Review
Global landscape of Mother & Child Health Handbook
2024 Volume 12 Issue 1 Pages 13-15
Details
2024 Volume 12 Issue 1 Pages 13-15
The Maternal and Child Health (MCH) Handbook has been introduced in more than 52 countries, both developing and developed. Currently, roughly 22 million MCH Handbooks are distributed per year and used in an estimated 16% of 140 million annual births worldwide. This is because health is not promoted in hospitals or health centers, but is nurtured at home and in communities. As confronting quality and safe maternal and child health services required by COVID-19, the MCH Handbook has undergone diverse developments, including digitization and unique content creation. In particular, in response to social vulnerabilities exposed during the pandemic, countries like Kenya have begun efforts to strengthen inclusive health system development that involves citizens, the government, private firms, and partners by fully enhancing digital transformation, starting with the MCH Handbook.
The Maternal and Child Health (MCH) Handbook is designed to promote the continuum of maternal and child health care and service equity. It has now been introduced in more than 52 countries, both developing and developed. Currently, roughly 22 million handbooks are distributed per year and used in an estimated 16% of 140 million annual births worldwide (Figure 1). The MCH Handbook not only serves as a home health record and information tool for mothers, it is also a tool that empowers each family member by enhancing parents to take responsibility for their children’s health as well as their own, and by enabling them to actively participate in decision-making and management of family well-being. This is because health is not promoted in hospitals or health centers, but is nurtured at home and in communities.
As confronting quality and safe maternal and child health services required by COVID-19, the MCH Handbook has undergone diverse developments including digitization and unique content creation. In particular, its adaptation to data-driven health governance and personal health record utilization through digitization, development based on special needs with consideration for diversity, and significance as a platform for MCH services that overcome differences in language and health systems have been recognized. Moreover, in response to social vulnerabilities that have arisen under pandemic conditions, countries such as Kenya have begun efforts to strengthen inclusive health system development that involves citizens, the government, private firms, and partners by fully enhancing digital transformation, starting with the MCH Handbook.1,2)
In December 2019, COVID-19 quickly spread across all regions of the world, reflecting economic globalization. In Africa, prenatal checkup rates dropped by 20%, along with decreases in institutional deliveries by 10% and family planning services by 15%. The pandemic has driven over 700 million girls out of school, as poverty and school closure has led to an increase in child marriages. There is concern that child marriages will increase by 2.5 million given the accumulated number of unwanted pregnancies and complications from unsafe abortions.3) In addition to gender-based violence and teenage pregnancy, there are fears that cases of female genital mutilation (FGM) may increase, with indirect social, economic, and psychological consequences, e.g., suspension and stagnation of various services, border and economic blockades, school and workplace closure, unemployment and bankruptcy, and self-restraint in civil activities.4,5) Furthermore, the pandemic has brought to light previously unresolved social issues such as poverty, inequality, environmental problems, aging society, minorities, and the promotion of discrimination and prejudice.
Since the introduction of the MCH Handbook in 2007, Kenya has seen its penetration rate exceed 90%, the highest in Africa. Public interest in the MCH Handbook is also much higher than before due to recent efforts to achieve universal health coverage as part of the national strategy to increase labor force participation for economic growth. This not only involved the dissemination of safe childbirth services and family planning programs, which have posed challenges in the past, but also the promotion of preventive health activities through health education, digitization of the MCH handbook, represented by the life course approach, and implementation of a cash transfer system for poor families as a social security program.6,7) In addition, efforts have been made to strengthen inclusive health systems by fully utilizing data health technology, which involves accumulating health records and reflecting them in health policies, as well as introducing an electronic health insurance system (M-TIBA).
Such E Health and M Health have unlimited scalability through linkage with information devices that transmit to people and objects via the Internet, known as Internet of Things (IoT). Telemedicine services and digitized diagnostic imaging and laboratory/medical records have improved accessibility to medical care for elderly and disabled people, and wearable tracking and self-testing services have contributed to improved drug compliance, self-care for health and mental health conditions, and linkage to Fintech, Femtech and Babytech, etc (Figure 2). The Singularity is about to be reached in all regions of the world, including Africa, through artificial intelligence augmentation with accumulation of health information by mobile and remote devices, including service extension to specific populations.
Social problems such as poverty, inequality, nutrition conditions, and education levels faced by low- and middle-income countries in Africa have been challenges for the international community to address. However, the COVID-19 pandemic caused enormous human and economic damage in high-income countries that, until then, had regarded the above issues long resolved. In other words, the pandemic revealed that the modern social system, which had been considered robust to date, is vulnerable to infectious diseases. In addition to ‘old’ vulnerabilities such as disparities in health and education due to economic disparities, there emerged a need to reconsider the effects of economic globalization, urbanization, work and educational environments, tourism, and entertainment as ‘new’ vulnerabilities that 21st century societies face.
As a means to overcome both new and old vulnerabilities, digital transformation accelerated by the COVID-19 pandemic has the potential to usher in the era of the “New Normal.” In the face of unknown viruses and pathogens, people in the world have often overcome their fears by exchanging experiences and ideas beyond national borders. The instantaneous sharing of experiences through the Internet, transcending language barriers, can eliminate our fears and enable us to take healthy action. According to Audrey Tan, Taiwan’s digital minister, the goal of the digitalized society is the realization of the “ultimate democracy,” where people are able to make decisions based on an inexhaustible supply of truly correct information, overcoming various constraints.
It is a mechanism of wisdom that will be extracted by superior mechanical intelligence as predictive behavior to avoid danger, innovate a resilient society, and enhance planetary awareness beyond the reach of human imagination. This may be the truth of wisdom that promotes the health of humanity in the ecosystem.
The abstract of this manuscript was presented at the Workshop of the 22nd Congress of the Federation of Asia and Oceania Perinatal Societies. I would like to thank Professor Mamoru Tanaka for giving me the opportunity to present my work, and Drs. Yasuhide Nakamura and Satoru Takeda for their efforts as chairpersons of the workshop at the Congress.
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