Three million women in Kenya have turned to an AI-enabled text messaging service in Swahili that empowers them to access essential care from pregnancy to postpartum.
- 0MillionMillion
Kenyan women are enrolled in PROMPTS
- >0
questions are received daily from pregnant women or new moms
- 0%%
of the questions are answered by AI, while the other, more urgent, ones are relayed to clinical nurses
Edna Chizi during her pregnancy. (Photo Courtesy of Edna Chizi)
The PROMPTS service is revolutionizing maternal and newborn healthcare in Kenya, and is primed for expansion in other African countries. Women enroll for free in public health facilities across the country. The service also is being piloted in Eswatini, Ghana, and Nigeria.
The Rockefeller Foundation is helping support those pilots as well as working to expand PROMPT’s scope to identify the growing health risks posed by increased extreme weather events, particularly the impact of punishing heat on mothers and babies.
“This partnership with Jacaranda Health is transformative and helps to demystify artificial intelligence,” said Andrew Sweet, Vice President, Innovation, The Rockefeller Foundation. “It is not some vague concept, but a tool to provide world-class care — equally, easily, and affordably — to women who typically don’t have access to such care.”
Jacaranda Health, a Kenya-based non-profit founded in 2016 with the mission to transform maternal healthcare in low-resource settings, partners with local governments and public facilities in 23 of Kenya’s busiest counties. This provides a broad distribution channel for PROMPTS (PROmoting Mothers in Pregnancy and Postpartum Through SMS.)
How PROMPTS Works
A Trusted Pregnancy Companion
A disproportionately large number of pregnant women die in Kenya, and about one-third of those maternal deaths result from delays in seeking needed care. Some 70 percent of Kenya’s of pregnant women and new moms live in rural areas, often far from healthcare facilities.
PROMPTS fills the information gap and provides a lifeline of information and support, answering questions with speed. It has quickly become a trusted companion on the pregnancy journey.
The service receives 10,000-12,000 questions per day. It uses AI to answer about 70 percent of them on its own within minutes. It elevates the other 30 percent that are urgent or particularly complex to about a dozen help desk agents who are trained clinical nurses. The unit cost is 74 cents per mom, making it economical. And it has been endorsed by the Kenyan government for national scaling.
Moms enrolled in PROMPTS also are 20 percent more likely to complete the recommended four or more prenatal visits, 1.85 times more likely to engage in postpartum family planning services, and 18 percent more likely to have two or more postpartum care visits.
“The AI model is able to classify a question as to type and urgency with 90-93 percent accuracy,” said Jay Patel, Jacaranda’s Director of Technology.
But the team is committed to continuous research and ongoing improvement, and the next goals focus on giving women a more personalized experience.
“Currently, we are working on making it more conversational so that it links a second question back to the previous one,” Patel said.
“And with the increased ability to be more conversational, we are also building in our ability to be more tailored to each mom through climate data, clinical history, and socio-economic information, giving them a more personalized experience,” added Anneka Wickramanayake, Jacaranda’s Director of Research, Evaluation, and Design.
Layering in Climate Data
Layering in climate data is anticipated to significantly enhance the service’s ability to support maternal and newborn health. Rising temperatures in Kenya are contributing to direct health risks, including dehydration, hypertensive disorders, and preterm births, as well as indirect risks such as increased infections and changing disease patterns.
The most vulnerable populations, including rural and under-resourced women, are disproportionately affected by these climate-related risks, with limited access to resources like water and adequate shelter.
Data shows a 66 percent increase in reported swelling, as well as a boost in other reported symptom like headaches, with higher temperatures (Graph Courtesy of Jacaranda Health)
PROMPTS is well-positioned to align with national climate adaptation plans and climate services programs, and provide targeted support and information at scale to help mothers navigate the growing heat burden. This includes timely alerts and advice to mothers, particularly those at higher risk due to conditions like hypertension or gestational diabetes.
“With weather data, we can know a spike in temperature is coming next week, and then we can proactively message the moms to stay out of the sun, plan health checkups accordingly, and drink more water,” added Patel. “The same for heavy rainfall. We can advise them to avoid standing water and suggest alternative routes to healthcare providers in case of floods.”
This is an opportunity to teach moms and their families about climate risks. “We need to explain why climate is a concern and what they should do in terms of prevention and response. This is a new area for us, and we have a big chunk of work to do around that,” said Wickramanayake.
In addition, PROMPTS could provide training and data to healthcare providers on heat-related risks and care practices such as adjusting clinic schedules during extreme heat and integrating climate considerations.
Data To Support Public Health
But Jacaranda’s ambitions are even larger.
They want to collect information that can help inform policymakers as they consider public health in an age of more extreme climate events.
The valuable data the platform collects on mothers’ experiences, health priorities, and care quality creates a continuous feedback loop to improve healthcare delivery.
This can be used to address wider health system challenges and guide national decision-making.
Nyiva lives about 30 kilometers (20 miles) south of Nairobi in Kitengela in Kenya’s Kajiado County, where municipal officials note there are not enough healthcare facilities.
Chizi lives in Kaloleni, an under-resourced town about 30 kilometers (20 miles) north of Mombasa.
Both women were advised to head to the hospital – something they would not have done as quickly had it not been for the PROMPTS guidance.
They both then received phone calls from Jacaranda’s helpdesk nurses to make sure they had been treated.
“PROMPTS is a five-star service,” said Chizi, who delivered a healthy baby in February.
“As a first-time mother, I really value it. It has made me more confident and able to interact with medical practitioners without fear.”
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