It’s fitting that in the final days of a rigorous year of testing, adapting, and refining our solutions, we arrive at a major milestone – reaching 1 million mums through our digital health tool PROMPTS (Promoting Mums through Pregnancy Through SMS).
1 million expectant and new mothers across Kenya now receive information and advice about pregnancy, delivery, and the postpartum period, and a lifeline to quality care when they need emergency support. These mothers live across twenty of Kenya’s biggest counties and represent a diverse cross-section of the population; from different wealth quintiles, age groups, geographies and with vastly varying levels of digital connectivity.
While digital health remains an underfunded aspect of global health, there’s clear evidence to show that digital tools, when designed and adapted with the voices of those they’ll serve, have the potential to expand primary healthcare coverage, strengthen health systems, reduce costs, improve care quality, and accelerate progress towards Universal Health Coverage (UHC).
Since its beginnings, PROMPTS has proven its effectiveness in addressing poor health seeking behavior amongst women, a delay accounting for a third of all maternal deaths in Kenya. For instance, we know that mums who interact with PROMPTS are around 20% more likely to achieve the recommended 4+ antenatal care visits, 3.5 times more likely to seek treatment if they experience signs of potential risk after delivery, and ~2 times more likely to take up family planning. This, in turn, has a knock-on effect for other areas of their wellbeing. Uptake of family planning solutions means longer birth spacing and therefore more time to safely return to work and support themselves and their children.
Amplifying women’s voices in the health system
Increasing women’s ability to make and act on decisions related to her health is pivotal for improved health outcomes. But giving her power and agency within the wider health system means these outcomes are sustained within a cycle of constant improvement. We know that there is political will to advance equitable maternal care in Kenya (the government’s initiative to introduce the free health insurance scheme Linda Mama is testament to that), but existing health inequities mean women are still left out of the design of health system solutions.
PROMPTS offers a solution. By sending its users monthly surveys about the quality of care they receive in facilities and sharing this feedback with providers and health managers, the platform helps close a feedback loop in the government health system – giving women the opportunity to affect change in the care they receive, and holding governments accountable to sustaining these improvements.
The volume of data has been significant. 250,000 mothers have already shared their feedback on factors like respectful care, and we’ve seen an increased demand from mums to receive all the appropriate clinical steps during their prenatal care appointments. By combining a care bundle and a quality improvement mechanism under one umbrella, our mums are empowered to access care they can trust.
Ensuring relevance at scale
We recognize that 1 million mums is a figure of scale, not necessarily one of impact, but it is indicative of growing uptake of a tool that is actually working for women. This has always been a firm priority for us as we scale – making sure that the platform continues to be responsive to the unique, evolving needs of mothers in different contexts.
One Nairobi-based mum shared that she had been pleasantly surprised that the nutritional advice she received from PROMPTS featured easily sourced carbohydrates like ugali (over more expensive options like pasta or rice), another from Bungoma County shared that PROMPTS had helped her build toys for her newborn out of pre-used materials she already had in her home.
Routine surveys of our user base mean that we’re never making assumptions about what mums want or need at any given time – and our direct line to facility in-charges and county health managers helps us marry these needs with quality maternal health care and county resources.
The Way Forward
Of course, with all milestones come greater ones. Over the coming months and years we aim to expand our technology infrastructure, test new channels to enroll mums, increase buy-in from local county governments, and grow our team here in Kenya to make PROMPTS a national digital health solution.