How free SMS alerts have reduced maternal, neonatal deaths in counties

Kakamega Governor Fernandes Barasa congratulates Maureen Vugusta after she delivered at Lumakanda Hospital's newly refurbished maternity wing. [Benjamin Sakwa, Standard]

When Maureen Vugutsa became pregnant for the first time, it invoked feelings of joy and hope.

With the help of a Community Health Promoter (CHP), Ms Vugutsa was enrolled in Jacaranda Health's SMS digital health navigator known as 'PROMPTS' at Lumakanda Sub County Hospital in Lugari constituency.

PROMPTS empowers expectant mothers with information to make informed decisions during and after pregnancy and seek the right care at the right time and place.

Mothers are supported to take up key services linked with better outcomes, such as pre and postnatal care check-ups, infant immunization appointments, and family planning services.

"I used to receive constant reminders about my prenatal care appointments and the importance of observing a balanced diet during pregnancy on my phone through a free SMS alert," said Ms Vugutsa.

The services made Vugutsa confident as she prepared to deliver.

"I was wondering which health facility would be ideal for me when I would be due to deliver my child but after Jacaranda Health equipped the maternity wing at Lumakanda Hospital, I was assured of safe delivery since the facility could manage emergencies in case of complications," she said.

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Vugutsa delivered her baby who is almost a year old now at the health facility and said and was satisfied with the services offered.

"You don't need to travel to Malava Level (IV) or Kakamega Level (V) Hospital to get proper medical care," she said.

She is a beneficiary of the program dubbed 'Tukutunze Kakamega' started last year by Jacaranda Health in partnership with the County government of Kakamega.

The initiative seeks to improve maternal and newborn survival through Service Delivery Redesign (SDR) in the county. Phase one of the programme will gobble Sh223 million.

The programme also involved improving infrastructure and equipping maternity hospitals to enhance maternal and newborn survival.

"Redesign focuses on improving the distribution of financing, staff, equipment, beds, and medicines to ensure that women receive 'right place, high-quality care' and mothers deliver in or close to well-functioning hospitals," said Cynthia Kahumbura, a co-executive director at Jacaranda.

Ms Kahumbura said the success of the program in Kakamega saw it replicated in 23 other counties in Kenya that have since received funding to fast-track infrastructure improvement and equipping of maternity wings.

"Over 90 percent of maternal and neonatal mortality are preventable and since we started the program across the 23 counties, we have noted a 27 percent increase of expectant mothers attending all the four recommended antenatal clinics," said Kahumbura

She added: "About 89 percent of mothers are exclusively breastfeeding their babies for six months, increased uptake of mothers on family planning, 87 percent of program nurses with improved confidence and competence and 50 percent increase in neonatal resuscitation skills amongst mentees."

In an interview with The Standard in Kakamega town, Ms Kahumbura said they are ensuring that when mothers visit a health facility, they receive skilled care. "Our main focus is on the public health facilities."

Kahumbura said they are using data to put in place preventive measures to curb neonatal and maternal deaths.

"We are reducing delays in the receipt of care by improving urgent and emergency referral systems through collaboration with Rescue Co, a reputable emergency transport provider," she said.

Governor Fernandes Barasa, who commissioned the facility last year in Lugari which was the second maternal facility after a similar one was launched in Malava, said the hospital would help reduce maternal and neonatal mortality in Kakamega.

"The strategy simply aims to provide medical attention to mothers as soon as possible so they don't go through difficult times," Barasa said.

"Through the partnership, the county received Sh223 million for phase one, 40 percent of which has come to Lugari sub-county. The objective of this initiative is to reduce the global maternal mortality ratio to less than 70 in every 100,000 live births," said Barasa.

Delivery statistics from Kakamega County show that only 37 percent of women give birth in a health facility equipped to handle maternal emergencies as 63 percent of women prefer giving birth at home.

The statistics indicate that deliveries are sparsely distributed, with 85 percent of facilities conducting fewer than 30 deliveries in a month. However, 99 percent of women living in Kakamega reside within an hour of advanced level four and level five facilities.

According to Governor Barasa, 30-45 percent of mothers who go to health facilities to deliver do not receive effective services.