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Overcrowded clinics, extensive wait times and overworked doctors are taking a devastating toll on mothers and children in India. In this eye-opening talk, urogynecologist and TED Fellow Aparna Hegde exposes the systemic gaps that lead to preventable deaths every minute — and introduces scalable, affordable and empowering tech solutions that improve maternal and child health outcomes, upend patriarchal family dynamics and save lives.
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[SHAPE YOUR FUTURE]
Anita died in my presence
while giving birth to life.
She bled to death and lost her child.
The irony was that she had access to care.
In the first trimester of pregnancy,
she had visited the antenatal clinic
of the hospital in Mumbai
where I was doing residency.
But over four hours of waiting
in the hot, sweaty,
dingy, overcrowded clinic
just to get a minute with me,
a harried, overworked resident doctor,
meant that she never came back,
only to die in labor months later.
I was wracked with guilt.
If only I had counseled her
about the danger signs,
why she needed to access regular care.
Would she and her child have survived?
She did not die
due to a terminal condition.
She died because of underlying anemia,
an easily treatable,
preventable condition.
I saw these stories daily.
Systemic, preventable problems
resulting in mothers and children dying
in the most unjust of circumstances.
In the next one hour,
three women will die
while giving birth somewhere in India.
Two children under age five
die every minute in India.
I am a practicing urogynecologist,
but very early in my medical training,
I realized that hospital-based
solutions were not enough.
And given the sheer scale
of India’s problems,
any solution that made a difference
had to be scalable,
accessible to the last woman
and child directly in their homes,
and yet cost-effective and resource-light.
And then the mobile phone came to India
and within a few years
everyone had a mobile phone.
There are currently more mobile phones
in India than toilets.
The idea then struck me.
Why not use a simple technological tool
like a mobile phone,
which is available in almost
every Indian household
to bridge the yawning
systemic gaps in health care?
Maybe we could have simply
called Anita weekly
with critical lifesaving information.
On the other hand,
maybe we could have provided
mobile-phone-based training
to the health worker who could have
diagnosed Anita’s anemia
in the community itself.
Thus was born my NGO ARMMAN.
Our programs, mMitra and Kilkari,
are free, weekly voice call services.
They provide preventive
information directly to women
through pregnancy and infancy
in their chosen time slot and language.
There are multiple tries
for every message,
a missed-call system,
and mMitra also has a call center.
If only Anita had received this service.
In the second month of pregnancy itself,
it would have told her about the need
to take an iron pill daily
from the third month of pregnancy.
When the third month arrived,
it would have sent her a reminder
and counseled her
on how to take the iron pills.
For example, the need to avoid tea, coffee
to improve the absorption of iron
and stress on why it is so necessary
to prevent anemia.
Two weeks later,
it would have spoken about how to tackle
the adverse effects of iron pills,
like constipation.
If she had any query,
she could have reached out
to our call center staff.
These are simple voice calls.
As a typical doctor,
I expected them to just inform
and hopefully lead to better
health behaviors.
However, the one unexpected
transformational benefit
that has completely blown my mind is this:
Information is empowerment.
Armed with this information,
women like Anita are upending
patriarchal family dynamics,
challenging entrenched mores
and demanding care.
Karnam, the wife of a deeply
conservative preacher,
convinced her husband
to adopt family planning
because mMitra told her
that spacing between
pregnancies is necessary.
And the change is intergenerational.
Punita, form a deeply conservative family,
sent her daughter
to an English medium school.
In addition to the big pictured messages,
the most underprivileged
of women want to know
when their child will understand color,
how to ensure psychosocial
stimulation of the child,
when their child will develop fingers
in their womb and so on.
Like any woman would.
Our services respect that.
Over 20 million women
in over 16 states in India
have enrolled for these
services since 2014.
This is testament to how easily scalable
and replicable these solutions are
anywhere in the world.
Similarly, our mHealth-based
refresher training program
for government frontline health workers
called Mobile Academy
has trained over 130,000
health workers in 13 states in India.
Both Kilkari and Mobile Academy,
in collaboration with the government,
will extend through the country
in the next three to five years.
Our goal is to be able to reach
over 15 million women
and their children every year,
and that would mean
over half of the mothers
and children born every year
have the information they need.
And this massive scale is only possible
because so many of our partners,
be it NGOs, hospitals and the government,
recognize the value of this approach
and provided the scaffold
on which we grew.
Our quest in the next five years
is to adopt multimedia approaches,
and given the massive amounts
of data we have,
use the power of AI
and predictive analytics
to better serve our mothers and children.
And our tech platform
and the networks we build are nimble.
When COVID-19 struck,
lockdown was announced overnight.
Among the worst affected were
the underprivileged women and children
in the slums of Mumbai and Delhi,
which were declared as containment zones.
However, pregnancy and infancy
can’t wait for a lockdown.
When there’s an emergency like bleeding,
care is needed immediately.
And we were right there and ready.
We repurposed our tech platform
within a matter of days.
We created a virtual clinic
for antenatal pediatric care
manned by qualified doctors.
Our call-center staff arranged
logistic support, like ambulances.
We also sent COVID-specific information
covering pregnancy and infancy
to over 300,000 pregnant women
and mothers through voice calls.
But why should you care
about our mothers and children?
The pandemic has made us confront
this most implacable of truths.
A robust primary health care system
is an absolute pillar
of a functioning and efficient society.
Improvement in maternal and child health
leads to horizontal development
of health systems
and improved primary health care.
A village that can look after
its mothers and children well
can look after all other
conditions by ripple effect.
And pregnancy is not a disease.
Childhood is not an ailment.
Dying due to natural life event
is not acceptable,
and we know why
our mothers and children die.
Yet we invest so little
in preventing their deaths.
There can be no global progress
until all our mothers
and children do well.
I implore you to add your voices to ours.
To amplify this message loud and clear.
That maternal and child health
is a human right.
Thank you.
Wired5 years ago
Wired5 years ago
Wired5 years ago
People & Blogs2 years ago
Wired5 years ago
Scot Fretwell
June 23, 2021 at 5:50 pm
Garbage level thinking if the whole family is not included.
Alexander Wilder
June 23, 2021 at 6:17 pm
bUT ThATs CuMUnisIM.
/s
steve jette
June 23, 2021 at 9:16 pm
@Alexander Wilder Oh, so THAT’S what communism is ! Thanks. I was wondering.
Alexander Wilder
June 23, 2021 at 9:24 pm
@steve jette I hope you know I was joking.
steve jette
June 23, 2021 at 9:39 pm
@Alexander Wilder did not know. Should I have seen that ? (I’m 74, so ..)
Alexander Wilder
June 23, 2021 at 9:45 pm
@steve jette It’s cool. The /s means sarcasm. Im just being silly. 😆
Lisa Love Ministries
June 23, 2021 at 5:55 pm
Proverbs 3:5-6
“Trust in the LORD with all your heart, and lean not on your own understanding; in all your ways acknowledge Him, and He will make your paths straight.”
Lisa McBride
June 23, 2021 at 6:02 pm
❤️
Salman Al-Tamimi
June 23, 2021 at 6:05 pm
It’s not a human right.
steve jette
June 23, 2021 at 9:07 pm
Salman – Neither was freedom from slavery or the right to vote until the government made it so.
chimpera1
June 23, 2021 at 6:16 pm
Neither you nor anybody else is entitled to the body or labor of another.
Lane Atkinson
June 23, 2021 at 6:24 pm
How are people STILL misunderstanding this topic in the exact same way? Educate yourself.
Alexander Wilder
June 23, 2021 at 6:34 pm
@Lane Atkinson Conservitive media rhetoric lying to them. So they get there vote.
Blessing Mansallay
June 23, 2021 at 7:10 pm
@Lane Atkinson “That’s not what it means, and no I won’t explain it” – what’s the point.
steve jette
June 23, 2021 at 9:24 pm
@Lane Atkinson EXACTLY !!
日西ディエゴ
June 23, 2021 at 6:20 pm
Human health is a human right
Meep Meep
June 27, 2021 at 7:00 pm
Yeah, tell that to China & the entire islamic world.
日西ディエゴ
June 27, 2021 at 7:47 pm
@Meep Meep in china it is free, tell that to the us
Ashutosh Srivastava
June 23, 2021 at 6:25 pm
Wait till she finds out that giving rights in itself don’t do anything.
steve jette
June 23, 2021 at 9:23 pm
Ash – That is true. Even if one has the RIGHT to go to a doctor doesn’t mean they can AFFORD to go.
Ben x
June 23, 2021 at 6:45 pm
Terminal overpopulation, poverty and the planet on the verge of ecological collapse. Especially in India. Even though it pains me to see human suffering, i cannot understand why anyone would fight for yet another and yet another baby. Free health care is economically impossible with billions of mouths to feed. It can unfortunately never be a human right. Birth control should be.
steve jette
June 23, 2021 at 9:15 pm
Ben x – You HAVE the right to health care !! You can go to the doctor, right ?
A Neutral Opinion
June 23, 2021 at 7:25 pm
Ted talks got the coldest take
TRIBE OF MENTORS
June 23, 2021 at 8:08 pm
*The most important thing is never be afraid to take a chance. Always remember the greatest failure is not having the will to try. Don’t quit before the miracle. Have a blessed & productive day* 🙏.
Allen Markham
June 23, 2021 at 8:23 pm
To support women up to birth, then not provide resources for the child & the women after birth seems cruel in the extreme.
Tiago C.
June 23, 2021 at 8:57 pm
nothing that requires the labor of others is a human rights, im sorry but maternal health and child health is a service just like any other, unless u wanna slave someone by taxes and force them to pay it otherwise they will be arrested, own let me guess you do it already.
GILL
June 23, 2021 at 9:18 pm
👏
Tony Holbert
June 23, 2021 at 11:13 pm
no one has a right to someone else’s labor
PastExpiryDotCom
June 23, 2021 at 11:31 pm
…. AND screw Dads! Happy Father’s Day! (Tip: health of biological father impacts kids as well…. but hey, nobody cares)
創業简書
June 24, 2021 at 12:27 am
作为中国人 我很庆幸可以看到这样的频道
简書 Audiobook
June 24, 2021 at 12:27 am
作为中国人 我很庆幸可以看到这样的频道
load ing
June 26, 2021 at 6:04 am
替你高興喔😊
简書 Audiobook
June 28, 2021 at 11:37 am
@load ing 可以关注我额
canigetachannel
June 24, 2021 at 5:51 am
You health is NOT a Right, at the expense of others. Your health is a personal responsibility, not a “state” or “governmental” responsibility.
Поэтический вечер 2k17
June 24, 2021 at 6:14 am
There are actually no essential human rights, that won’t lead to oppression. If someone has a right for life, that means, another person is OBLIGED to share his property, labour etc with one who doesn’t want to pay for another’s person resources, but just for the fact the last has the right for life, and that’s an obvious oppression. Think about it. If a human doesn’t want to share, – it’s up to him, which doesn’t always mean, he won’t share, but carrying this principle, nobody will be really enslaved and oppressed, except outlaw cases.
Moto Amateur
June 24, 2021 at 9:06 am
Hi, what is the meaning of the dot on your forehad please? thank you
JANE IRENE
June 24, 2021 at 3:45 pm
I’m highly favored that I was opportune to have met dr Onosetale on YouTube who helped me beat Alzheimer disease with his herbal supplement that I took for 3 weeks and it worked perfectly well…..
आदित्य Aditya मेहेंदळे Mehendale
June 24, 2021 at 3:58 pm
Since when is “an English-medium school” a sign of progress or emancipation? 4:27
bla blup
June 24, 2021 at 4:00 pm
Totally what Indian society needs at the moment. More children living in poverty. As if there aren’t enough problems caused by their massive population.
Seema warrier
June 25, 2021 at 6:06 am
Very well articulated!! 👌👌👏👏👏
maclectic
June 28, 2021 at 8:54 am
If you wander outside the reach of a doctor, or hospital, you loose your humanity