Jacaranda Health advances maternal and infant health across Kenya and beyond with AWS

Kenya has one of the world’s highest maternal mortality rates, at 39 deaths per 1000 live births annually. About 30% of maternal deaths in Kenya occur due to delays in seeking care. By the numbers, 62% of women in Kenya don’t receive more than four antenatal care visits during pregnancy, and 43% don’t attend a postnatal checkup after birth. Not receiving this critical health support and other health education increases risks for maternal and neonatal mortality. But many mothers don’t have the right information to make informed choices about where to seek care, and when.

Jacaranda Health, a Kenya-based nonprofit organization, is on a mission to end preventable maternal and newborn deaths by deploying low-cost, sustainable solutions that improve the quality of care in government health systems. Jacaranda Health is a recipient of the 2021 AWS IMAGINE Grant award from Amazon Web Services (AWS), a public grant opportunity open to registered 501(c) nonprofit organizations in the United States who are using cloud technology to solve the world’s most pressing challenges. For one key initiative, Jacaranda Health uses AWS to power a health platform that uses artificial intelligence (AI) to connect mothers with timely information about pregnancy care, as well as potentially lifesaving advice and referrals to care facilities when it matters most.

Transforming health behaviors to end preventable maternal and newborn mortality

To provide mothers with the information they need to seek the right care at the right time, Jacaranda Health knew they needed an affordable, simple to use, and scalable solution. Jacaranda Health turned to AWS for its cloud-based digital health platform called PROMPTS (PROmoting Mums through Pregnancy Through SMS). PROMPTS is a no-cost SMS service for mothers that sends text messages, or “nudges,” that prompt and encourage health-seeking behavior based on the gestation-specific stage of the mother’s pregnancy. PROMPTS is built on RapidPro, an open-source platform that makes it simple to build mobile-based messaging services and data collection platforms. RapidPro uses Amazon Elastic Compute Cloud (Amazon EC2) and Amazon Simple Storage Service (Amazon S3).

Jacaranda Health designed PROMPTS with functionalities tailor-made to the reality and needs of mothers. Using AWS Cloud services, PROMPTS can disseminate vital information to mothers anytime, anywhere—even in remote and hard-to-reach places. PROMPTS also collects information from mothers on key health priorities—including whether they have attended pre- and post-natal check-ups, their experiences of care in facilities, and updates on their baby’s immunization status—throughout their motherhood journeys. In turn, this information becomes a vital input in a continuous feedback loop to help Jacaranda Health improve its program delivery.

The platform also has an AI-enabled two-way helpdesk service that responds to thousands of incoming messages from mothers each day in English or Swahili. PROMPTS uses natural language processing (NLP) to analyze these messages for clinical danger signs and rapidly alerts Jacaranda Health’s clinical help desk agents—who are qualified nurses and medics—so they can rapidly respond to mothers within an hour and refer them to the closest care facility.

Figure 1. While mobile phones are commonplace in Kenya, internet-based telecommunications are less popular. For that reason, PROMPTS sends SMS in both English and Swahili to mothers. A message sent in the first trimester might read: “Watch for danger signs in pregnancy. Do you experience vaginal bleeding, severe nausea, vomiting, fever, or severe abdominal pain? If you see any of these danger signs, respond with an explanation of what you are seeing and go to the nearest hospital immediately.”

Beyond services delivered directly to mothers, Jacaranda Health uses Amazon Glue to integrate a vast amount of collected data into an intelligent data warehouse infrastructure built with Amazon Relational Database Services (Amazon RDS). From there, Jacaranda Health uses Amazon QuickSight to make sense of large data sets with real-time analytics, visualization, and reporting. All data is anonymized, and any personal identifiable information (PII) is strictly access-controlled, secured, and encrypted from the point of collection, through to transfer and storage.

Figure 2: Using AWS services like Amazon S3, Amazon Glue, and Amazon RDS, PROMPTS disseminates vital information in remote, hard-to-reach places and scales out horizontally by provisioning more application servers. PROMPTS relies on AWS Cloud services to facilitate data collection, aggregation, and analytics.

The strategic use of collected data helps Jacaranda Health optimize program design by allowing them to seamlessly connect siloed datasets using visual tools, and build compelling dashboards to better make sense of complex data. This creates a granular picture of how mothers use the platform, which helps optimize message flows and other functionalities on PROMPTS. This data also offers nurses and health system managers real-time, responsive data to effectively respond to systemic weaknesses in care quality, improve service delivery, and allocate resources.

Jacaranda Health reaches new milestone and continues to grow on AWS

Jacaranda Health now reaches over 1.5 million mothers across Kenya through its network of over a thousand government partner hospitals and health facilities. These mothers come from different socioeconomic backgrounds, age groups, geographies, and levels of digital connectivity. To date, mothers that use PROMPTS are 22% more likely to achieve the recommended amount of antenatal care visits (more than four); are 3.5 times more likely to get care if experiencing danger signs after delivery; and are twice as likely to take up family planning.

Jay Patel, Jacaranda Health’s head of technology stated, “Thanks to the AWS IMAGINE Grant, we’re in a strong position to rapidly scale our locally-developed solutions to transform health outcomes for more mothers and babies, in Kenya and beyond. Strengthening our existing technology is integral to this future growth, and doing this in a way that is both cost-efficient and context-specific, will ensure the sustainability of our programs as a longer-term national resource.”

By leveraging cloud technology to build a secure, agile, and scalable technology foundation, Jacaranda Health puts data and power back in the hands of mothers and help them drive crucial health decisions. Looking forward, Jacaranda Health will continue to scale-up to a critical mass of public hospitals, setting the stage for improving Kenya’s health system and beyond.

The AWS Imagine Grant aims to empower nonprofit organizations to prioritize technology as a mission-critical component of their projects and provide support for organizations pursuing technology driven goals. Sign up for 2023 AWS Imagine Grant email alerts to be notified when the application window opens. Learn more about how AWS supports nonprofits at the AWS for Nonprofits hub.

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Jacaranda Health advances maternal and infant health across Kenya and beyond with AWS

Transforming health behaviors to end preventable maternal and newborn mortality

Jacaranda Health reaches new milestone and continues to grow on AWS

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