Interview with Deborah Maufi

In the 21st century we are witnessing a digital revolution. Big Tech and other digital companies quickly gained momentum, overwhelming us with innovations like: AI, VR and AR, Machine Learning, 5G, Quantum Computing, Blockchain (and other obscure terms). It seems like a very tecky “silicon valley clique” has embarked on a SpaceX Starship, rushing at supersonic speeds towards a utopian future. In the meantime, 41% of our planet population, if given a laptop, would, probably, use it as a nutcracker. The problem of digital division becomes a real challenge. It is not just a matter of personal habits and preferences of the older generation anymore, but a way of systemic exclusion from digital services of whole groups/societies. Social issues are complex subjects. Thus, I suggest we start tackling it with the health department. For this purpose, I am happy to introduce Deborah Maufi, who is a health project manager with work experience in Africa and Europe.

Dear Deborah, one of your professional objectives is expanding digital health equity. It’s quite an intricate term, so let’s break it into small pieces.  What is health equity and how is it combined with digitalization?

Health equity is about ensuring that each person has the opportunity to reach his full health potential, regardless of his race, gender or socio-economic background. These factors influence the kind of care that one needs. When we bring digitalization into equation, we intend to make healthcare more effective and efficient. That’s why it is important to make sure that this digital complement actually helps and enhances access to healthcare, but does not create a barrier.

So, equality means giving everyone the same thing, whereas equity is about giving people what they need. Though, we’re used to think that people need the same things regardless of their background and not depending on it. Could you elaborate more on this idea?

For instance, there are some diseases that affect more the black than the white population and, in many areas, black people are a minority. The problem is that the healthcare system is tailored around the health indicators of the majority. Take the Body Mass Index (BMI), which is used to assess a person’s overall health. The “norm” ranges from 18.5 to 24.9, but it does not consider a person’s gender or ethnicity. A large 2003 study has shown that higher BMIs are more optimal for Black people, while lower BMIs are more common for Asians. Consequently, using a universal index for assessing the health of people of different races might lead to inequities.

Another example would be developing countries. If we are to bring them a complex and expensive tool, we are not going to help them, but rather create an additional barrier accessing a certain health service. Maybe they can’t afford maintaining the tool or even don’t know how to use it. It is essential to make sure that innovative digital solutions are suited for them. That’s why I am advocating for digital health literacy, trying to bridge that gap between solutions and an effective use of those solutions.

How do you exactly tackle these problems?

I founded a platform, Realize Health Equity (RHE), to promote health equity through education, partnerships and community engagement. I am also the Ambassador of HIMSS, a global health equity network, where I collaborate with members from diverse communities, to share insights, best practices and resources through virtual and in-person education events. This also includes speaking at conferences, publishing articles, collaborating with innovators and trying to find optimal solutions that will actually be adopted by the end user. An important part of this is working on implementation strategies, which is about diversifying the healthcare workforce and also making it inclusive.

I am very curious to know what made you pursue the mission of promoting health equity in the first place…

(Chuckling)…You know, I’m from Tanzania and when I grew up, I realized there’s quite a big gap between the rich and the poor. Only the rich had access to healthcare benefits and insurance. But when I moved to the Netherlands, I was surprised to notice that it was not a privilege, but a healthcare system that included everyone.  That was the point when I understood that healthcare is a human right and thought that it would be a good idea to bring the problem of health inequity to light. It’s going to be a long journey, but we have to start somewhere. If we want to see change tomorrow, we have to start today.

on picture: Geta Rasciuc – founder & CEO of Babymoon CARE & Deborah Maufi MD / MBA, Chief Medical Officer at Babymoon CARE during October 2020 Babymoon Catwalk 

You are also a health project manager and a chief medical officer at Babymoon Care. How do you help this particular business?

My role at Babymoon is to develop and implement health care strategies for baby wearing. Ordinary baby-carriers are just a means of transport, but we believe that they are much more than that. Think about premature babies that are kept in incubators. Babymoon’s solutions allow an infant to achieve healthier outcomes psychically, emotionally and socially through the skin-to-skin contact with a parent, which is also a more cost-effective tool that can replace incubators (in less severe cases). This also benefits developing countries, which can’t afford incubators, but can easily adopt baby-carriers. There is so much evidence about it. The idea originated in Colombia and has been there for years, but only now the World Health Organization actually recommends it as a cost-effective solution for premature babies.

It is wonderful how a bit of research does not lead to a greater digitalization, but encourages the return to our natural state

Indeed. We moved to a digital world and forgot that the simple things are the best. Now we are seeking new partnerships in new cultural contexts to implement this solution.

What other business can benefit from your expertise?

Hospitals, Healthcare Facilities, Digital Transformation Agencies, policy makers, Community-Based Organizations (CBOs), but also innovators.

Moldova is also a developing country, so I was wondering what systematic ways of treating the problem of digital health inequity you would suggest? How to involve the state?

I think the key is meaningful advocacy to relevant stakeholders. We need to find win-win situations for both parties: the community and the policy makers themselves. I tailor my message differently for every stakeholder, finding solutions that will benefit them and the community at the same time. This makes it easier for them do adopt the solutions that I am proposing. Let’s take the example of a developer of a self-management health app. What the developer needs to understand is that there are many factors that will influence the experience of the end-user. My work is to research the cultural/religious/health/economic differences and adjust the value propositions to different target-groups. This leads to a shorter customer adoption process, a better service for the end-user and also benefits the health system in general, reducing the burden on hospitals and increasing the socioeconomic status of the users. For these purposes, I am using the HIMSS platform, which has the right audience, with over 100.000 members from all levels.

Could you also share with us your most significant achievements in the field of health equity?

I recently got nominated for HIMSS Future50 Community, in the category of digital health leaders who make significant contributions to digital health globally.  The goal of this community is to drive digital transformation on a global level.

My warm congratulations, Deborah! And, last but not least, I would like to ask for an advice. What should we prepare for and how can anyone contribute personally to achieving digital health equity?

Everyone should definitely prepare for the digital transformation, because it’s already happening. This starts from encouraging young people from different cultures to discover the field of science, medicine and tech, hereby making the workforce more diverse and inclusive. I’ll put it into simple words and state that „diversity is being invited to the party but inclusion is being asked to dance”.

It starts from you showing your grandmother how to use a self-care app at home and healthcare workers learning digital skills, to innovators creating user-friendly apps and the state making policies that increase digital literacy, including digital skills into the curriculum. Everyone has a role to play. That’s as simple as that.

interview by Mihaela Dima via

European Babywearing Week 2021: Safe in my arms with Babymoon Care

Today marks the beginning of European Babywearing Week, where we celebrate babywearing in our communities. It is also a day to bring awareness about the history and evolution of babywearing. Babywearing has evolved and continues to evolve. It has been practised for centuries where different communities improvised fabrics and other materials to carry their babies. This was meant to increase mobility of the parent without separating from their child. As this practice kept growing, it gained more attention, followed by research around it. Today babywearing is an evidence-based practice that benefits the mother and child’s physical, mental and social wellbeing.

Geta Rascuic- Founder and CEO Babymoon Care BV 

The European Babywearing Week concept was initiated at the Babywearing Conference in Antwerp in 2016. Rosie Knowles together with members of the corresponding Facebook group from various countries in Europe made EBW 2017 happen. This year’s theme is ‘Safe in my arms’ and it will be translated to all European languages and promoted on social media with the hashtag #EBW2021.

There are several babywearing tools but baby carriers are becoming more popular in the babywearing world each day. Carriers offer ease of mobility; hands-free convenience and they increase the bond between the parent and child. They are also easier to carry compared to prams and strollers therefore reducing the number of products a parent needs to carry. All these are drivers for demand for awareness and influence purchase behavior. Another key driver that influences parents’ decision to purchase a baby carrier is safety. The Babymoon carriers are designed based on traditional Asian carriers to be lightweight and to grow together with your baby. They support the natural C-shape curvature and grow with the baby for each step of their spine development. They are simple to use and equipped with two wide shoulder straps (top rail), a long hip strap and offers multiple buckling options for front, hip and back carry for complete adjustability and even weight distribution without pressure points. The baby’s knees are slightly higher than the buttocks in these carriers and the legs are spread from the hips which also produces a clinging reflex. This position is ideal for the development of the spine and hips of your baby. Babymoon carriers are certified by the International Hip Dysplasia Institute as ‘’hip healthy’’. This means the Babymoon carrier hammock is designed to support the baby’s hips in the safe M-position, supporting the spread-squat positioning of the baby and preventing hip dysplasia.

Furthermore, Babymoon carriers are not just a means of transport. We offer a care package with a range of health benefits to both mother and child. They can also be used to perform Kangaroo Care (KC)- an effective intervention for low birth weight, preterm and term babies that facilitates positive physical, social, and emotional development for the dyad. Functionally, they are very versatile adapting to the growing weight of the baby in a variety of settings and uses – from skin-to-skin Kangaroo Care, to burping, cuddling, discrete breastfeeding and/or mobility of the caregiver.

Kangaroo Mother Care

For better health outcomes for premature infants

“Kangaroo Mother Care is a comprehensive intervention recommended for all newborns especially those born too soon or too small. It is the most feasible and preferred intervention for decreasing neonatal morbidity and mortality” – Healthy Newborn Network, 2020

Babymoon care

Most babies born too soon or too small are prone to a range of diseases, learning disabilities and in some cases, death. According to UNICEF, complications from preterm birth,account for nearly 1 million deaths each year. Social, economic, gender and geographic disparities can exacerbate the circumstance.

Achieving physiological independence during the transition from intra- to extrauterine life reflects the the infant’s ability to maintain homeostatic control. This is a time of high risk, and specifically preterm infants are at higher risk of mortality and morbidity because of underdeveloped physiological functions such as, cardiac, respiratory, neurophysiology, gastrointestinal, musculoskeletal, renal, metabolic, and immunity.

“Every year, 15 million babies are born prematurely – more than 1 in 10 of all babies around the world.” – UNICEF

In most countries, the use of incubators is the standard for thermal care of babies born too soon or too small. However, incubator care is not widely available especially in developing countries. Problems such as cost burden, maintenance and power outage reduces the availability of functional incubators. Furthermore, babies in incubators are separated from their mothers which strains the attachment between mother and baby. Fortunately, there’s an alternative approach for improving the survival of premature babies- namely Kangaroo Mother Care (KMC).

The key elements of kmc are:

  • Position: early, continuous and prolonged skin-to-skin contact between the mother and the baby
  • Nutrition: exclusive breastfeeding
  • Discharge: with adequate support and follow up
  • Support: supportive environment in the health care facility and at home.

KMC is a method of care of preterm infants introduced more than 40 years ago in Bogota, Colombia, as an alternative approach to traditional neonatal intensive care unit (NICU) care for low-birth weight infants. The method involves a diaper-clad infant being carried in an upright prone position skin-to-skin with the parent (most often the mother) and covered with clothing, to regulate temperature and breathing, enable breast feeding and promote mother and baby bonding. The duration of skin-to-skin contact varies but usually lasts 1 – 3hours per session with cardiorespiratory and temperature monitoring of the infant during this time. It is a cost-effective and easy-to-use method to promote the health and well-being of infants born preterm as well as full-term. KMC has since been adopted in countries around the world.

Implementation and research have made it clear that engaging parents in extended skin-to-skin front-to-front contact with their infants during prematurity and in the hour following birth are by now medically recognized and evidence-based interventions.

“Babies born too soon refers to babies born before 37 weeks of pregnancy are completed. Rates of preterm birth are rising in the majority of countries with adequate data. Across 184 countries, the rate of preterm birth ranges from 5% to 18% of babies born.” – World Health Organization, 2018

Physiology of premature infants

Ideally, the physiological birth of a human baby takes place at the end of 37–42 weeks in the uterus, where the environment is characterized by stable temperature and cushioning with amniotic fluid.

Afterward, development would normally progress with the mother providing most sensory care for the baby such as skin-to-skin contact, rhythmic movements and breastfeeding. When new experience is mismatched to the developmental stage, neurodevelopment is likely to be disturbed resulting in a neurobiological stress response, intensified by separation from the mother and removal of her capacity to promote regulation of her baby’s physiological status.

Several circulatory, cardiac, and pulmonary adaptations are required at birth for the lungs to successfully replace the placenta as the site of respiratory gas exchange. Preterm birth often challenges the immature cardiorespiratory functionality, resulting in a need for medical intervention and ongoing support. Neurophysiological aspects of premature baby are disturbed by preterm birth, resulting in the likelihood of long-lasting anatomical, and physiological neuropathology. Premature babies are at greater risk for developing various sensory defects, including sensory integrative disorders, than full-term babies. Affected sensory systems include tactile, vestibular, olfactory, auditory, and visual pathways.

Benefits of KMC to preterm infants

There are several evidence-based benefits of KMC as an aid to the mitigation of prematurity complications. Extended skin-to-skin contact in the hour following birth is now a medically recognized and evidence-based intervention that can save the lives of babies born too soon. The hour following birth has been found to be a delicate moment for the maturation of specific developmental skills, and the kind of care they receive has major and lasting effects on the infant. However, the time span where an infant is highly susceptible to the stimuli of infant carrying extends at minimum to 1000 days postpartum and beyond until an infant has achieved major motor milestones, such as sitting and crawling. Hence, infant carrying beyond prematurity and the postpartum hour supports the achievement of better neonatal health outcomes.

“Kangaroo Mother Care is recommended for the routine care of newborns weighing 2000 g or less at birth, and should be initiated in health-care facilities as soon as the newborns are clinically stable.” – World Health Organization, 2015

Benefits of infant carrying beyond prematurity and the postpartum hour

  • Improved nutritional outcomes through breastfeeding
  • ThermoregulationImproved gastrointestinal function
  • Decreased energy expenditure & satisfactory weight gain
  • Infants are much less stressed and this provides neurological protection to the infant and the result is:
  • Improved neurodevelopment
  • Better organized sleep patterns
  • More mature and organized electrical brain activity
  • Insecure early parent-infant relations predict a four-fold increase in adult illness. Infant carrying promotes attachment quality and represents a scalable and economically efficient intervention;.
  • Infant carrying modulates paternal hormones for strengthened family cohesion and dedication. Paternal child care involvement is associated with better social, emotional, and physical health for children. Early socio-emotional adversity is a strong predictor of substance abuse;
  • Infant carrying enables women to combine optimum motherhood during early infancy with socio-economic activities
  • Improved bonding between mother and infant
  • Significant cost-savings as well as better outcomes
  • Less dependence on incubators
  • Less nursing staff necessary
  • Shorter hospital stay
  • Improved morale & quality of careBetter infant survival with decreased morbidity and mortality rates

What Does Kangaroo Mother Care Look like in the 21st Century?

Every year on the 17 November is World Prematurity Day. With this year’s theme, Together for Babies Born too Soon – Caring for the Future; Babymoon Care plays an important role by supporting families with premature infants by promoting attachment therapy, ensuring parents who are actively involved in the care of their newborn are in close physical and emotional contact with their baby as early after birth as possible, during hospitalization and at home. This active involvement decreases parental stress, enabling parents to better care for their baby, positively affecting on the parent-child bond and family life in general.

Babymoon Care’s Solutions combine health, fashion and tech for parents in the 21st century and beyond enabling them to practice KMC safely and efficiently in hospitals and/or at home. Our solution today supports the World Health Organization’s recommendation to move from using simple carriers to using solutions which support infant-attachment. We leverage millennia of effective parenting, by replacing common baby carriers with engineered babywearing solutions to achieve better infant & toddler healthcare outcomes. With easy adjustability, excellent weight distribution, the upright position is maintained through out the carrying period while supporting the parent’s shoulders and back.

World Health Organization (WHO) recommends that during COVID-19 pandemic, healthcare providers should “enable mothers and infants to remain together and practice skin-to-skin contact, and rooming-in throughout the day and night, especially straight after birth during the establishment of breastfeeding, whether or not the mother or child has suspected, probable, or confirmed COVID-19”.