Josephine's Story

Living in Bungoma, a Kenyan County hugging Uganda’s border, Josephine Mucoro was in the later stages of pregnancy when she came across PROMPTS, Jacaranda’s AI enabled digital health platform. Combining carefully designed SMS “nudge” messages and a rapid response helpdesk service, the platform connects  expecting and new mothers with lifesaving advice and referral to maternity care, and collects data on the quality of care mothers receive when seeking care in health facilities.  

The service has already reached 758,000 mothers across 750 public hospitals and health centers in 15 of Kenya’s Counties, including Bungoma. Josephine signed up to PROMPTS at her local clinic, Chwele Sub County Hospital, following a recommendation by the clinic nurses. Enrolling is easy; mothers simply share their phone number with the facility, and immediately start receiving pregnancy-based information from the team at Jacaranda. The platform deliberately relies on SMS, a technology accessible to over 95% of Kenya’s population, and is cheaper than buying data. 

The ‘nudge’ messages women receive through the platform vary, offering information on nutrition during pregnancy,  how to stay healthy, tips on hygiene and sanitation, and messages on looking after newborns. ‘I received a message [from PROMPTS] about diet, saying that I should try to eat meat, fish or eggs at least once a week.’ says Josephine. ‘After seeing the message my husband started buying them to support me and our unborn child’.  

The platform is also designed to improve care-seeking behavior at key moments during and after pregnancy which, in turn, links with better health outcomes. One of the most significant drivers of maternal deaths in Kenya is that mothers and their families are not empowered or informed to seek care at the appropriate time. Through PROMPTS, expecting mothers receive messages with reminders to attend the recommended four antenatal visits, and new mothers are encouraged to seek critical postnatal care, postpartum family planning, and exclusive breastfeeding in facilities near where they live.

Critically, PROMPTS is set up to identify and refer mothers to care when there is risk of compilation. An AI-based system triages questions from mothers and prioritizes them for clinical urgency, allowing helpdesk agents to respond to urgent questions linked to possible danger signs within hours. ‘I received one message saying that if my legs swell and there is no dent when I press them, I should not worry, but if there is a dent, I should go to hospital.’ Josephine explains. 

Whilst Josephine wasn’t experiencing ‘dents’ in her legs, it was a few days before she received another message that would save her life. ‘One of the messages said that if I feel pain in my upper abdomen, I could be at risk and should head to hospital.’ She explains. ‘One Thursday, after coming from church, I started feeling some pain in my upper abdomen. I thought it would pass, but it persisted.’ Realizing this correlated with the warning in the PROMPTS message, Josephine quickly called on a neighboring friend and asked if she would accompany her to a nearby clinic. On arrival at the facility, her blood pressure was tested and found to be high, and she was immediately referred and admitted into urgent care at Chwele Hospital. 

The referral proved life saving. ‘From Thursday to Saturday my baby was not moving’ explains Josephine. The hospital took action, performing an emergency cesarean section that would save both Josephine, and her newborn baby’s life. ‘I’m so grateful to Jacaranda for sending these messages.’ she says. ‘Because of PROMPTS, I was able to recognize the pain I was feeling was not normal and I sought  care at the hospital. I don’t know what might have happened to me and the baby otherwise.’

PROMPTS has proven effective in improving referral and triage of urgent cases, connecting mothers facing life-threatening clinical conditions to the closest facilities equipped to deal with their emergency.  91% of women would seek care if they recognized severe pregnancy and postpartum danger signs. By empowering women like Josephine with knowledge and information, and leveraging innovations in digital health, PROMPTS is connecting them to critical care when and where they need it.