Anna Cecilia Frellsen has been the CEO of Maternity Foundation for three years, which is a Danish development organization that aims to reduce maternal and child mortality in developing countries by developing sustainable and innovative maternal health solutions to be scaled up. One of these solutions is the Safe Delivery App developed in collaboration with Copenhagen University and University of Southern Denmark. She holds an MBA from IESE and has more than 15 years of business experience within strategy, marketing and general management. She has worked as the CEO for a small start-up, as a partner with KPMG Strategy, and she spent more than seven years with McKinsey & Company. She started her career working in the pharmaceutical industry in New Jersey, US and the UK. In addition to her position with Maternity Foundation, she sits on the board of the Danish NGO “Children Exposed to Domestic Violence.”
- Q: Tell us about your background?
A: I am Danish and have been with Maternity foundation for the past three years. Before that I had general business background. When I joined the Maternity Foundation we were a smaller organisation with a programme on the ground in Ethiopia, and working with the classical NGO projects in Western Ethiopia. We were also testing and finalising this digital tool called the Safe Delivery App. Over the past three years Maternity Foundation has grown tremendously, we are 22 people and about to scale up our activities across developing countries.
- Q: One of SMW’s goals is ensuring women everywhere have access to the highest quality maternal care, before, during, and after pregnancy. Your organisation is committed to saving lives during childbirth. Why is this still a problem in 2016? What you think will address this persistent problem?
We are focused on developing countries and low income countries. It’s really clear that there is a very strong evidence supporting the idea that if you can empower women to seek care, and good quality of care during pregnancy and childbirth, then most of the problems can be solved. This is very much a measure of access to quality care. It doesn’t have to be too much – I think most lives can be saved with basic care. A skilled nurse or a skilled midwife can make all the difference.
We talk about the “three delays” – the first delay is that the woman does not seek the care. Why does the woman not even think about seeking out the right care? I think it’s because of lack of information, it’s lack of priority… if you are living in a setting of poverty, the first priority is to get food on the table and take care of the children you already have in the house. There are also cultural barriers, where women are told that “this is so natural, why should you have to seek out a facility, we can handle this from home.” This is why it is important to go out and create a solid understanding that lives can be saved if you get the right care. We have to work with not only the women, but also the men and the village leaders and religious leaders to overcome those social and cultural barriers.
The second delay is more structural barriers, such as poor infrastructure first and foremost. These include poor roads, poor ambulances. Also timely access. Planning properly can achieve a lot.
The third delay is that once you actually reach the facility that you do receive proper care. That is the quality question. It is one thing to get to a facility, it is another to ensure that they have the right sills and equipment in place. There are many nurses and midwives working in the health system, in rural settings and so forth, who just lack really basic qualifications. This really impacts on the first delay too – if the expected quality of care is poor then you might as well just stay at home. It is a vicious cycle. If you build up the quality of care and then empower the women, then most of the work is done.
There is also the issue of the woman getting pregnant in the first place – the woman should be able to decide with whom and when and how often she gets pregnant. We have to look at spacing the pregnancies correctly, not being too young when they get pregnant for the first time, and all those types of things. It is women’s rights.
Our main goal is to get the pregnant women to safer care and then they will receive the proper care. That is the core of what we do. We also do work in family planning and informing the women of opportunities in that.
- Q: The Maternity Foundation have now developed an app on Safe Delivery. Can you tell me what the aims and objectives of this app are?
A: The app is focused on addressing the quality of care. We want to reach the health workers that are difficult to reach, and give them good instructions and training in terms of how to handle basic emergencies that may occur before during and after a childbirth. What we know is that 9- per cent of all new born deaths could be prevented if the woman had given birth with basic skilled care, not advanced facilities or specialist doctors, but just a basic quality of care. That is what the app addresses. We have taken the latest global clinical guidelines on emergency care, and then we have boiled that down into some simple animated instructions. The main concept of the app is to provide very simple instructions on how to handle simple emergencies that may emerge during childbirth according to UNPFA and WHO and so forth. So that is the main purpose of the app – it is a narrow simple focus. It is taking very long global guidelines and translating that into real key learnings that you cannot miss. We don’t want to lose any essential content, so that was a quite a task. The reason it involves animations is that you overcome some language and literacy barriers by using animation. With animation you can also see the interior and the exterior of the woman. It is very clear what needs to be done rather than if you had a photograph or video. In order to make sure that the app would build these sills, we had a clinical trial back in 2014. This involved a control group versus an intervention group, over a period of 12 months, and the development of their skills. We saw a significant improvement among the health workers using the app.
The app has now been downloaded over 6,000 times since it as launched in April 2015. It is available free for download for everyone. We have been focused on advocacy and awareness, as well as engaging with ministries on how to best use the app and getting it in to the hands of as many health workers as possible. They still have to actively decide to download the app, so we are looking at integrating it into their pre-service training as well as the ongoing in-service training programmes. We want it to not be a standalone tool but integrated into those efforts. The next version of the app will see us building a layer of learning around it, where questions will be put to the health worker using it on an ongoing basis so it will take them through a learning curve. It will start with very simple questions and take them right through to key learnings. We are also looking at ways to certify the health workers that use it. It will become much more of a learning platform and point of access for information. We made a commitment last year that by the end of 2017 we will reach 10,000 health workers and by doing that we will have ensured a safer birth for more than one million women.
- Q: Our theme for Safe Motherhood Week this year is: Motherhood is our power to shape the future. It is everyone’s responsibility to make it safe. What are your thoughts on this statement?
We should all be responsible for anything to do with maternal or neonatal mortality – it is not only the problem for the particular area where the problem is bigger. By working together across sectors, across countries, across levels, we can fix this problem because we know what it takes.
Find out more about the Safe Delivery App here: