Digital Health for Migrant Mothers Network: Maternal Care in Dadaab Camps

我们名为“移民母亲的数字健康”的网络在联合国、非洲和英国的学术界、工业界（非洲虚拟现实公司“黑犀牛”）和助产士之间建立了一种创新合作，探索如何利用数字工具加强难民营环境中难民的孕产妇保健。联合国指出，尽管全球趋势有所改善，但生活在难民营等人道主义环境中的妇女的孕产妇和新生儿死亡率仍然高得不成比例。这一挑战的一个核心组成部分是缺乏训练有素的助产士来应对妇女面临的这些紧迫挑战，孕产妇保健已被战略性地确定为可持续发展目标（5和3）的一部分。我们的项目建立在以前gcrf资助的研究（“边境分娩”PI Bagelman）的基础上，并在世界上最大和历史最悠久的难民营之一解决这些挑战：与索马里接壤的肯尼亚达达阿布难民营。达达阿布难民营目前收容了40多万难民（占育龄人口的40%），孕产妇发病率和死亡率非常高（Gee等人，2019年）。我们的项目提出了一个创新的网络，将一个多元化但协调一致的团队聚集在一起，共同设计一个数字卫生应对方案，以应对长期流离失所环境中移民母亲面临的紧迫挑战。我们的项目本质上是协作的，采用敏捷的参与式研究模式，而不是从上面强加模型。鉴于助产士迫切需要在孕产妇护理的数字化提供和教育中发挥更大的作用，我们的项目将建立一个参与式网络，探索“培训”助产士的可能性，通过设计联合国支持的助产教育数字化“教学工具包”来提高她们的数字素养。尽管国际社会在达达阿布的生殖健康方面投入了大量资金，但与该地区其他困难地区相比，孕产妇和新生儿死亡率高得不成比例（Gee等人，2019年）。研究表明，这种差异是由于难民营内孕产妇护理的系统性脱节：虽然大多数难民妇女依赖助产士（因为她们认为提供情感上、文化上敏感的支持），但训练有素的助产士很少（Bagelman等人，即将出版）。见简历)。尽管助产士在支持难民产前和产后护理方面发挥了关键作用，但助产士培训仍然资源不足，而且是临时设计的。虽然有大量资源专门用于促进生物医学从业人员的数字化学习和培训，但助产士主导的健康教育平台仍然得不到支持（世卫组织，2016年）。特别是，大多数助产士仍然无法获得数字卫生工具。例如，虽然虚拟现实（VR）作为一种富有成效的学习和教学机制已经在生物医学社区得到了完善，但助产士很少有机会获得这种工具。造成这种数字差距的主要原因有两个：1)数字技术的缺乏削弱了妇女提供护理的能力；2)直接影响了难民营中依赖（有时完全依赖）助产士接受护理的难民妇女。总而言之，我们的网络将非洲数字专业知识放在首位，在其方法中按性别划分，并将那些在数字辩论中经常被边缘化的人作为中心，以促进在紧急营地地区采取创新和敏捷的应对措施。参考文献：Gee， S., Vargas， J. and Foster, a.m., 2019。“探索社会文化背景的作用以及难民署在肯尼亚支助的难民营中索马里难民对孕产妇和新生儿保健护理的看法”。冲突与健康，13(1)，第11页。

Our Network entitled 'Digital Health for Migrant Mothers' establishes an innovative collaboration between the UN, African and UK-based academics, industry (African-based VR company 'Black Rhino') and midwives to explore how digital tools can be used to enhance maternal care for refugees within camp environments. The UN has noted that despite improving global trends, maternal and neonatal mortality rates remain disproportionately high for women living in humanitarian settings, such as refugee camps. A central component in this challenge is the lack of trained midwifes with Combating these pressing challenges facing women's maternal health care has been strategically identified as part of the SDGs (5 & 3). Our project builds upon previous GCRF-funded research ('Birthing at the Borders' PI Bagelman) and addresses these challenges in one of the worlds' largest and longest-standing refugee camps: Dadaab camps in Kenya which borders Somalia. The Dadaab camps currently host over 400,000 refuges (40% of reproductive age) where maternal morbidity and mortality is notably high (Gee et al, 2019). Our project proposes an innovative Network bringing together a diverse but coherent team to co-design a digital health response to the urgent challenges facing migrant mothers in an environment of protracted displacement. Our project is collaborative in nature, employing agile participatory modes of research rather than imposing models from above. Given the urgent need for midwives to have a more empowered role in the digital provision and education of maternal care our project will develop an engaged Network to explore the possibilities of 'training up' midwives, enhancing their digital literacy through the design of digital 'teaching toolkits' for midwifery education supported by UN.Despite significant international funding spent on reproductive health in Dadaab, maternal and neonatal death rates are disproportionately high as compared to other hardship areas in the region (Gee et al, 2019). Research demonstrates that this discrepancy is due to a systemic disconnect in maternal care within the camp: while most refugee women rely on midwives (as they perceived to provide emotional, culturally-sensitive support) there are only few trained midwives available (Bagelman et al, forthcoming. See CV). Despite the key role that midwives play in supporting refugees in pre to post-natal care, midwifery training remains under-resourced and designed on an ad-hoc basis. While significant resources are earmarked for promoting digital learning and training for biomedical practitioners, midwifery-led health education platforms remain under-supported (WHO, 2016). In particular, digital health tools remain inaccessible to most midwives. For instance, while Virtual Reality (VR) have been well-established within biomedical communities as a productive mechanism for learning and teaching, midwives have little access to such tools. This digital gap is problematic for two main reasons: 1) the absence of digital technology underprivileges women in their ability to provide care 2) and directly impinges upon refugee women in camps who rely - sometimes exclusively - on midwives in receiving care. In sum, our Network places primacy on African digital expertise, is gendered in its approach and centres those often marginalised in digital debates to promote an innovative, and agile response in emergency camp geographies.Reference: Gee, S., Vargas, J. and Foster, A.M., 2019. "exploring the role of sociocultural context and perceptions of care on maternal and newborn health among Somali refugees in UNHCR supported camps in Kenya". Conflict and health, 13(1), p.11.