access is even more limiting, especially in the poor population.

In the north of Lima, Peru, is recorded before the pandemic, access to timely prenatal care from the first trimester of pregnancy only 43% of pregnant women and only 36% managed to be 6 prenatal care for the year 2018. 

“GestAmor” is a mobile application that will help improve access to MINSA health services. This application will have 3 use cases: 1) The first option is for women who suspect pregnancy, this option will allow women to obtain a presumptive pregnancy result and a health professional will contact her to confirm the pregnancy by a quick test, then confirmed cases will be referred to health facilities for care. 2) The second option is for pregnant women, this option will allow to identify if they have signs and / or alarm symptoms, later a health professional will contact her to provide tele-counseling and referral to health facilities. 3) In the third option, we will provide a comprehensive accompaniment to the pregnant woman to strengthen clinical and nutritional health from the first trimester of pregnancy to the first month of life of the newborn. During this time, tele-counseling on alarm signs and symptoms, birth plan, healthy eating, breastfeeding will be provided. In addition, virtual sessions of psychoprophylaxis and preparation of low-cost and healthy recipes will also be provided.

The target population is pregnant women from the 9 districts of North Lima, women are suspected of pregnancy, pregnant women from the first trimester of pregnancy to the puerperium and newborns from birth to one month of life.

In a maternal and child health pilot carried out by the same organization, it was found that 92% of the pregnant population had access to an android cell phone with the WhatsApp instant messages application. Despite the poverty in which they live, the pregnant population has access to this technology and uses the internet with low-cost data plans of around 5 soles per week.

During our intervention we will have constant contact with our target population, to refine the solution that we offer both to women who are suspected of pregnancy, pregnant women who have new consultations on symptoms that threaten their health, and new mothers, we believe that This interactive process will provide them a better opportunity to be cared for and accompanied appropriately during their pregnancy, strengthening health care and preventing complications.

In 2015,maternal mortality in Peru decreased to 68 deaths per 100,000 live births. However,it is anticipated that these statistics could be affected by the context in which we live,mainly because currently there is a large gap in access to health services,which could cause maternal morbidity and mortality to increase.GestAmor,is a mobile application that will identify women with suspected pregnancy and pregnant women to provide assistance through tele-counseling. We chose a mobile application because currently in Peru,85% of the population has access to internet services through a mobile phone,which allows access to a greater number of people from the target group.

GestAmor is a mobile application that can be shared through a link, through the use of the internet, through a mobile phone. In Peru, it has been identified that 85% of the population between 25 and 49 years of age has access to the internet and that they remain in front of a phone screen for approximately 3 hours a day.

Mobile telephony and internet use can support and strengthen additional communication efforts by connecting pregnant women with specialized health facilities and professionals so that they can access accurate information safely and faster than ever before, and it even makes it possible to speed up access to immediate care, even in times of pandemic.

GestAmor has also developed and validated a scale that helps to strengthen the suspicion of a pregnancy. The presumptive results of a pregnancy will be accompanied by a phone call from specialized professionals and the application of a rapid test. From this, each pregnant woman will receive the invitation to participate in a community intervention focused on improving maternal health. 

GestAmor, is a mobile application that will be shared through a link on an internet page, which can be accessed through a mobile phone. It has the facility of reaching a general population, it has a friendly design directed specifically at a woman of childbearing age, it contains images that complement the questions that may be considered more difficult to answer, and it presents a multiple choice of answers avoiding conditionality in the woman's response.

GestAmor also allows a quick and direct communication of pregnant women with specialized professionals, health personnel. This provides pregnant women with more qualified primary care, breaking their geographical isolation and currently due to restrictions under the COVID-19 context, their social isolation.

An additional feature of GestAmor is its low internet data consumption on a mobile phone. This feature will allow people who do not have internet through a WIFI network to use the application without fear of investing a large part of their internet service data plan.  

Pregnancy is a stage in a woman's life that requires attention from health services. Surveillance of pregnancy guarantees that every pregnant mother has the prenatal care that corresponds to her needs. However, the support of mobile applications in prenatal care becomes stronger due to the context of the pandemic in which we find ourselves. However, there are previous successful experiences, such as the mobile application "AmaneceNET", implemented in Chiapas, Mexico, which It allowed monitoring the health of pregnant women in a condition of marginalization. Community midwives sent text messages to the health facility in the event of any complications that could be attended to immediately.

The Argentine government recently implemented the “CHAT Crecer”, a virtual assistant designed to accompany women during pregnancy and the baby's first year, with personalized information and reminders of attendance at health check-ups. Its main objective was to increase the number of prenatal controls, until the beginning of 2020, 1 in 3 pregnant women who tried the Chatbot attended on average 1.2 controls more than those who never used it.

The mobile application, GestAmor, was thought as a tool to adapt to a new way of life produced by the COVID-19 pandemic and social confinement, where it is proposed to improve access for women with suspected pregnancy to health facilities with the goal of timely diagnosis and monitoring of pregnancy remotely.

The use of this tool would help to reduce the times in the diagnosis of a woman with suspected pregnancy, allowing timely and comprehensive care in the care of her pregnancy. Likewise, it would allow the effective detection of risk factors and health problems that could be counterproductive in pregnancy.

In Peru, 85% of the population uses the Internet through a cell phone, so directing our intervention using this type of technology is considered viable. In addition to the existence of new reports and scientific evidence that mention that the use of mobile applications aimed at people's health has become increasingly frequent and useful.

Therefore, we consider that Gestamor will become a sustainable tool over time with and without pandemics. That they contribute to the work of health professionals and bring people closer to health facilities.  

Goal 1: By December 2020, Improve access to prenatal care for 100 women from the Carabayllo district, reaching 60% of pregnant women attended from the first trimester of pregnancy and 1,000 pregnant women from 8 districts of Lima, reaching 60% of maternal health consultations

Goal 2: By October 2021, Improve access to prenatal care for 4,000 women in the Carabayllo district, reaching 60% of pregnant women attended since the first trimester of pregnancy and 9,000 pregnant women in 8 districts, reaching 70% of consultations maternal health

Goal 3: By October 2026, provide access to 13,000 pregnant women from 9 districts of the North Lima area, through coordination with the Ministry of Health

Meta 2: La organización viene interviniendo en un pequeño piloto de 100 gestantes con un presupuesto limitado para 4 establecimientos de salud, se busca buscar financiadores para escalar a 13 establecimientos del distrito de Carabayllo y postular al presupuesto participativo municipal

Meta 3: Para octubre de 2026, brindar el acceso a 192,000 gestantes en la ciudad de Lima-Perú, se pretende buscar articulaciones con el Ministerio de Salud, la Municipalidad de Lima y otros financiadores extranjeros mediante postulaciones.

Lack of sufficient funds for product development is the biggest barrier.

We hope to find more partners and donors to support the development of our product.

A total of 5 employees will work full time on our solution.

Socios en Salud is a non-profit organization positioned for 23 years in Peru with experience in tuberculosis projects and for 4 years with experience in community projects such as Maternal Health and child development. It is made up of 5 health professionals, 1 graduate in obstetrics and with a postgraduate degree in public health (project coordinator), 2 professionals in obstetrics, with a specialty in obstetric emergencies, and 2 nutrition professionals who specialize in maternal care and breastfeeding. The work team aims to contribute to comprehensive care for pregnant women and children.

There are other indirect personnel that enrich the development of the project activities: 1 social communicator and 1 professional system engineer (analyst programmer of information systems) who carry out the creation of the application and will maintain correct and effective operation during the project period.

With the Ministry of Health, through an inter-institutional agreement, our organization has been strengthening the activities established in the technical health standards focused on preventive health of diseases and health promotion.

The GestAmor mobile application will be free for all people, due to its versatility and accessibility and with a dissemination scheme, discouraging its use and effectiveness through this pilot project, it will become an application with thousands of users.

The application will have free benefits directly related to the approach of the project services, but in turn will serve so that companies or independent professionals with products or services aimed at mothers can present them through the application.

These products or services will be in a wide range that satisfies the users' needs, from nutrition, clinical, children's clothing, early stimulation, etc.

The back-commerce team of Socios En Salud will receive the requests of the individuals or companies that offer them and will evaluate the quality of the service or product before being offered through a mobile application. This in order to guarantee the seriousness of the bidders and also to review the service or product that will be offered and that is oriented with the mission of the project. For example, junk food offers will not be accepted.

This back-commerce service, which also includes compliance and legal work, will have a cost that will be assumed by the company or bidder, in addition to establishing commissions for services or products placed.

This mobile application will serve as an e-Commerce platform for individuals or other organizations that want to offer or demand products or services.

There are two ways. The first is that the application is assumed by the Peruvian government as part of its health strategy, but also the application will serve as an e.commerce mechanism that will generate its own income. 

We believe that SOLVE is a good ally and we would like to be part of the partners and in this way help the poorest communities in Lima Peru.

We would like to partner with any partner that is in line with our institutional goals.

Gestamor is a technological proposal that includes comprehensive support for pregnant women from the first trimester of pregnancy. The budget will be used to strengthen health through the following activities:

Mobile application:
1. Identification of women with suspected pregnancy:
- The woman through the mobile application will obtain a presumptive pregnancy diagnosis
- Specialized professionals will contact the participant to confirm these results using the rapid test from the telephone call center.
- The participant with a positive result will be referred to health facilities from the telephone call center.
2. Pregnant woman with symptomatic consultations:
- Free access to a consultation and referral chat, registering your alarm signs / symptoms through CHAT.
- Specialized professionals will answer the queries of the pregnant women from a personalized tele-orientation.

Comprehensive support:
1. Clinical component: It consists of 3 activities
Accompaniment and monitoring of the pregnant woman: The identification of warning signs and care through prenatal care or monitoring of her health are important for the reduction of obstetric complications. The follow-up will be carried out through phone calls and referrals to health facilities
Accompaniment and counseling in the birth plan: The birth plan is a strategy of the Ministry of Health, where the woman, her partner and her family prepare the conditions for the care of pregnancy, childbirth and the puerperium. The birth plan consists of 3 counseling through 03 phone call

-Delivery of psychoprophylaxis sessions: It is a MINSA strategy that contributes to the reduction of pre and postnatal obstetric complications by physically and psychologically preparing the pregnant woman for a delivery without fear. 6 psycho-prophylaxis sessions will be delivered in virtual groups of 8 pregnant women.
2. Nutritional component:
- Accompaniment and nutritional counseling: Its purpose is to help pregnant women to have a balanced and healthy diet and to strengthen exclusive breastfeeding. There will be 3 counseling sessions during pregnancy and 3 videos recorded with nutritional recipes will be provided.