Jacaranda Health, Jabavu Gate 788, Jabavu Road, Nairobi, 52595-00100, Kenya.
Population Council, Nairobi Kenya. Avenue 5, 3 Floor, Rose Avenue, Nairobi, 17643-00500, Kenya.
BMC Pregnancy Childbirth. 2024 Mar 27;24(1):222. doi: 10.1186/s12884-024-06373-7.
The rapid urbanization of Kenya has led to an increase in the growth of informal settlements. There are challenges with access to maternal, newborn, and child health (MNCH) services and higher maternal mortality rates in settlements. The Kuboresha Afya Mitaani (KAM) study aimed to improve access to MNCH services. We evaluate one component of the KAM study, PROMPTS (Promoting Mothers through Pregnancy and Postpartum), an innovative digital health intervention aimed at improving MNCH outcomes. PROMPTS is a two-way AI-enabled SMS-based platform that sends messages to pregnant and postnatal mothers based on pregnancy stage, and connects mothers with a clinical help desk to respond and refer urgent cases in minutes.
PROMPTS was rolled out in informal settlements in Mathare and Kawangware in Nairobi County. The study adopted a pre-post intervention design, comparing baseline and endline population outcomes (1,416 participants, Baseline = 678, Endline = 738). To further explore PROMPTS's effect, outcomes were compared between endline participants enrolled and not enrolled in PROMPTS (738 participants). Outcomes related to antenatal (ANC) and postnatal (PNC) service uptake and knowledge were assessed using univariate and multivariate linear and logistic regression.
Between baseline and enldine, mothers were 1.85 times more likely to report their babies and 1.88 times more likely to report themselves being checked by a provider post-delivery. There were improvements in moms and babies receiving care on time. 45% of the 738 endline participants were enrolled in the PROMPTS program, with 87% of these participants sending at least one message to the system. Enrolled mothers were 2.28 times more likely to report completing four or more ANC visits relative to unenrolled mothers. Similarly, enrolled mothers were 4.20 times more likely to report their babies and 1.52 times more likely to report themselves being checked by a provider post-delivery compared to unenrolled mothers.
This research demonstrates that a digital health tool can be used to improve care-seeking and knowledge levels among pregnant and postnatal women in informal settlements. Additional research is needed to refine and target solutions amongst those that were less likely to enroll in PROMPTS and to further drive improved MNCH outcomes amongst this population.
肯尼亚的快速城市化导致非正规住区的增长。这些住区在获得产妇、新生儿和儿童健康（MNCH）服务方面存在挑战，并且产妇死亡率较高。Kuboresha Afya Mitaani（KAM）研究旨在改善 MNCH 服务的获取途径。我们评估了 KAM 研究的一个组成部分，即 PROMPTS（通过怀孕和产后促进母亲），这是一项创新的数字健康干预措施，旨在改善 MNCH 结果。PROMPTS 是一个基于双向人工智能的短信平台，根据妊娠阶段向孕妇和产后母亲发送信息，并将母亲与临床帮助台连接起来，以便在几分钟内对紧急情况做出反应并转介。
PROMPTS 在内罗毕县的马萨雷和卡旺加瓦的非正规住区推出。该研究采用了前后干预设计，比较了基线和终线人群结果（1416 名参与者，基线=678，终线=738）。为了进一步探索 PROMPTS 的效果，比较了终线参与者中参加和未参加 PROMPTS 的参与者之间的结果（738 名参与者）。使用单变量和多变量线性和逻辑回归评估与产前（ANC）和产后（PNC）服务获取和知识相关的结果。
在基线和终线之间，母亲报告婴儿和自己在产后接受提供者检查的可能性分别增加了 1.85 倍和 1.88 倍。按时接受护理的母亲和婴儿的比例有所提高。738 名终线参与者中有 45%参加了 PROMPTS 计划，其中 87%的参与者向系统发送了至少一条信息。与未参加者相比，参加者完成四次或更多 ANC 就诊的可能性高 2.28 倍。同样，与未参加者相比，参加者报告婴儿和自己在产后接受提供者检查的可能性分别高 4.20 倍和 1.52 倍。
这项研究表明，数字健康工具可用于改善非正式住区孕妇和产后妇女的护理寻求和知识水平。需要进一步研究以改进和针对那些不太可能参加 PROMPTS 的人制定解决方案，并进一步推动该人群的改善 MNCH 结果。
