The first time Elness Shukran became pregnant, she expected a routine experience with the usual worries that come with early pregnancy. Instead, she experienced an ectopic pregnancy that ended in the loss of her first child and left her with a scarring anxiety about her own health and future attempts at motherhood.

She carried unanswered questions with her. How would she know if something was wrong if she tried again? Would she even be able to recognize danger signs early enough? Beyond clinic visits, what support existed in the local health system? An all too familiar mix of questions which echo the isolation, shame and loss that women in her position face.

When she became pregnant again, naturally, she had mixed emotions. Every pain felt like a threat, and any unfamiliar symptom raised anxiety. Like many women in Kilifi County, she had access to antenatal care at Mtwapa Sub-County Hospital, which is about 20 minutes away from her home by motorbike, but her appointments were spaced weeks apart, and her anxiety spawned new questions in her mind daily. 

Between clinic visits, the uncertainty was constant. She relied on guesswork, advice from other women, and her own memories of what had gone wrong before.

However, this pregnancy came with a difference. At her second antenatal clinic visit, a nurse introduced Elness to PROMPTS, a two-way SMS platform from Jacaranda Health designed to support her during her pregnancy. PROMPTS uses the Ministry of Health’s approved maternal health information to provide a real-time reference for expectant mothers to ask questions, while flagging conversations that highlight warning signs for a human help desk to pick up the conversation urgently. 

“When they enrolled me, the nurse told me that I could ask questions at any time about anything regarding my pregnancy,” Elness recalls.

As Elness progressed through her pregnancy, PROMPTS became part of her daily routine. She received messages that explained what changes to expect in her body, which symptoms were normal, and which required prompt medical attention. When she felt discomfort or uncertainty, she quickly sent a message to the PROMPTS shortcode 21884 and received a response, allowing her to move forward with greater confidence. Knowing whether to rest or go to the clinic. 

This renewed confidence and sense of autonomy mattered deeply to her after her previous loss because it reduced the fear that she might miss something important again.

Elness Shukran receiving messages on PROMPTS; Photo Credits: Allan Gichigi

“I continued to get messages about my pregnancy. It reminded me of my clinic dates, which is something I often forgot about.” 

With the messages from PROMPTS, she felt prepared for her clinic appointments and empowered to ask even clearer questions during her antenatal clinics. Instead of feeling passive and anxious, she felt informed and involved in her own care.

By the time Elness was further along in her pregnancy, she felt more confident seeking care when needed and more assured that she was doing the right things to protect her health and her baby’s health.

PROMPTS did not remove risk from her pregnancy, but it reduced uncertainty and helped her act earlier and more appropriately when concerns arose. This is exactly what the platform is built for. 

Unbeknown to them, many women enter pregnancy with prior complications or underlying risk factors, yet critical decisions are often made at home, outside of facilities. By the time it is captured at the facility, it is a full-blown emergency. This is not the fault of mothers like Elness, but a reflection of the gap in knowledge at the primary healthcare level. 

PROMPTS is designed to close this gap by delivering consistent health information that supports timely care-seeking and reinforces trust in frontline health services. Furthermore, by being directly in the hands of the mothers themselves, it reduces anxiety and increases predictability which is critical for a woman whose body is already strained by the natural processes of pregnancy.

For Elness, PROMPTS meant she was no longer navigating her pregnancy in fear. She knew that the information she was receiving was reliable, relevant, and connected to the care offered at her clinic.  

After delivery, Elness now receives messages on postnatal care that help her take care of herself and her baby, Habel.