2022: A Year in Pictures

We talk a lot about data; that of mothers reached, deliveries impacted, time to referral, or skills improvement among frontline health providers. Data is, after all, the raw evidence that our efforts correlate with better quality, timely care for mothers and babies.

But real impact is, as ever, best conveyed through the lens of real people. Mothers, babies, frontline nurses, and the passionate team at Jacaranda - field staff, clinicians, software developers, helpdesk agents - working behind the scenes to ensure our solutions are working as hard as possible for the mothers they support.

After two years of COVID-driven isolation, we embraced the opportunity to get out into the field and spend time with our country-wide network of nurses and the mothers they serve, and bring their experiences to global audiences at international conferences, multi-stakeholder meetings, and summits.

Here are some of the images that spoke to us last year.

Terry Ngare attends to a prenatal mother in her third trimester in the maternity ward of a Busia-based hospital. Terry is a mentor in Jacaranda’s facility-based MENTORS program, which equips frontline nurses with critical skills in basic and emergency maternal care.

Nurse Collins Kiptoo takes a moment to greet a returning mother and the baby he helped deliver some months back. Respectful care sits at the core of Jacaranda’s programs. Our MENTORS program equips nurses with vital skills in communication, decision-making, and dignified care, and PROMPTS serves as an anonymous channel for mothers to feedback on whether they were treated with respect in facilities.

Mary Njoki speaks to her neighbor Mary Njogu outside her home in Dagoretti, Nairobi, close to the hospital where she plans to give birth. Mary has been using PROMPTS, Jacaranda’s two-way SMS companion mothers, to ask questions throughout her pregnancy, including details about how to prepare for delivery.

Gabriel Mweni Nzioka talks through details of her birth plan with a nurse on the ward at Waithaka Health Center. After each prenatal care visit, PROMPTS sends mothers a short, SMS survey checking on the clinical quality of care they received, including key information like a birth plan and vital checks, such as a urine test.

First-time mother Esther Gathoni walks home from her postnatal check-up in Machakos County. Esther signed-up for PROMPTS early in her pregnancy, and has been using the service ever since to guide her around newborn care, nutrition, and family planning.

Head Nurse Evangeline Karambu acts the part as her colleagues simulate a more complicated delivery involving a shoulder dystocia. Jacaranda’s MENTORS program combines theoretical learning with practical simulation-based exercises within facilities to help providers improve their skills as they deliver services.

Lilian stands outside her home in Kibera, a large informal settlement in Nairobi. She signed up for PROMPTS when pregnant with her third child, and quickly found that it not only a channel for advice and information during pregnancy, but somewhere she could report on her experiences of care - both clinical and respectful - in her local health facility. ‘I give my feedback so women in my community have a better chance of giving birth safely.’ she says.

Cynthia Kahumbura, Jacaranda’s Country Director in Kenya, speaks to government officials at a consultative meeting held in June. The meeting brought together representatives from Jacaranda with Kenya’s Ministry of Health, Council of Governors, and members of county government to discuss the impact of our evidence-based solutions, and explore opportunities for greater collaboration to reach national scale.

A group of facility in-charges and medical students at Mutuini facility cluster around Head Nurse Alice Muhonja for a short CME (Continuous Medical Education) on birth asphyxia. Program mentors like Alice are trained to conduct routine training around common, or complex cases on the ward with their colleagues, helping reinforce knowledge and enforce consistent care at different levels of seniority. ‘We see so much movement of staff between facilities’. Alice explains. ‘Mistakes happen, but before [MENTORS] we didn’t have a way of making them part of our improvement. Now our providers - no matter how new they are - learn from each other, and we correct mistakes then and there.’ 

Members of the Jacaranda Health team receive the Award of Excellence in Advancing Maternal & Child Health at the 2022 Quality Healthcare Kenyan Awards, held in April, in recognition of PROMPTS. Thanks to rigorous design, adaptation, and scale-up efforts, PROMPTS now supports 2 million mums safely navigate their pregnancy journeys, and gives them a voice in the health system.

A team building in June brought our Nairobi-based staff together with their overseas colleagues for a day of games, dancing, and discussion. In 2022, we welcomed long-overdue time together in person, at team buildings, trainings, strategic planning retreats, and conferences, and welcomed 27 new colleagues from diverse disciplinary backgrounds.

A mother is supported by a trained emergency medical technician (EMT) on the way to hospital. Since 2019, Jacaranda and a local coalition of partners have supported the county government improve maternal survival by shifting where and when mothers access care. The strategy relies on cross-sectoral efforts to improve and sustainably finance core health services, facilities, and emergency transport systems - so that mothers only give birth in well-equipped hospitals in case of complications. Between 2021 and 2022, improvements to staff count, bed capacity, and maternity services mean three of the county’s major hospitals now capably and safely handle more deliveries.

Clients at Matete Health Center, Kakamega County, trial a new ticketing system in November, with the aim of encouraging equal client treatment and improving service delivery efficiency. The ticketing activity is currently being piloted in three health facilities across the county as part of an ‘Innovation 'Lab’ series, conducted by Jacaranda and Thinkplace, focussing on designing solutions with and for the needs of mothers, healthcare workers, and the community.

In November, Co-Executive Director Sathy Rajasekharan discussed the importance of collaborative research to fully and equitably harness the power of AI for health on a I-DAIR-hosted panel at UNGA77. Speaking at the same event, Country Director Cynthia Kahumbura highlighted the importance of locally-led, integrated solutions to strengthen maternal health systems in an intimate Dexex-hosted interview.

In October, Jacaranda virtually joined forces with global experts for an immersive day of problem-solving around a challenge; namely, building a clinical ‘home record’ for moms. Results from the Hackathon bring us a step forward to putting mothers in the driving seat of their own health outcomes and ensuring facilities are better prepared to offer timely, targeted care to incoming cases. Thanks to our partners at Amazon Web Services for the opportunity, and for all contributors for taking part.

A mother and baby stand outside their home in Makueni, a populous county in Kenya’s Southern Province. Almost 100,000 pre and postnatal women have signed up to receive information through PROMPTS within 75 public health facilities across the county.

Helpdesk Coordinator Pauline Nafula is part of the rapidly-growing Helpdesk team underpinning PROMPTS’ two-way messaging and referral capabilities. Upgrades to the helpdesk technology and an expanded team of agents have enabled faster response times for mothers. The helpdesk now manages ~5,000 incoming questions daily with ever-increasing accuracy, and high-risk flagged queries are responded to in under 15 minutes. 90% of the high-risk mothers we refer to care now report receipt of care at hospital.