Improving Maternal, Newborn and Infant Health with Smartphones and SmartCHVs

To address high rates of maternal and infant mortality in western Kenya, AMPATH is collaborating with the Kenya Ministry of Health (MOH) to support innovative approaches to improve maternal, newborn and child health. As presented in the summer Gazeti, the Primary Health Care (PHC) program at AMPATH has developed state-of-the-art information technology that fosters rapid communication and feedback between mothers, their communities, and their healthcare providers: the Mother-Baby Health Network.

This article will highlight the mHealth project in Kosirai District, Kenya, funded by Grand Challenges Rising Stars. In order to improve communication, 89 government Community Health Volunteers (CHVs) have been equipped with tools to implement home-based assessments of mothers and newborns using Android phones. Louis Fazen, an MD/PhD student from Yale University, in partnership with Regenstrief Institute in Indianapolis, Indiana, spearheaded the software development. Designed to be open source and link with OpenMRS, this software has multiple applications to assist CHVs with their work.

National and international guidelines were adapted into clinical decision-support (CDS) algorithms that include the danger signs of pregnancy, infancy and the immediate postpartum. By asking algorithmic questions through the phone, the CHVs are guided to assess whether a mother or child might be at risk.

The data from these visits are immediately transmitted to the AMPATH medical record system (AMRS) and are available for viewing by health providers in the health facilities. Furthermore, all MOH community reports are electronically generated on a monthly basis in order to ensure quality monitoring and evaluation. CHVs are now equipped to triage women and infants for referral, ensuring that the decision to seek care is not left to the woman alone but advocated by her CHV and peers.

The goal is to strengthen dialogue between communities and facilities to create a sustainable, community-driven demand for accountable maternal and newborn care at all levels of service. Recognizing that ‘it takes a village,’ the Mother-Baby Health Network will provide communities in western Kenya with the information and communication tools they need to ensure that every mother and child has access to essential care in pregnancy and infancy.