Towards a Modelling Framework for Self-Sovereign Identity Systems

Self-sovereign Identity promises to give users control of their own data, and has the potential to foster advancements in terms of personal data privacy. Self-sovereign concepts can also be applied to other entities, such as datasets and devices. Systems adopting this paradigm will be decentralised, with messages passing between multiple actors, both human and representing other entities, in order to issue and request credentials necessary to meet individual and collective goals. Such systems are complex, and build upon social and technical interactions and behaviours. Modelling self-sovereign identity systems seeks to provide stakeholders and software architects with tools to enable them to communicate effectively, and lead to effective and well-regarded system designs and implementations. This paper draws upon research from Actor-based Modelling to guide a way forward in modelling self-sovereign systems, and reports early success in utilising the iStar 2.0 framework to provide a representation of a birth registration case study

Maternal and child health in Yushu, Qinghai Province, China

<p>Abstract</p> <p>Introduction</p> <p>Surmang, Qinghai Province is a rural nomadic Tibetan region in western China recently devastated by the 2010 Yushu earthquake; little information is available on access and coverage of maternal and child health services.</p> <p>Methods</p> <p>A cross-sectional household survey was conducted in August 2004. 402 women of reproductive age (15-50) were interviewed regarding their pregnancy history, access to and utilization of health care, and infant and child health care practices.</p> <p>Results</p> <p>Women's access to education was low at 15% for any formal schooling; adult female literacy was <20%. One third of women received any antenatal care during their last pregnancy. Institutional delivery and skilled birth attendance were <1%, and there were no reported cesarean deliveries. Birth was commonly attended by a female relative, and 8% of women delivered alone. Use of unsterilized instrument to cut the umbilical cord was nearly universal (94%), while coverage for tetanus toxoid immunization was only 14%. Traditional Tibetan healers were frequently sought for problems during pregnancy (70%), the postpartum period (87%), and for childhood illnesses (74%). Western medicine (61%) was preferred over Tibetan medicine (9%) for preventive antenatal care. The average time to reach a health facility was 4.3 hours. Postpartum infectious morbidity appeared to be high, but only 3% of women with postpartum problems received western medical care. 64% of recently pregnant women reported that they were very worried about dying in childbirth. The community reported 3 maternal deaths and 103 live births in the 19 months prior to the survey.</p> <p>Conclusions</p> <p>While China is on track to achieve national Millennium Development Goal targets for maternal and child health, women and children in Surmang suffer from substantial health inequities in access to antenatal, skilled birth and postpartum care. Institutional delivery, skilled attendance and cesarean delivery are virtually inaccessible, and consequently maternal and infant morbidity and mortality are likely high. Urgent action is needed to improve access to maternal, neonatal and child health care in these marginalized populations. The reconstruction after the recent earthquake provides a unique opportunity to link this population with the health system.</p

Development of a Mobile, Self-Sovereign Identity Approach for Facility Birth Registration in Kenya

Birth registration is a critical element of newborn care. Increasing the coverage of birth registration is an essential part of the strategy to improve newborn survival globally, and is central to achieving greater health, social, and economic equity as defined under the United Nations Sustainable Development Goals. Parts of Eastern and Southern Africa have some of the lowest birth registration rates in the world. Mobile technologies have been used successfully with mothers and health workers in Africa to increase coverage of essential newborn care, including birth registration. However, mounting concerns about data ownership and data protection in the digital age are driving the search for scalable, user-centered, privacy protecting identity solutions. There is increasing interest in understanding if a self-sovereign identity (SSI) approach can help lower the barriers to birth registration by empowering families with a smartphone based process while providing high levels of data privacy and security in populations where birth registration rates are low. The process of birth registration and the barriers experienced by stakeholders are highly contextual. There is currently a gap in the literature with regard to modeling birth registration using SSI technology. This paper describes the development of a smartphone-based prototype system that allows interaction between families and health workers to carry out the initial steps of birth registration and linkage of mothers-baby pairs in an urban Kenyan setting using verifiable credentials, decentralized identifiers, and the emerging standards for their implementation in identity systems. The goal of the project was to develop a high fidelity prototype that could be used to obtain end-user feedback related to the feasibility and acceptability of an SSI approach in a particular Kenyan healthcare context. This paper will focus on how this technology was adapted for the specific context and implications for future research

The American College of Nurse-Midwives Clarity in Collaboration Project: Describing Midwifery Care in Interprofessional Collaborative Care Models.

In 2014, the American College of Nurse-Midwives (ACNM) launched a project called Clarity in Collaboration to develop data definitions related to midwifery and maternity care delivery processes. These definitions are needed to ensure midwifery care delivered in collaborative care models is accurately and consistently captured in clinical documentation systems, data registries, and systems being developed as part of health care restructuring and payment reform. The Clarity in Collaboration project builds on the efforts of the Women\u27s Health Registry Alliance (WHRA), which was recently established by the American College of Obstetricians and Gynecologists. Clarity in Collaboration mirrored the process used by ReVITALize, WHRA\u27s first maternity data standardization project, which focused on establishing standardized clinical data definitions for obstetrics. The ACNM Clarity in Collaboration project brought together maternity and midwifery care experts to complete a year-long consensus process, including a period of public comment, resulting in development of 20 concept definitions. These definitions can be used to describe midwifery care within the context of collaborative care models. This article provides a summary of the ACNM Clarity in Collaboration process with discussion of implications for maternity data collection

Standardizing Maternity Care Data to Improve Coordination of Care

The amount of data generated by health information technology systems is staggering, and using those data to make meaningful care decisions that improve patient outcomes is difficult. The purpose of this article is to describe the Maternal Health Information Initiative, a multidisciplinary group of maternity care stakeholders charged with standardizing maternity care data. Complementary strategies that practicing clinicians can use to support this initiative and improve the usability of maternity care data are provided