Maternal Health Task Force

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Tech4MH: Supporting Postpartum Family Planning with Human-Powered SMS Innovation

By: Allison Ettenger, Program Manager, Jacaranda Health; Grace Lesser, Knowledge Manager, Jacaranda Health

Jacaranda Health, a social enterprise, has been providing affordable, high-quality maternal and newborn health care for over two years in Kenya. Our clinics are located in peri-urban areas where population density is high and access to safe maternity care is low. The mothers we serve live in variable income, and we believe that it’s possible to provide them with respectful, patient-centered care at an affordable price. Over 80% of our clients have mobile phones, and we see potential in leveraging this mobile connectivity to put critical health knowledge in their hands.

Mobile phone technology can be an incredible tool for outreach and engaging with our clients. One of the ways we’ve used mobile phones to communicate with our clients is through the ubiquitous SMS. We know from our market research that there is a high unmet need for family planning in the months after birth, but that reliable family planning information is scarce and there are often misconceptions about the options and methods available.

With this in mind, in the past few months we have designed an interactive family planning-focused SMS campaign using the Echo Mobile platform. Echo Mobile is a fully cloud-based, SMS-powered web service that allows organizations to communicate with remote customers in real time. We started by sending family planning-related SMS to a small group of postpartum clients to see what we could learn about their knowledge and needs – a prototype. We encouraged them to respond to the SMS for more information, and if they took action they received a follow-up call. Given how many junk messages are sent in Kenya, we were impressed with the response: nearly one third of the women who received messages asked for more information about family planning. They asked specific questions about long term methods, side effects, and breastfeeding. Family planning visits at Jacaranda increased by 35% during the month of the campaign.

We are excited by the results and plan to roll out an expanded campaign to interact with a much larger group of clients about family planning. Technology enabled this program, but the union of technology and people was critical to its implementation. Community health workers designed the SMS content and nurse-midwives followed up with more family planning information. The human interaction with clinicians instilled important trust about the validity of the information in our clients – and on the back end, we had a team in place to analyze the client response.

Technology is a key part of our model for delivering maternity care, and technological tools have helped us uncover crucial insights about how we can improve quality, strengthen demand creation, and ensure that services are financially accessible. However, no matter how valuable a tool is, it requires significant human power to support its implementation. As we integrate technology into our expanded services, we have to ensure that there is enough human resource capacity to manage execution, tackle the questions that emerge, and improve our services according to the lessons we learn.

Check out Jacaranda Health’s blog for more about how Jacaranda is using technology for patient education, savings, clinical decision support, and tracking impact. 

Tech4MH is an ongoing guest blog series curated by MHTF Research Assistant Yogeeta Manglani. If you would like to submit a guest blog post for possible inclusion the series, please email Yogeeta at ymm108@mail.harvard.edu.

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