Smart cards to stem maternal deaths

By Luke Anami

An estimated 7,000 women in Kenya die annually from pregnancy-related complications due to inability to access medical care.

Another 52 out of 1,000 children die at birth.

But this is set to change with the introduction of a new smart card payment platform.

It is now easier for pregnant women to deliver in hospitals without the pains of carrying hard cash, thanks to the introduction of mobile money transfer technology.

Through a partnership programme with Pumwani Maternity Hospital, mothers in low-income areas who have no access to medical schemes and insurance can save money on the Changamka Smart Card, thanks to Changamka MicrcoHealth Ltd.

"In the convergence of the 3Ms (Mobile), — M-technology, M-money and M-health, expectant mothers can now top up prepaid cards with small amounts of money using M-Pesa," says Samuel Agutu, Managing Director Changamka Microhealth Ltd.

The system, also known as m-health, allows users to transfer money via M-Pesa to a prepaid smart card.

The prepaid electronic smart card, known as Changamka (Swahili for "Get a life" or "Cheer Up"), enables the bearer to save and receive outpatient primary health care treatment at a pre-contracted price.

"When pregnant women visit the hospital to give birth, the hospital fees are taken out of their smart cards," says Agutu.

"This way, families aren’t hit with a big fee all at once.

The use of Changamka would boost the usage of quality ante-natal and maternity facilities among the low income women in Kenya," he adds.

Agutu says under the scheme, an expectant mother is required to purchase one Changamka card at Sh450.

The next step is to find out the cost of delivery at the hospital.

"In the case of Pumwani Maternity Hospital, it is Sh 3,600 per delivery," Agutu said.

Once this is ascertained, the card bearer can top up the smart card using M-Pesa with at least Sh600 per month for a period of six months or more during the pregnancy period.

Money thus saved is available for ante-natal, delivery and post-natal care as well as outpatient treatment for themselves and their families.

At the time of delivery or any other service, the bearer of the smart card presents the card to Pumwani hospital.

"The cost due will be deducted from the savings on the card," Agutu added.

Unlike in the developed world where a woman’s risk of dying during or following pregnancy is 1 in 4,300, the risk of maternal death in Sub Saharan Africa is very high at 1 in 31.

According to the Kenya Demographic Health Survey 2008/9, 53 per cent of births are delivered at home with only 43 per cent at a health facility.

Maternal deaths are currently estimated at an average of 560 per 100,000 live births.

Another 760 in 100,000 mothers in slums die during delivery. This compares unfavourably against the 147 target set under the Millennium Development Goals by 2015.

This grim picture has leveraged the role of technology in the provision of quality healthcare.

"Undoubtedly, there is room for mobile money services in healthcare," says Agutu.

"For registered users of mobile money transfer services, a new platform that allows the payment for healthcare services can be valuable."

The Changamka-Pumwani maternity programme was the overall winner of the Kenyan Millenium Development Goals 2010 award for MDGs Goal 5 — a call that seeks to improve maternal health.

The initiative hopes to ride the deep mobile phone penetration estimated at 51 per cent to provide healthcare to underserved sections of the population.

Out of 38 million Kenyans, mobile phone handsets are said to be in the region 19 million.

So far, Changamka has distributed more than 10,000 smart cards specifically targeted at pregnant women.

Through the programme, 1,000 women have received health education in the country.

"The use of technology to improve access to affordable healthcare to millions of the working poor, is gaining momentum," Agutu says.

More than 2,000 technology and health experts recently met at the second annual mHeath Summit on November 8 to 10 this year in Washington, DC.

The summit aimed explored the potential of mobile technology in healthcare and to promote its use.

Agutu also addressed the forum that was co-sponsored by the mHealth Alliance and the Foundation for the National Institutes of Health (NIH).

Conference speakers included William Gates, head of the Gates Foundation, Aneesh Chopra, US Chief Technology Officer, Julio Frenk, Dean of the Harvard School of Public Health and Chairman of The Partnership for Maternal, Newborn & Child Health.

Others were Ted Turner, Chairman and Founder of the United Nations Foundation and Judith Rodin, President of the Rockefeller Foundation.

For healthcare providers, a mobile payment scheme for services delivered could guarantee revenue from patients and reimbursements from governments.

The platform also spells increased revenue sources for mobile operators.