In Nigeria, Using Mobile Technology to Help Pregnant Women with Gestational Diabetes

In Nigeria, Using Mobile Technology to Help Pregnant Women with Gestational Diabetes

{Photo Credit: Rui Pires}Photo Credit: Rui Pires

At an event discussing maternal, newborn, and child survival, MSH’s country representative from Nigeria called for more attention on gestational diabetes (GDM) in her country.

The January 19 summit in Washington, DC, titled “Reaching the Last 25 Percent: Saving the Lives of Women and Newborns Through a Life Cycle Approach,” was convened by MSH, Novo Nordisk, and the NCD Roundtable. The meeting’s keynote address and two panel discussions focused on how governments, civil society, and the private sector in low- and middle-income countries are addressing maternal mortality and morbidity from non-communicable diseases (NCDs).

During a panel titled “Examples of NCD Integration in Maternal Health,” MSH Nigeria Country Representative Dr. Zipporah Kpamor discussed a recent pilot program that uses mobile health technology to measure blood glucose levels in pregnant women with GDM. The program aimed to provide women with faster, more convenient, and confidential blood glucose monitoring and a way to limit appointments, and reduce waiting time and transportation costs. The program was funded by MSH’s Internal Innovations Challenge (INCH) fund.

Studies in Nigeria show that approximately 2 percent of pregnant women in the country have gestational diabetes, which, if untreated, increases the risk of eclampsia, miscarriage, obstructed labor, hemorrhage, and other conditions. But 15 percent of the women screened for MSH’s pilot program tested positive for GDM, Kpamor said.  

“We’re telling Nigeria, ‘look, this is not 2 percent … it’s more than that. And therefore each state, you need to do some kind of assessment to determine how many of your pregnant women are actually diabetic,’” she said. “We know that [GDM] is an emergency that is just waiting to happen.”

According to the International Diabetes Federation, up to 80 percent of diabetes cases in Africa go undiagnosed, and the organization has called GDM “an invisible maternal and child health issue” to policy makers. In a country with a population of more than 170 million, and with 7 million births every year, even small percentages represent a huge number of people, Kpamor said.

As a result of the pilot program, Kpamor said that 70 percent of participants consistently tested themselves, and 90 percent had well-controlled blood glucose readings while they were self-monitoring.

Still, the program faced unforeseen challenges, including a strike by government health care workers, which shortened the implementation period, and women whose husbands did not give them permission to return for future appointments.

“We need to make the process of diagnosis very easy,” said Kpamor. “If we’re able to say, ‘you have the risk, this is what you need to do,’ in one go, then we’re more likely to recruit many [women with GDM] and then help them.”

Kpamor made recommendations for addressing these challenges and called for making GDM screening a routine part of antenatal care.

Watch the full event