Saving Next Gen Initiative (SNGI)

According to the World Health Organization (WHO), 190 Indonesian mothers die per 100,000 live births. 

SNGI uses a data driven approach to help solve this problem. We mobilize Community Health Workers (CHW) to submit the data of pregnant woman monthly through the SNGI mobile apps. The collected data is leveraged by our dashboard with the help of unique algorithms as an early detection system in case of potential emergency.

We had piloted our model in Garut city of West Java for 3 years. At this stage the model is very culturally relevant to Indonesia, however it addresses an issue that affects many woman in the developing world.

After 3 years in operation, we have witnessed a significant decrease in the number of maternal deaths and seen growing support in the community for mothers in rural regions of Indonesia. We aim to expand this solution to other cities in Indonesia.

Every 11 seconds, a woman or newborn dies of complications related to pregnancy or childbirth, mostly from avoidable causes. In Indonesia, 190 mothers die per 100,000 live births according to the World Health Organization (WHO). Woman in rural areas and from poor families are more likely to die from high risk pregnancy than their peers.  Root causes of this tragedy are a social determinant lack of knowledge; unhealthy lifestyle; and poverty.  We are working collaboratively with existing stakeholders to democratizing the better maternal monitoring using information technology which are now mostly accessible in where those vulnerable woman lives.

SNGI is our preventive measure to solve the problems above. We are focusing on on education and intervention based on evidence (data) to increase the identification and management of high-risk pregnancies. The importance of data analytics has becoming more important than ever, especially in this digital edge. 

Based on the latest survey of the Association of Internet Service Providers, Number of Internet Users in Indonesia Rises to 186 Million. People in the village now getting more access to the internet thanks to mobile penetration.   

Hence, we are building our own information system using LEAN methods, consist of:

 1. Saving next Gen apps in android for 2 users: CHW in Posyandu (community health post) & Village midwives;

2.  Dashboard, where our experts/doctors/our staffs with the help of special algorithm can do data analyzing. This dashboard also accessible for the authority in that particular area as an input for monitoring and policies;

3. memobayi apps to monitor baby-child growth

Based on the data we held the education, limited intervention, monitoring, and programs. Our staffs also provide capacity building, and the most importantly is working with stakeholders on each role.

Our direct beneficiaries are more than 1200 CHWs, village midwives (they are the users of our apps), as well as primary health care and the office of health affairs.

Our most critical beneficiaries is pregnant woman, breastfeeding mother, and children below 5 years.

You can see that they are existing stakeholder of maternal care. Our presence is leverage their work with technology, we empower them to maximize their valuable work so that they can save more lives. We developed the system altogether with them so we made sure they can benefit from this innovation.

Our theory of change is to solve the challenges we face with the capacity building and equip them with the appropriate technology.

The output: numbers of CHW’s and village midwives we have trained and worked together, new knowledge get by our direct beneficiaries (measured by post-test).

The outcome of those outputs: behavioral changes on certain areas we intervene (new highly motivated CHW’s, increasing number of male CHW’s that shown maternal is not just woman responsibility, growing support from village’s administration, growing number of local govt who has shown commitment to allocate the budget for this program in their cities)

We use data analytic as an early warning system for measuring risk pregnancy. Our data is quite rich, from Bio, number, to medical record (blood pressure, HB, upper arm size, body weight, complications), and other pregnancy history. Based on this data analytic were doing risk stratification and producing suggestion / advice to each pregnancy. All of our education and intervention are based on data. As far as we know, this data-driven approach is new here in Indonesia, Were developing the technology based on user experience (lean principle) to encourage Community Health Workers and Village Midwive use this.  

We leverage technology to improve maternal health and early pregnancy risk detection. The importance of data analytics has becoming more important than ever, especially in this digital edge. We believe tech is a huge part of it, saving mother lives and the next generation using data.

we are building our own ‘technology’,  consist of:

 1.saving next Gen apps in android, for local cadres in Posyandu and village midwives to submit the data,

2. Dashboard, where our experts/doctors with the help of special algorithm can do data analyzing,

3. memobayi apps to monitor baby-child growth.

part of it, saving mother lives and the next generation using data.

http://uu.diva-portal.org/smas...

https://kompas.id/baca/tokoh/s...

Our theory of change: to work with existing stakeholder to solve the challenges we face with the capacity building and equip them with the simple technology that they can use (it’s been validated on our pilot phase). Parallel with this grassroots’ activities we are building advocacy so that this initiative can be replicated by local government. The output of those activities have been: numbers of CHW’s and village midwives we have trained and worked together, the user who has used our system, new knowledge get by our direct beneficiaries (measured by post-test and exams, so they have a certificate as our partner).

The outcome of those outputs so far are: behavioral changes on certain areas we intervene (new highly motivated CHW’s, increasing number of male CHW’s that shown that maternal things is not just woman responsibility, growing support from village’s administration for example they support their CHW’s with new fancy android, more data-driven stakeholders, and growing number of local govt who seems has shown commitment to allocate the budget for this program in their cities, etc).

The impact we have measured now is the decreasing number of maternal deaths in area we are working for more than 3 years. So we believe that we have contributed in sense of Expand access to high-quality, affordable care for women, new mothers, and newborns. We can also say that we could manage the high risk pregnancies that contributed to the maternal deaths before.

current numbers: we've been reach out almost 12.000 pregnancy with 587 of CHW's

one year (including the replication will be done shortly after pandemic ends): 5000 woman

in 5 years projection: more than 100.000 pregnancy in several cities/provinces in Indonesia

We have an agreement with Dompet Dhuafa to replicate this model in 6 cities-provinces in Indonesia. So thats the 1 year target

We also doing advocacy to local govt in several cities provinces currently. we hope we will have an agreement at least 50% from the number of advocacy.
So we hope that in the next 5 years we will also contributed to the evidence based on policy in maternal healthcare and children development.

the uncertain commitment from Govt. lots of talks, but different stakeholders different  commitments and interest. Political dynamic might change during long effort of advocacy.

Early stage of business model: we can serve middle income segment, some of our services are fee for service model, but it is still under our expectation.

better mapping of stakeholders and using more powerful networks.

working with partners for further business model iteration and validation (pivoting).

SNGI is tripartit collaboration now with Dompet Dhuafa and Applicative Medicalcare system.

in the early stage Asgar Muda Foundation was the initial founder of SNGI

full time: 5

part time: 2

volunteers: more than 1000 CHW and midwives

contractor: 2

Board of Expert: dr. Achmad Mediana, s.pog (obgyn), dr. Gustomo Prananto s.pa (pediatrician), dr. Minessa mahardika s.pg, dr. Gina;

Jefri & Rahman : back end programmer & data specialist

ummi kultsum: program officer (midwives)

isma nurhayati (admin)

syifa nurhayati (communication)

Shanti Deliani (managing director)

DOmpet Dhuafa (contribute to funding and replication);

Applicative Medicalcare System (busines model, IT)

Midwives academy (education and community development)

our business model is: 

-Third party payer and fee for service model

Customer segment: CHW's and midwives.

Target population: productive age woman, girl adolescent, pregnant woman, newborn baby;

Canal : cooperation with government

Value preposition: maternal care services run by existing stakeholders (equipped with innovation in technology & program), Free for targeted population, lots of benefit for member (pregnant woman)

currently our funding is hybrid. some of it comes from grants from Dompet Dhuafa (largest Islamic charity NGO in Indonesia), some from business model (fee for services model from middle class segment).

Starting next year with the assumption that we will scale up to several cities, our model will switch mostly to third party payer while we maintain the working model 

Why we are interested to join SOLVE community

We realize that in order to solve adaptive challenging problem we have to work together..

we’d like to scale up our initiative so we can impact more lives. We think that your expertise, networks, technologies might boost our credential in doing so..

- We'd like to have a help in technology development. It is quite complicated if we want to scale up.

- We'd like also to learn about partnership with research institution related with maternal health.

- we'd like to learn more as well about effective advocacy :)

Tech Businesses who can help our UX design better;

Research institution on maternal health to turns our data into recommendation;

Health tech start up, to learn more broaden business model of health tech start ups;

almost 99% of our target population is woman.

And 90% of CHW who is the the front line of its program is woman;

The concept creator of apps algorithm also woman in our team

Innovation for woman prize will be beneficial for the capacity building of our member to develop their potential and further develop community empowerment on economic activities.

According to the World Health Organization (WHO), 190 Indonesian mothers die per 100,000 live births, the highest in Southeast Asia. Many of these cases happen in rural areas, where expectant mothers do not have easy access to primary healthcare facilities, and instead, rely on informal not-qualified midwives for giving birth (dukun beranak we call it in Indonesia).

This case links with child death, stunting, and malnutrition. Over 9 million Indonesian children are stunted. More than 4.5 million are severely stunted. Those problems will become threat to the future generation. Indonesia is predicted to benefit from demography Bonus by 2025. Those 2 are really crucial in global agenda to achieve Sustainable Development Goals (SDG’s) target.

Garut region, apparently has the second highest death rate of women in cases related to pregnancy or childbirth in West Java Province. Apart from the lack of medical facilities and support, the community who mostly still live in poverty. In the remote areas of the vast district, young girls from poor family tend to enter marriages at such young age, with poor education. They are not well-equipped with sufficient knowledge on pregnancy health, birth, or how to raise children.

access to training for health workers is at the heart of our activities. Some of them are:

• Pre Natal academy, to equip parents with the proper knowledge and practice of family planning, pregnancy, and psychological preparation;
• Lactation counseling,
• Pregnancy class,
• Various education class: on nutrition, etc
• Doctor’s visit (USG from obgyn, children health with pediatrician)

As we said in previous section, We are now doing advocacy to several local govt. Mostly they are interested on replicating the program but budget planning is quite tricky because the budget we can try to access is for next year. We were wondering if we can create small pilot in their area (maybe in 1-2 primary health care), so it will strengthen our evidence in doing advocacy.