Customer Profile
Through a USAID-funded Pathfinder International program, Voxiva worked with the Regional Health Directorate of Ucayali, a region south of Lima in the Amazon, and the Peru Ministry of Health to develop Nacer, a maternal and child health solution. Nacer enables rapid, real-time information exchange between remote health posts, medical experts, and regional hospitals.

Situation and Challenges
Throughout the developing world, more than half a million women die each year from pregnancy and childbirth related complications. In addition, millions of infants die within their first weeks of life, often as a result of poor maternal care during pregnancy and delivery. With appropriate health services and nutrition during and after pregnancy, many of these deaths are preventable.

In the year 2000, the maternal death rate in the Ucayali region was 185 per 100,000 compared to 146 per 100,000 for Peru's national average. The infant mortality rate was 52 per 1,000 compared to 34 per 1,000 nationally. Reducing these rates by half is a primary health goal of the Regional Health Directorate of Ucayali and the Peru Ministry of Health. This is difficult to achieve in many areas of Ucayali. Thick Amazon rainforests make it impossible to travel via motorized land vehicles. Most transportation is by river, which can take two to seven days to reach desired destinations.

Solution
Nacer is a phone- and web- based information and communication system that allows health professionals in remote locations to communicate and exchange critical health information between themselves, medical experts, and regional hospitals. All reported data is recorded in a central database, and is available to health officials in real-time for analysis and decision-making. Health workers in locations without Internet connectivity can access the system using any phone (satellite, fixed-line, mobile, or community pay phone).

The Nacer solution includes the following capabilities:

  Patient Monitoring: Health workers electronically report information about the progress of women's pregnancies, allowing experts at regional hospitals to monitor the health status of pregnant women, answer questions from health personnel regarding recommended care, and suggest treatment options.

  Patient Referral: Local health workers can refer women requiring specialized or emergency care to regional health facilities, and provide key clinical information to the hospital.

 Follow-up Care: Once a woman is discharged from a regional hospital, attending specialists can send notifications to local health posts regarding recommended follow up care.

  Critical Supply Tracking: Nacer allows regional health personnel to notify health officials of critical supply levels, such as medical equipment and drug supplies. This ensures remote health posts have adequate supplies of pharmaceuticals and other equipment for treatment.

  Disease Surveillance: Workers at remote health posts can report cases of infectious disease in pregnant women and others receiving health services. This allows officials to monitor overall health trends in the region and use public health resources to prevent and respond quickly to disease outbreaks.

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GIS Map displays real-time information of reported disease cases by district	Patient referral registry hospitals of incoming patient, and provides key clinical data

Benefits
  Increased Coordination: Health outposts can share critical data with hospitals when referring patients, and receive feedback for follow-up.

Reduced Supply Shortages or Stock-outs: Program managers can view the status of critical supplies (e.g., drugs) in real-time, and receive notifications when clinic equipment needs repair or replacement.

  Increased Data for Decision-Making and Response: Health officials at regional hospitals receive real-time information about the health status of women in remote regions. These officials can also provide feedback to health workers when reported conditions raise medical concern.

  Improved Health and Safety: Health officials can receive real-time reports of infectious disease cases (in pregnant women and others), as well as cases of people affected by natural disasters. The surveillance functionality can be used to monitor overall health trends and appropriately respond when disease outbreaks or disasters occur.