What happens when you put over 250 gynaecologists together in one room? Jacaranda Health had the opportunity to find out in mid-February at the 41st Annual Scientific Conference of the Kenya Obstetrics and Gynaecological Society (KOGS) in Mombasa, Kenya. It turns out that what you find are: calls for better conditions for public sector doctors, heated debates over access to post-abortion care, and stories of promising clinical and programmatic interventions, such as fetal medicine services and county forums to review maternal mortality. I represented Jacaranda and presented on two of our unique programs—Group Antenatal Care (ANC) and Data to Drive Decision-Making. I learned there is great enthusiasm among KOGS members to strengthen leadership in reproductive healthcare and to find sustainable solutions to the issues gynaecologists see in their communities.
The conference focused on translating research into clinical practice and policy. For Jacaranda, this theme has always meant sharing the results of our internal innovations and implementation with the broader health community. The Group ANC program at Jacaranda, for example, was one of the first in Kenya. Based on previous research from the US showing that group care results in positive health outcomes for moms and babies related to preterm birth, stress, and care-seeking behavior, Jacaranda piloted the model starting in 2015. At the KOGS conference, we showcased our results to date. While there have been some challenges in retention, overall we’ve seen increases in the number of ANC visits women attend, their satisfaction with care, their postpartum family planning uptake, and their chances of delivering at a high-quality facility such as Jacaranda. But how would our model (a trained nurse facilitating four 2-hour sessions for a group of 6-10 women) translate into the public sector? Is it cost-effective? How feasible is using WhatsApp as an alternative means to scale the innovation? These are some of the questions that arose at the conference. They are also the questions we are working hard on internally as we consider scaling Group ANC. KOGS members were quick to point out that similar group models have been used for other purposes (savings & loan, HIV-care) and were interested to see how it could apply to the area of maternity care.
Data to Drive Decision-Making was a common thread throughout the KOGS conference, also relating to the theme of translating research into practice. Presenters included UNFPA supporting the case for family planning with data, and Family Health Options Kenya (FHOK) supporting adolescent access to reproductive health services based on the sometimes uncomfortable reality of the data around teenage pregnancy. What I emphasized in the presentation from the Jacaranda perspective was that we cannot be afraid of having high-quality data, no matter how inconvenient the results. Without being able to measure one’s outcomes and processes, one cannot hope to improve upon them effectively. At Jacaranda, this meant that after seeing a rise in suspected neonatal sepsis cases through our internal dashboard, we took quick actions. First, we swabbed the entire hospital to find out where infections might be starting from. Then, we started auditing the handwashing behaviors of staff, outlawed outside clothing and streamlined visitor numbers, and introduced individualized buckets for every new baby to be bathed in. After that, we collected data again. Luckily the interventions worked, but without continuous monitoring, we may never have known. We continue to use data to drive our internal decision-making and seek out new ways to incorporate data from elsewhere to strengthen our practices.
The 41st Annual KOGS conference provided a forum for sharing, networking, and discussion. Jacaranda is proud to be a part of those conversations as we, along with so many medical professionals throughout Kenya, work towards providing comprehensive care to women and their families. We look forward to seeing what data drives practice this year and where it might lead innovations to present next year.