In a world buzzing with conversations about artificial intelligence—from self-driving cars to AI-generated art—it’s easy to overlook one of its most profound and life-affirming impacts: saving lives at birth. Nowhere is this more apparent than in Malawi, a southeastern African nation where limited healthcare resources have long been a challenge. At the Area 25 Health Centre in Lilongwe, an innovative use of AI is quietly transforming maternal care—and changing the future for thousands of families.
This is not just a story about new technology. It’s a story about hope, ingenuity, and how human lives are being saved by the thoughtful application of artificial intelligence in one of the most vulnerable and overlooked parts of the world. Since introducing an AI-augmented fetal monitoring system, the clinic has reported an extraordinary 82% reduction in stillbirths and neonatal deaths, a figure that has stunned both medical professionals and AI developers alike.
This blog post will take you through the incredible journey of how AI came to be used in maternal healthcare in Malawi. You’ll learn how the system works, why it’s proving effective, and what its implications are—not just for Malawi, but for global healthcare. We’ll explore real-life stories, expert insights, and research-backed data. Along the way, we’ll also dive into some deeper philosophical questions: What role should machines play in life-or-death situations? Can AI truly replicate human intuition in medicine? And what happens when technology succeeds where traditional methods have long failed?
Expect a blend of inspiring human stories, scientific insights, light-hearted reflection, and thoughtful debate. Whether you’re an AI enthusiast, a healthcare professional, or just someone who believes in the power of innovation, this story will offer you a new perspective on what technology can do when it’s applied not for profit, but for people.
Let’s explore how, in one small clinic in Malawi, AI is redefining what it means to give life a fighting chance.
The Challenge: Maternal and Neonatal Health in Malawi
For decades, Malawi has faced some of the world’s most daunting maternal and neonatal health challenges. Despite progress in various health sectors, childbirth remains a perilous event for far too many Malawian women and their newborns. According to UNICEF and the World Health Organization, Malawi has consistently recorded high maternal and neonatal mortality rates, with 19 out of every 1,000 babies dying during delivery or within the first few days of life (WHO, 2022). This isn’t just a statistic—it’s a staggering human cost, often hidden behind hospital walls, rural clinics, or distant village births that never make the news.
A History of Struggle
Malawi’s healthcare system has long been under-resourced. Historical underinvestment in healthcare infrastructure, coupled with economic limitations and a high disease burden, has strained the country’s ability to provide safe childbirth conditions. Many health facilities operate with minimal staff, intermittent electricity, and limited access to essential supplies such as fetal monitoring devices, clean water, and medications.
For years, mothers have walked miles while in labor to reach the nearest health center—often arriving too late for life-saving interventions. Rural areas, where nearly 83% of the population resides, are particularly affected, with health centers sometimes staffed by just one nurse or midwife attending to dozens of laboring women (NSO Malawi, 2021).
The Systemic and Cultural Barriers
1. Healthcare Workforce Shortages
Malawi has one of the lowest healthcare worker-to-population ratios in the world. According to a WHO report, there are approximately 2 physicians and 28 nurses per 100,000 people—a fraction of what is needed. This extreme shortage means most labor wards are severely understaffed, making continuous monitoring during labor practically impossible.
2. Inadequate Monitoring Tools
In many Malawian clinics, monitoring fetal heart rate is still done manually using a Pinard horn or intermittent auscultation—methods that are highly dependent on the skills, timing, and judgment of overworked nurses. Without continuous monitoring, signs of fetal distress can go unnoticed until it’s too late.
3. Training and Resource Gaps
Even when technology is available, there’s often a lack of trained personnel who can use it effectively. Resource constraints also mean limited access to emergency cesarean sections, anesthesia, and neonatal resuscitation tools. In many areas, a single adverse event—like prolonged labor or a cord accident—can become fatal.
4. Social and Economic Determinants
Malawi’s maternal health crisis is also shaped by larger social forces. Poverty, malnutrition, early marriage, and lack of education increase the risk of complications during pregnancy. Cultural beliefs can delay women from seeking care, and many still give birth at home without skilled attendants, especially in rural districts.
5. Logistical and Geographic Barriers
Roads can be nearly impassable during the rainy season, and public transport is inconsistent. A journey of 20 kilometers to a clinic may take hours, or may not be feasible at all during labor, leaving women with no choice but to deliver in unsafe conditions.
6. Lack of Data-Driven Decision Making
Prior to AI and digital innovations, many healthcare facilities in Malawi relied on manual record-keeping, which made it difficult to spot patterns or learn from outcomes. Without robust data, it’s hard to improve systems or identify where interventions are most needed.
The Bigger Picture: A Global Issue
While Malawi’s case is extreme, it reflects a broader challenge across sub-Saharan Africa and other low-income regions where 94% of all maternal deaths occur globally (WHO, 2023). The reasons are often similar: insufficient resources, underdeveloped infrastructure, and an urgent need for scalable, sustainable solutions.
But here’s the twist: what if the solution to one of humanity’s oldest challenges—ensuring a safe birth—comes not just from more hands on deck, but from smarter systems? What if the bottleneck isn’t just about staffing or supplies, but about information, and the ability to act on it in real time?
As the Area 25 Health Centre is showing, AI might not replace human care—but it can elevate it. And in places where every second counts, that may be the difference between life and death.
The Solution: AI-Augmented Fetal Monitoring Comes to Malawi
Against the backdrop of Malawi’s longstanding maternal healthcare challenges, the arrival of artificial intelligence has been nothing short of transformational. At the Area 25 Health Centre in Lilongwe, the introduction of AI-augmented fetal monitoring technology has led to an 82% reduction in stillbirths and early neonatal deaths—a dramatic improvement that speaks to both the power of innovation and the importance of international collaboration.
What’s Happening on the Ground
In 2022, the Area 25 Health Centre, one of Malawi’s busiest maternity facilities, began piloting a continuous AI-enhanced fetal monitoring system that allows clinicians to monitor babies’ heart rates and mothers’ uterine contractions in real time. This was a groundbreaking shift from the traditional intermittent manual checks, which left wide gaps in monitoring—especially dangerous in high-volume labor wards with limited staff.
The system works around the clock, automatically detecting patterns that signal fetal distress, such as bradycardia (slow heart rate), tachycardia (fast heart rate), or decreased variability in heart rate—signs that can precede complications like asphyxia or stillbirth. When concerning trends are detected, the system sends out real-time alerts to healthcare workers, who can then quickly intervene, often performing emergency cesarean sections or adjusting delivery plans accordingly.
It’s not just about monitoring—it’s about decision support. The AI doesn’t replace the clinician’s judgment but enhances it, offering a second set of eyes that never blinks, never tires, and processes patterns across thousands of births to predict potential risks.
The Technology: What’s Being Used
The fetal monitoring solution was developed by PeriGen, a U.S.-based medical technology company specializing in AI-powered obstetric tools. Their platform, PeriWatch Vigilance, is a cloud-based system that applies machine learning algorithms to continuously assess electronic fetal monitoring (EFM) data. In higher-income settings, PeriGen’s technology is used to improve maternal outcomes and reduce unnecessary interventions. In Malawi, it’s being applied in an even more fundamental way—to save lives where death was once expected.
The system includes:
- Wireless fetal heart rate monitors and contraction sensors
- Automated alerts that signal concerning trends
- Visual dashboards that help staff triage patients more effectively
- Cloud-connected software that stores and analyzes data to improve ongoing care
Importantly, this technology was donated, not sold—making this more than a business initiative; it was a philanthropic one, rooted in a shared goal of improving global maternal health.
The Power of Partnerships
This innovation would not be possible without the partnership between Texas Children’s Hospital (TCH), Baylor College of Medicine, PeriGen, and the Malawi Ministry of Health.
- Texas Children’s Hospital played a central role by leading implementation, training local staff, and helping adapt the system for low-resource settings.
- Baylor College of Medicine, which has a long-standing maternal and child health program in Malawi, provided the clinical expertise and research infrastructure needed to evaluate the program’s impact.
- PeriGen provided the technology, tailoring it for the Malawian context and ensuring the software could function even in environments with intermittent internet and electricity.
- The Malawi Ministry of Health gave the program full institutional support, making it possible to integrate the new system into an existing public hospital without major disruption.
Dr. Jeffrey Wilkinson, an obstetrician with Texas Children’s Hospital and one of the program’s leads, put it simply:
“You can prevent most deaths by making sure the baby is safe during the delivery process. The challenge is knowing when that process is going wrong—this system makes that visible.” (The Guardian, 2024)
This kind of cross-sector collaboration—public health, private tech, academic medicine, and local government—shows what’s possible when the goal isn’t just innovation, but equity in innovation.
Not Just a Tool, But a Catalyst
What’s remarkable about this initiative is that it didn’t just introduce a new gadget—it introduced a new way of working. For the first time, midwives and nurses at Area 25 had access to a real-time, data-driven support system that backed up their decisions and reduced guesswork. The technology acted as both a safety net and a confidence booster, especially for newer clinicians.
Dr. Chikondi Chiweza, the hospital’s lead obstetrician, noted:
“It’s like having an experienced second opinion with you all the time. It helps our midwives act faster, with more certainty, and better outcomes.”
Real-Life Impact: Ellen’s Story – One Mother, One Machine, One Life Saved
It was just after sunset in Lilongwe when Ellen Kaphamtengo, only 18 years old and nine months pregnant, felt something shift inside her—something that didn’t feel right. She had been experiencing mild cramps all day, but now the pain was sharper, deeper. Her baby, who had been active all day, had suddenly gone quiet.
Her village was a good walk from the clinic, but instinct overruled fatigue. With her mother by her side and the moon rising overhead, she made her way to Area 25 Health Centre, one of Malawi’s busiest maternity wards. She arrived exhausted, scared, and in pain.
Inside the clinic, midwives quickly attached a wireless fetal monitor to her abdomen, syncing it to a newly implemented AI-powered fetal surveillance system. The setup was subtle—a band, a few sensors, a blinking monitor on the wall—but what it revealed was anything but small.
Almost instantly, the system issued a high-priority alert.
“The baby’s heart rate was dipping below safe levels. It was classic bradycardia. In previous years, we might not have noticed this in time,” said Dr. Chikondi Chiweza, head of maternal services at Area 25.
Thanks to the AI-driven alert, the clinical team recognized signs of fetal distress far earlier than they could have with manual checks alone. Within minutes, Ellen was wheeled into the surgical ward for an emergency cesarean section.
As the operating room lights buzzed to life, a hush fell. The baby was delivered with the umbilical cord wrapped tightly around his neck—silent and motionless at first. But this team, supported by real-time data and prepared in advance, had already initiated neonatal resuscitation protocols.
After a tense few minutes, the baby gasped. Then he cried.
“That first cry… that’s when we all breathed again,” recalled Mary Banda, one of the attending midwives.
“And to think—we might have lost him. But this system gave us time. It gave us a warning.”
Ellen named her son Justice. She said it was because he got the chance every baby deserves—the chance to live.
“I don’t know much about machines,” Ellen later told a local health educator, “but I know this one gave me my baby. It’s like it was watching over us.”
A Turning Point in Maternal Care
Before this AI system was introduced, fetal monitoring at Area 25 was done manually, often using a Pinard horn, a 19th-century device that relies entirely on human hearing. In crowded wards with a single nurse monitoring up to 10 laboring women, it was easy for warning signs to slip by unnoticed.
Now, with PeriGen’s AI-enhanced PeriWatch Vigilance system, clinicians receive automated alerts whenever the fetal heart rate signals trouble. The system, originally developed for hospitals in the U.S., was adapted for low-resource settings in a unique partnership between PeriGen, Texas Children’s Hospital, Baylor College of Medicine, and the Malawi Ministry of Health.
“Technology should not be a luxury for the wealthy—it should be a lifeline for the vulnerable,” said Dr. Jeffrey Wilkinson, an obstetrician with Texas Children’s Hospital who helped spearhead the initiative.
“In Malawi, we’ve seen firsthand what AI can do when it’s placed in the hands of committed local health professionals.”
The story of Ellen and Justice is not just a triumph of modern medicine—it’s a window into what’s possible when global collaboration meets local dedication.
“This system doesn’t replace the midwife,” said Dr. Chiweza. “It empowers her. It gives her more certainty, more time, and more peace of mind.”
And in a place where every second can mean the difference between life and death, that time is priceless.
Justice now rests peacefully in Ellen’s arms, unaware that a quiet algorithm running in the background helped write the first chapter of his life—a chapter that nearly ended before it began.
Philosophical Reflections: When AI Enters the Delivery Room
In the soft-lit halls of the Area 25 Health Centre, it might seem like just another machine—a monitor with data points, beeps, and blinking signals. But what happens when that machine quietly helps save a life? What happens when an artificial intelligence system becomes the difference between heartbreak and hope?
This is more than just a technological milestone. It’s a philosophical crossroad.
The story unfolding in Malawi is not only about what AI can do, but also about what we allow it to do, what we trust it to do, and what we risk losing or gaining when machines begin to participate in moments that are deeply human—like the birth of a child.
AI as a Partner, Not a Proxy
There’s a common fear in the age of AI: that machines will replace humans, and with them, the intuition, compassion, and wisdom that define us. But in Malawi, something quite different is happening. The AI system isn’t replacing midwives—it’s reinforcing them. It’s offering exhausted staff a second set of eyes, a whisper in the chaos that says, “Look closer. Act now.”
“This isn’t automation—it’s augmentation,” said Dr. Anna Li, a digital health ethicist at Oxford University.
“We should stop imagining AI as an intruder in the room, and start seeing it as a colleague—one that never tires, never panics, and helps catch what the human eye may miss.”
In this framing, the AI becomes a moral ally, helping prevent avoidable suffering in places where human bandwidth has reached its limit.
Equity in Innovation: Who Gets the Algorithm?
But there’s a more uncomfortable question underneath the success story: Why did it take so long for Malawi to get access to this technology? If AI-driven monitoring is standard in well-funded hospitals in the U.S. or Europe, why is it only now arriving in places with the highest maternal mortality?
Technology is not inherently equitable. It goes where markets flourish—not always where the need is greatest. What’s different here is the intentional redistribution of innovation—AI being donated, not sold. A private company partnered with global health institutions not for profit, but for purpose.
“The real ethical breakthrough here isn’t just the algorithm—it’s the collaboration,” says Dr. Reuben Mphatso, a public health policy advisor in Malawi.
“It’s the fact that people in the Global North looked at our reality and didn’t ask how to make money, but how to make a difference.”
In doing so, this initiative challenges one of the deepest inequities in healthcare: the idea that some lives are more technologically protectable than others.
The Soul of the Machine
It’s worth asking: Can something as sterile as code participate in something as sacred as birth? Is it strange—even unsettling—to imagine that a machine helped usher a human soul into the world?
Perhaps. But perhaps not.
After all, for centuries, humans have extended their abilities with tools—from the midwife’s hands to the stethoscope, from anesthesia to incubators. In many ways, AI is just the next instrument in a very old orchestra—its music more complex, but its intention the same: to preserve life, to reduce suffering, to honor the sacredness of birth.
What AI offers isn’t a replacement for human care—it’s a lens that sharpens it. And in places where time, staff, and resources are scarce, that lens can transform chaos into clarity.
A New Model of Ethical Tech
The project in Malawi offers a powerful new blueprint for AI: not as a force that accelerates inequality or displaces people, but one that amplifies justice and restores balance. When AI is guided by collaboration, humility, and ethics, it becomes not a threat—but a promise.
A promise that no mother should fear childbirth because of where she was born.
A promise that no baby should lose their first breath for lack of a timely alert.
A promise that innovation, when directed with empathy, can become intervention.
In this way, the AI in Malawi is more than a machine—it is a mirror. It reflects who we are, what we value, and how far we’re willing to go to ensure that every birth has a chance at becoming a beginning, not an ending.
Expert Opinions: Why AI Belongs in the Places That Need It Most
The success of AI-augmented fetal monitoring at Area 25 Health Centre has caught the attention of healthcare professionals and tech innovators around the globe. What’s emerging is not just excitement over the technology—but a deeper consensus: the places with the scarcest healthcare resources stand to gain the most from AI innovation.
“We tend to associate cutting-edge technology with rich, urban hospitals,” says Dr. Chikondi Chiweza, head of maternal care at Area 25.
“But in Malawi, AI isn’t a luxury—it’s a lifeline. When you’re managing a full ward with one or two staff, having intelligent monitoring that doesn’t sleep makes a world of difference.”
This view is echoed by global experts in both public health and artificial intelligence, who see initiatives like Malawi’s not as exceptions, but as early examples of what ethical, scalable AI should look like.
🧠 AI as a Bridge in the Global Health Divide
“The greatest potential for AI isn’t in automating routine tasks in Silicon Valley—it’s in saving lives in places like rural Malawi, where human capacity is stretched thin,”
says Dr. John Nosta, digital health futurist and member of the WHO Roster of Experts.
“We have a moral imperative to deploy intelligent tools where they’re needed most—not just where they’re most profitable.”
This sentiment is supported by recent research published in The Lancet Digital Health, which argues that AI’s value in global health increases as access to skilled professionals decreases. In high-income countries, AI is seen as a convenience; in low-income countries, it’s often the difference between early intervention and tragic delay.
🌍 From Tools to Transformation
“In places with chronic understaffing, AI can help systems leapfrog over generations of underdevelopment,”
explains Dr. Catherine Kyobutungi, Executive Director of the African Population and Health Research Center.
“But it has to be deployed thoughtfully—with community training, cultural adaptation, and respect for clinical judgment.”
She cautions, however, that tech must never come in as a top-down imposition. “We’ve seen too many ‘parachute innovations’—solutions designed far away, with no local context. The project in Malawi is different because it’s rooted in partnership, not paternalism.”
💡 Human-AI Collaboration in Critical Moments
At Texas Children’s Hospital, one of the initiative’s lead partners, the sentiment is similar.
“This is about giving clinicians more time to do what humans do best—listen, decide, and act with empathy,”
says Dr. Jeffrey Wilkinson, an obstetrician and longtime partner on maternal health projects in Africa.
“AI doesn’t replace clinical wisdom—it extends it. And in a system where time equals life, that extension is priceless.”
🤖 The Ethical Tech Lens
From the tech side, Matthew Sappern, CEO of PeriGen (developer of the monitoring platform), emphasizes intentional deployment over innovation for innovation’s sake.
“When we designed PeriWatch Vigilance, we never imagined its impact would be felt most in a labor ward in Malawi,” he said in a recent interview.
“But that’s exactly why we do this—to create tools that can adapt across the spectrum of care, and to stand behind their implementation, not just their invention.”
🔎 AI Can See What Humans Miss—Especially Where It Matters Most
AI researchers like Dr. Suchi Saria, director of the Machine Learning and Healthcare Lab at Johns Hopkins, reinforce the clinical logic behind using AI in labor wards.
“Even the most skilled nurse or midwife can’t monitor multiple patients continuously without missing things,” she notes.
“AI excels at pattern recognition and consistency. That kind of support is not a convenience—it’s essential when lives hang in the balance.”
🛠️ The Message is Clear
Across disciplines—from public health to clinical obstetrics, from software engineering to ethics—the message is consistent: If AI can thrive in the high-tech world, it can do wonders in low-resource ones. But only if we invest with intention.
And Malawi, through its quiet revolution in one busy maternity ward, is showing the world exactly what that looks like.
Looking Ahead: A Glimpse into the Future of Global Health
What’s happening at Area 25 Health Centre in Malawi isn’t just a success story—it’s a signal of what’s possible. This AI-powered breakthrough could mark the beginning of a much broader transformation in how the world approaches healthcare in low-resource settings.
🌍 Near-Term: Scaling Smarter Care
In the next few years, we may see this model replicated in maternity wards across sub-Saharan Africa, South Asia, and other underserved regions. With the right funding, AI-powered monitoring could become a standard of care, helping clinicians respond faster, allocate resources more efficiently, and reduce preventable maternal and infant deaths.
Global health institutions—from WHO to private NGOs—are already watching Malawi’s model closely as a proof of concept that low-cost AI interventions can yield high-impact results. The success here could attract new investment and accelerate the development of AI tools tailored for the realities of rural clinics: low bandwidth, intermittent power, minimal training required.
🚀 Long-Term: Redesigning Health Systems from the Ground Up
In the long term, this innovation could help redefine how we build healthcare systems in developing regions. Instead of trying to catch up with expensive, Western-style hospital infrastructure, countries could leapfrog directly into smart, decentralized, data-driven systems—where AI supports front-line health workers, mobile devices monitor chronic conditions, and predictive analytics anticipate disease outbreaks.
More importantly, this could reset the ethical compass of global innovation: showing that the greatest breakthroughs don’t belong in the richest hospitals, but in the hands of those who need them most.
As Malawi has shown, a single well-placed algorithm—guided by empathy, rooted in collaboration—can change not just one life, but the trajectory of an entire system.
Call to Action: What Will We Choose to Build?
The story unfolding in Malawi is more than a medical breakthrough—it’s a call to rethink how we share the best of what we create. If artificial intelligence can save lives in a crowded maternity ward in Lilongwe, what else could it do if we dared to invest in equity, not just advancement?
Now is the time for tech companies, donors, policymakers, and global health leaders to follow this example. To ask not just, “Can we build it?”—but “Who needs it most?”
If you’re in a position to support global health, advocate for ethical AI, or fund life-saving innovation, consider this your invitation. Whether you build systems, shape policy, or simply raise awareness—you are part of this story.
Justice’s life was saved by a quiet algorithm, a few sensors, and a team that believed the future should belong to everyone. That’s not science fiction. That’s today.
Let’s make sure it becomes tomorrow—everywhere.
Conclusion: Justice, Delivered
In the end, this story begins and ends with a child named Justice—a name that carries more than just hope. It’s a name that now echoes with meaning: the right to be born safely, the right to a mother’s joy instead of grief, the right to a future made possible not just by science, but by solidarity.
Justice isn’t just a baby. He is a symbol.
A symbol of what happens when humanity and technology meet in the right place, at the right time, with the right intention.
In his first breath, there’s a quiet revolution.
In his name, a reminder: Every life is worth protecting. And every tool that can help us do that—should.
📚 Reference List
- Baylor College of Medicine. (2023, February 7). AI used to reduce intrapartum stillbirths and early neonatal deaths in Malawi. https://www.bcm.edu/news/ai-used-to-reduce-intrapartum-stillbirths-and-early-neonatal-deaths-in-malawi
- Chiweza, C., Iwuh, I., Hasan, A., Malata, A., Belfort, M., & Wilkinson, J. (2024). Can artificial intelligence-augmented fetal monitoring prevent intrapartum stillbirth and neonatal death in a low-income setting: An observational study? BJOG: An International Journal of Obstetrics & Gynaecology, 131(1), 109–111. https://doi.org/10.1111/1471-0528.17321
- Kimeu, C. (2024, December 6). How AI monitoring is cutting stillbirths and neonatal deaths in a clinic in Malawi. The Guardian. https://www.theguardian.com/global-development/2024/dec/06/how-ai-monitoring-is-cutting-stillbirths-and-neonatal-deaths-in-a-clinic-in-malawi
- World Health Organization. (2023). Maternal mortality. https://www.who.int/news-room/fact-sheets/detail/maternal-mortality
- National Statistical Office Malawi. (2021). 2021 Malawi Demographic and Health Survey. https://www.nsomalawi.mw
🧭 Additional Resources
- PeriGen (AI Fetal Monitoring Company)
https://www.perigen.com - Texas Children’s Hospital Global Women’s Health Program
https://www.texaschildrens.org/global-health/womens-health - Baylor College of Medicine Center for Global Health
https://www.bcm.edu/healthcare/global-health - Malawi Ministry of Health
https://www.health.gov.mw - WHO Digital Health Atlas
https://digitalhealthatlas.org
📖 Additional Readings
- Ersdal, H. L., Mduma, E., Svensen, E., & Perlman, J. M. (2012). Birth asphyxia: A major cause of early neonatal mortality in a Tanzanian rural hospital. Pediatrics, 129(5), e1238–e1243. https://doi.org/10.1542/peds.2011-3134
- Saria, S., Rajpurkar, P., & Wang, L. (2022). The future of machine learning in healthcare: A roadmap and agenda. Nature Medicine, 28, 1–8. https://doi.org/10.1038/s41591-022-01738-2
- Alfirevic, Z., Devane, D., Gyte, G. M., & Cuthbert, A. (2017). Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour. Cochrane Database of Systematic Reviews, (2), CD006066. https://doi.org/10.1002/14651858.CD006066.pub3
- Nosta, J. (2023). Why AI in emerging markets will define the future of global health. Digital Health Today. https://www.digitalhealthtoday.com
- Kyobutungi, C. (2022). Tech equity in Africa: Lessons from COVID and a look ahead. Health Policy Watch. https://healthpolicy-watch.news