Building a scalable emergency and referral service for mothers and newborns on AWS with Vodafone Foundation

Vodafone Foundation invests in underserved communities to make long-term sustainability impacts such as advancing health equity. The foundation piloted m-mama in Tanzania to help mothers and babies access care. During an emergency, a mother or a representative can call a toll-free number to request transportation. When nurses or midwives in a dispatch center answer the call, they collect information about the patient’s location and condition in the m-mama application and complete triage. If the mother or baby is eligible for care, the dispatcher works with the closest relevant health facility to receive the patient and arrange transportation by using ambulances or community drivers that the government reimburses.

Vodafone Foundation wanted to invest in a scalable, cost-effective cloud solution that could expand to Lesotho and beyond rather than continuing with the initial third-party application. The foundation chose AWS because of its range of services, advanced security features, global infrastructure, and flexibility to adapt to the needs of different governments. “We didn’t have the infrastructure to host and scale our technical solution, so we explored cloud providers that could offer reliability and data security,” says Omar Farook, solutions architect at Vodafone Foundation. “AWS is a leader in cloud and AI technology and has a strong presence in African regions.”

Starting in September 2020, Vodafone Foundation migrated m-mama to AWS, creating a solution that is applicable to multiple countries. In addition to support from AWS, Vodafone Foundation received funding from the AWS Health Equity Initiative—a pledge from AWS to donate a total of 60 million dollars over 3 years for supporting organizations that use its cloud technology in accelerating research and innovation to advance global health equity.

Vodafone Foundation then deployed m-mama for implementation and national scale up in Tanzania and Lesotho. For long-term sustainability and government ownership, the foundation transitioned the ICT system to the government of Tanzania in June 2022 and the government of Lesotho in June 2023. Hosted on AWS, m-mama continues to communicate with government systems to collect patient data and support program dashboards.

Without transportation, women and babies who experience an emergency might not receive appropriate, timely care. Currently, m-mama facilitates more than 70,000 emergency transportations per year in Tanzania and Lesotho. Patients in remote locations now use community drivers 30 percent of the time, getting access to care they didn’t have before. Community drivers offer a cost-effective solution for governments, helping to bridge the transportation gap when government ambulances are unavailable. Vodafone Foundation estimates that it provided transportation for over 6,500 lifesaving events. According to a study by the National Institute for Medical Research, m-mama has helped reduce maternal deaths by 15 percent in Tanzania.

Because dispatchers might not have internet access, m-mama works offline and synchronizes data when back online by using AWS infrastructure and an open source technical solution for the data application process. To pregenerate and optimize routes, distance, time, and payments for the community drivers, the foundation uses Amazon Location Service (Amazon Location)—which lets businesses easily and securely add location data and mapping functionalities to applications.

Using AWS, Vodafone Foundation can manage the complexity of m-mama and its mobile app, backend web interface, database, and dashboards. The solution uses APIs to pay community drivers and share data with government healthcare systems. Stakeholders from health facilities and national and local governments have access to operational dashboards that are powered by AWS. For example, district health management teams, reproductive health coordinators, and representatives from ministries of health can access resources such as monthly flash reports, which display key performance indicators collected in m-mama. These dashboards help stakeholders assess m-mama services and make decisions, such as improving a facility’s readiness to receive patients.

Vodafone Foundation built m-mama on AWS modularly—that is, using separate modules for different countries—and can effortlessly transition each module to the corresponding government for oversight. The foundation works with local governments from the beginning to adapt and set up m-mama. It then builds capacity and transfers knowledge to them so that they can sustain the system independently going forward.

With the flexibility and scalability of AWS services, Vodafone Foundation can accomplish its mission with a small technical team. “Using AWS, we can host our application without requiring an extensive infrastructure,” says Farook. “The cloud simplifies things for us.” As the foundation expands the system to new countries, it can replicate m-mama while offering customizations. To meet evolving business needs, the foundation can also iterate and add new features, such as enhancing how patient outcomes are collected or adding private ambulances to the service network.

Following the AWS Shared Responsibility Model, Vodafone Foundation fortifies security by using tools such as built-in encryption for Amazon Relational Database Service (Amazon RDS), easy-to-manage relational databases optimized for total cost of ownership. The foundation can also cost-effectively back up data by using AWS and avoid the risk of data loss from physical data center malfunctions, which can impede patient care. “It’s reassuring that the ICT system is hosted on AWS for the implementation phase in each country so that we can facilitate data security, privacy, and loss prevention, which are very important to governments,” says Samy Ellouze, chief implementation officer for m-mama at Vodafone Foundation.

Vodafone Foundation plans to expand m-mama to Malawi by the end of 2025. Initial planning is also underway for expansion into three additional countries in Africa. “The solution has been very successful over the last 5 years since we’ve been working alongside and hosting our application on AWS,” says Farook.