Over the first three weeks of January, several Harvard School of Public Health graduate students took part in the Field Experience in Maternal Health winter session, organized by the Women and Health Initiative and the Maternal Health Task Force. In this blog post, Megan Loucks writes about her field experience with Jacaranda Health in Kenya.
I spent my winter session working with Jacaranda Health, a non-profit based in Nairobi that provides prenatal care via mobile clinics. Jacaranda Health became operational in July 2011, and plans to open their fixed clinic in April 2012. They will soon be offering obstetric care, postnatal care and family planning services. With a commitment to innovation and evidence-based standards, Jacaranda Health is exploring areas of care that they can add to their core model. For my project I was exploring the evidence base for three areas:
1) Clinical decision support (CDS) in labor wards.
Clinical decision support has been shown to be effective in improving compliance with prenatal care standards, ensuring completeness of documentation, improving drug dosing, and improving the providing of preventative advice and screening. For Jacaranda, evidence suggests CDS should be part of a multifaceted strategy that includes a system for continual integration of local conditions and changing standards of care.
2) Partner participation in maternal health services, specifically antenatal care.
Jacaranda will need to use a variety of evidence-based strategies to address common barriers to partner participation including the socio-cultural (assumptions about the proper role of the partner in maternal health services), financial, and operational factors. As one alternative to partner-provided support, there is ample evidence on the effectiveness of minimally-trained doulas.
3) Health savings programs using mobile phones.
An M-Health application that uses M-Money could help women save for future healthcare expenditures: a key part of birth preparedness. There are two known applications of this theory: Changamka and Mamakiba. Both have been developed in Kenya and utilize M-PESA, Kenya’s mobile money service used by 60% of adults. Jacaranda Health plans on using Mamakiba, an M-PESA savings plan where savings are designated specifically to cover the costs of labor and delivery. Going forward, there will be a need to further ease transaction costs, address barriers for non-users, and coordinate platforms to ensure interoperability.
Learn more about Jacaranda Health’s approach to improving maternal health in Kenya here.