“With this phone, you have enabled me to reach areas that I couldn’t reach with my own legs and feet,” said a community health worker in Kilifi, Kenya. “Thank you for giving me the wings to fly.”
Every day, approximately 800 women die from preventable causes related to pregnancy and childbirth (WHO, 2014). In Kilifi, Kenya, where the health infrastructure is lacking, these rates are even higher.
Renewing confidence in the health system
In order to change these statistics, all of the arms of the health system need to come together to form a bridge between a pregnant woman and the care she needs. If she has her baby in the presence of a skilled clinician, studies show that she’s more likely to survive childbirth. But millions of women are not able to make that trip for a variety of reasons: lack of trust in the health system, distance to the hospital, cost of transportation, and responsibilities at home. She’s leaving her kids, her husband, and her daily duties to travel hours to the hospital while pregnant. If she has never had a positive interaction with the health system, why would they make the trek at all?
Tools designed with community health workers
The Medic Mobile toolkit is designed to help make it as easy as possible for a woman to see a trained health care provider. Our tools for feature phones, smartphones, and web platforms layer on top of an intricate network of community health workers managed by Kilifi Kids, an NGO dedicated to improving maternal and child health in Kenya. Kilifi Kids is an early adopter of technology tools to strengthen health systems.
Kilifi Kids has found success by embedding themselves in local communities. They work with local leaders and other NGOs, including Rotary International, to empower everyone to actively improve the health of women and their children. Kilifi Kids expands their work by building long-term relationships with Ministries of Health and setting up partnerships defined by transparency and shared responsibility. Work between Medic Mobile and Kilifi Kids began in 2009 and they continue to work together to help health workers reach more people.
The best-designed inbox for global health
Community health workers use Medic Mobile to register newly pregnant women in their village. Often, this first visit from the community health worker is the first time the family has had any contact with their local health system.They record the mother's name, age, potential danger signs, and estimated due date. This information is sent via SMS to a centralized database, cloud-hosted so that decision-makers and clinic staff can view it.
The Medic Mobile platform takes in this data and uses it to automatically schedule appointments for the mothers. When an expectant mother has an appointment coming up, the community health worker is notified via SMS so that she knows to pay a reminder visit to the to-be mother's home. These reminders strengthens the ties, and trust, between community health workers and members of their community. They also deepen the trust the pregnant woman has with health care providers at their closest facility. She learns the risks of giving birth at home, protects her own health by having at least four antenatal care visits and is able to plan ahead and prepare to visit the facility for her birth.
We're happy to report that the careful collaboration of Kilifi Kids, Medic Mobile, Ministry of Health, and hundreds of health workers is making a real impact in dropping the number of pregnancy related deaths in Kilifi.
“The first time I visited Kilifi and the Kilifi Kids team,” says Katanu, Regional Designer at Medic Mobile, “I could see the happiness in the health workers eyes.”
After our first pilot, we saw monthly facility-based deliveries more than double from the previous year (pilot data by Medic Mobile, 2013). This project has now scaled to 459 community health workers trained in Kilifi and we are currently evaluating this next phase.
ABOUT THE AUTHOR
Katie Kelly loves creative storytelling and is excited to shine a spotlight on Medic Mobile's incredible mission. She comes to Medic Mobile with a background in marketing and advertising, telling stories for big brands like Hershey and Proctor & Gamble and young startups like Rdio and Dot & Bo. Katie has also volunteered her writing for Watsi and DailyGood. She is unabashedly in love with travel, yoga, capture the flag and writing young adult fiction.