Embracing Modern Technology in Providing Maternal Child Health: A Case of Malaica Pregnancy Program in Kenya
Ikisiri
Background: Modern technology has been embraced across sectors such as education, business, agriculture, and health to improve service delivery. In Kenya, the maternal mortality ratio (MMR) remains high at 355 per 100,000 live births, compared to the global average of 223 per 100,000. Gaps and delays in accessing quality maternal health care are major contributors to this. Mobile health (mHealth), which uses mobile applications and social media to deliver health services, has emerged as a strategy to bridge these gaps and improve maternal outcomes. Intervention: The Malaica Pregnancy Program is one of Kenya’s mHealth initiatives aimed at providing comprehensive, personalized care for pregnant and postnatal mothers. It supports Kenya’s goal of reducing maternal and neonatal mortality and contributes to Sustainable Development Goal 3 (SDG 3): ensuring good health and well-being for all. The program operates through WhatsApp, where each mother is assigned a nurse-midwife who provides evidence-based care according to World Health Organization (WHO) guidelines. Mothers are added to WhatsApp support groups moderated by trained "Supamoms," connecting them with peers who share similar due dates. Participants receive daily updates about pregnancy progress, appointment reminders, and health tips. Malaica also hosts Flash Chats—short expert-led Q&A sessions on pregnancy and parenting topics. Outcome: Malaica has improved maternal and child health outcomes by increasing awareness and promoting early detection of complications. Mothers receive continuous support, enabling timely interventions when necessary. The program empowers mothers to create birth plans and prepare for emergencies in collaboration with their assigned nurse-midwives. Overall, it has made the pregnancy and postpartum experience more convenient, informed, and safe, showcasing the significant potential of mHealth in transforming maternal care in Kenya
Upakuaji
Marejeleo
Bhavnani, S. P., Narula, J., & Sengupta, P. P. (2016). Mobile technology and the digitization of healthcare. European Heart Journal, 37(18), 1428– 1438. https://doi.org/10.1093/eurheartj/ehv770
Bjelke, M., Martinsson, A., Lendahls, L., & Oscarsson, M. (2016). Using the Internet as a source of information during pregnancy — A descriptive cross-sectional study in Sweden. Midwifery, 40, 187–191. https://doi.org/10.1016/j.midw.2016.06.020
Bossman, E., Johansen, M. A., & Zanaboni, P. (2022). mHealth interventions to reduce maternal and child mortality in Sub-Saharan Africa and Southern Asia: A systematic literature review. Frontiers in Global Women S Health, 3. https://doi.org/10.3389/fgwh.2022.942146
Deshmukh S. (2015). Analysis of WhatsApp users and its usage worldwide. International Journal of Scientific and Research Publications, 5(8). Retrieved from https://www.ijsrp.org/research-paper-0815/ijsrp-p4487.pdf
Funnell, E. L., Spadaro, B., Benacek, J., Martin-Key, N. A., Metcalfe, T., Olmert, T., Bahn, S. (2022). Learnings from user feedback of a novel digital mental health assessment. Frontiers in Psychiatry, 13. https://doi.org/10.3389/fpsyt.2022.1018095
Gayesa, R. T., Ngai, F. W., & Xie, Y. J. (2023). The effects of mHealth interventions on improving institutional delivery and uptake of postnatal care services in low-and lower-middle-income countries: a systematic review and meta-analysis. BMC Health Services Research, 23(1). https://doi.org/10.1186/s12913-023-09581-7
Giri, S. (2020). Digital technologies and service delivery. Retrieved from https://www.researchgate.net/publication/338986558_digital_technologies_and_service_delivery
Gurman, T. A., Rubin, S. E., & Roess, A. A. (2012). Effectiveness of MHealth Behavior Change Communication Interventions in Developing Countries: A Systematic Review of the Literature. Journal of Health Communication, 17(sup1), 82– 104. https://doi.org/10.1080/10810730.2011.649160
Kamali, S., Ahmadian, L., Khajouei, R., & Bahaadinbeigy, K. (2017). Health information needs of pregnant women: information sources, motives and barriers. Health Information & Libraries Journal, 35(1), 24–37. https://doi.org/10.1111/hir.12200
KNBS and ICF. (2023). Kenya Demographic and Health Survey 2022. Nairobi, Kenya, and Rockville, Maryland, USA: KNBS and ICF.
Kruk, M. E., Gage, A. D., Joseph, N. T., Danaei, G., García-Saisó, S., & Salomon, J. A. (2018). Mortality due to low-quality health systems in the universal health coverage era: a systematic analysis of amenable deaths in 137 countries. The Lancet, 392(10160), 2203–2212. https://doi.org/10.1016/s0140-6736(18)31668-4
Lang’at, E., Mwanri, L., & Temmerman, M. (2019). Effects of implementing free maternity service policy in Kenya: an interrupted time series analysis. BMC Health Services Research, 19(1). https://doi.org/10.1186/s12913-019-4462-x
Lee, S. H., Nurmatov, U. B., Nwaru, B. I., Mukherjee, M., Grant, L., & Pagliari, C. (2015). Effectiveness of mHealth interventions for maternal, newborn and child health in low– and middle–income countries: Systematic review and meta-analysis. Journal of Global Health, 6(1). https://doi.org/10.7189/jogh.06.010401
Levine, R., et al. (2015, June). mHealth compendium, volume five. Arlington, VA: African Strategies for Health, Management Sciences for Health. Retrieved February 12, 2025, from https://msh.org/resources/mhealth-compendium-volume-five/
Majeed-Ariss, R., Hall, A. G., McDonagh, J., Fallon, D., & Swallow, V. (2015). Mobile phone and tablet apps to support young people’s management of their Physical Long-Term Conditions: A Systematic Review Protocol. JMIR Research Protocols, 4(2), e40. https://doi.org/10.2196/resprot.4159
Masaba, B. B., Mmusi-Phetoe, R., Rono, B., Moraa, D., Moturi, J. K., Kabo, J. W., . . . Taiswa, J. (2022). The healthcare system and client failures contributing to maternal mortality in rural Kenya. BMC Pregnancy and Childbirth, 22(1). https://doi.org/10.1186/s12884-022-05259-w
Mlambo, C., Sibanda, K., Ntshangase, B., & Mvuyana, B. (2022). ICT and Women’s Health: An Examination of the Impact of ICT on Maternal Health in SADC States. Healthcare, 10(5), 802. https://doi.org/10.3390/healthcare10050802
Modi, D., Dholakia, N., Gopalan, R., Venkatraman, S., Dave, K., Shah, S., Shah, P. (2019). mHealth intervention “ImTeCHO” to improve delivery of maternal, neonatal, and childcare services—A cluster-randomized trial in tribal areas of Gujarat, India. PLoS Medicine, 16(10), e1002939. https://doi.org/10.1371/journal.pmed.1002939
Naaz, A., & Muneshwar, K. N. (2023). How maternal nutritional and mental health affects child health during pregnancy: A Narrative review. Cureus. https://doi.org/10.7759/cureus.48763
Nigussie, Z.et al. (2021). Using mHealth to Improve Timeliness and Quality of Maternal and Newborn Health in the Primary Health Care System in Ethiopia. Global health, science and practice, 9(3), 668–681. https://doi.org/10.9745/GHSP-D-20-00685
Njoroge, M., Zurovac, D., Ogara, A., Chuma, J., & Kirigia, D. (2017). Assessing the feasibility of eHealth and mHealth: a systematic review and analysis of initiatives implemented in Kenya. BMC Research Notes, 10(1). https://doi.org/10.1186/s13104-017-2416-0
Ochieng, S., Hariharan, N., Abuya, T., Okondo, C., Ndwiga, C., Warren, C. E., . . . Rajasekharan, S. (2024). Exploring the implementation of an SMS-based digital health tool on maternal and infant health in informal settlements. BMC Pregnancy and Childbirth, 24(1). https://doi.org/10.1186/s12884-024-06373-7
Odeny, T. A., Bailey, R. C., Bukusi, E. A., Simoni, J. M., Tapia, K. A., Yuhas, K., Holmes, K. K., & McClelland, R. S. (2012). Text Messaging to Improve Attendance at Post-Operative Clinic Visits after Adult Male Circumcision for HIV Prevention: A Randomized Controlled Trial. PLoS ONE, 7(9), e43832. https://doi.org/10.1371/journal.pone.0043832
Osma, J., Barrera, A. Z., & Ramphos, E. (2016). Are pregnant and postpartum women interested in Health-Related Apps? Implications for the Prevention of Perinatal Depression. Cyberpsychology Behavior and Social Networking, 19(6), 412–415. https://doi.org/10.1089/cyber.2015.0549
Oyugi, B., Kendall, S., Peckham, S., Orangi, S., & Barasa, E. (2023). Exploring the adaptations of the free maternity policy implementation by health workers and county officials in Kenya. Global Health Science and Practice, 11(5), e2300083. https://doi.org/10.9745/ghsp-d-23-00083
Pagalday-Olivares, P., Sjöqvist, B. A., De Beek, J. A., Abudey, S., Silberberg, A. R., & Buendia, R. (2017). Exploring the feasibility of eHealth solutions to decrease delays in maternal healthcare in remote communities of Ghana. BMC Medical Informatics and Decision Making, 17(1). https://doi.org/10.1186/s12911-017-0552-z
Peprah, P. et al. (2020). Lessening barriers to healthcare in rural Ghana: providers and users’ perspectives on the role of mHealth technology. A qualitative exploration. BMC Medical Informatics and Decision Making, 20(1). https://doi.org/10.1186/s12911-020-1040-4
Shiferaw, S., Spigt, M., Tekie, M., Abdullah, M., Fantahun, M., & Dinant, G. (2016). The Effects of a Locally Developed mHealth Intervention on Delivery and Postnatal Care Utilization; A Prospective Controlled Evaluation among Health Centres in Ethiopia. PLoS ONE, 11(7), e0158600. https://doi.org/10.1371/journal.pone.0158600
Sim, I. (2019). Mobile devices and health. New England Journal of Medicine, 381(10), 956–968. https://doi.org/10.1056/nejmra1806949
UNICEF. (2024). Antenatal care. Retrieved February 18, 2025, from https://data.unicef.org/topic/maternal-health/antenatal-care/
Varma, D. S., Mualem, M., Goodin, A., Gurka, K. K., Wen, T. S., Gurka, M. J., & Roussos-Ross, K. (2023). Acceptability of an MHealth app for monitoring perinatal and postpartum mental health: Qualitative study with women and providers. JMIR Formative Research, 7, e44500. https://doi.org/10.2196/44500
Vogels-Broeke, M., Daemers, D., Budé, L., De Vries, R., & Nieuwenhuijze, M. (2022). Sources of information used by women during pregnancy and the perceived quality. BMC Pregnancy and Childbirth, 22(1). https://doi.org/10.1186/s12884-022-04422-7
World Health Organization: WHO. (2022, March 30). WHO urges quality care for women and newborns in critical first weeks after childbirth. World Health Organisation. Retrieved February 18, 2025, from https://www.who.int/news/item/30-03-2022-who-urges-quality-care-for-women-and-newborns-in-critical-first-weeks-after-childbirth
World Health Organization, UNICEF, United Nations Population Fund, and The World Bank (2023). Trends in Maternal Mortality: 2000 to 2020 WHO, Geneva, 2023
World Health Organization. (2019). Trends in maternal mortality 2000 to 2017: estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division: executive summary. World Health Organization. https://iris.who.int/handle/10665/327596
World Health Organization: WHO. (2019, September 23). Maternal health. https://www.who.int/health-topics/maternal-health#tab=tab_1 retrieved on 18th February 2025.
World Health Organization: WHO. (2024, April 26). Maternal mortality. https://www.who.int/news-room/fact-sheets/detail/maternal-mortality retrieved on 18th February 2024.
Yeung, A. et al. (2023). The promise of digital healthcare technologies. Frontiers in Public Health, 11. https://doi.org/10.3389/fpubh.2023.1196596
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