Afya Research Africa

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Portfolio Title: Ubuntu Digital Collaboration

Grant Type: Innovation

Counties: Turkana

Timeline: July 2017 - March 2019

Funding Round: 3

The Problem

Turkana County has the third highest Maternal Mortality Ratio (MMR)1 in Kenya. This is driven by a complex web of factors, such as the pastoral lifestyle that means mothers seek care from many different health providers, which makes it difficult to provide continued care and follow-up during pregnancy and after delivery. In addition, cultural norms condone early marriage leading to more teenage pregnancies associated with a higher risk of complications. The harsh conditions and poor infrastructure further contribute to poor access to health information, leading to poor health seeking behaviour.

Turkana mothers and their children are quite mobile on account of the realities of nomadic livelihoods. Mothers seek care, if available, from different healthcare providers in their path of movement. Thus, providers are unaware of complications previously identified, care and treatment plans are mixed inappropriately, tracking the mother or patient at the community level is difficult, and patient education is fractured. Existing health information systems only exist at the facility level and do not link to the community or across facilities. As a consequence, there is significant loss to follow-up and inconsistency in MNH care, lowering the quality of care during pregnancy and the post-natal period. Clients are double registered across health facilities and community health units, making for grossly inaccurate data being fed into the DHIS2 - the government aggregate data repository.

Ubuntu Digital Collaboration

Afya Research Africa is implementing a project called Ubuntu Digital Collaboration (UDC) to address these challenges. The collaboration creates a digital and physical network of healthcare providers connected to women of reproductive age, including pregnant adolescents, to effectively follow them through pregnancy and the postpartum period. It provides integrated electronic health record tools that empower community health workers and clinicians to provide basic maternal and newborn health services to this migratory population. Utilising the STONE HMIS® electronic medical records system, health workers are able to uniquely identify, educate, empower, treat, and follow-up pregnant women within a pastoralist community. The UDC platform provides connectivity that allows identification and tracking of women from communities to the health facilities, thus increasing the uptake of antenatal care services and skilled delivery. The STONE HMIS® platform uses biometrics to uniquely identify mothers and enhance collaborative service delivery across multiple providers.

Expected Results

The digital collaboration interlinking various service delivery points is expected to enhance mapping, unique identification and follow-up of clients resulting in improved access to and quality of maternal and newborn health care services.  The project targets to benefit at least 1800 mother-baby pairs, who will receive services at 10 digitally linked health facilities.

Progress as of August 2018

  • Developed a fully functional UDC platform, including a system of unique patient/client identifiers using biometrics;
  • Digitally linked 10 Health facilities (including the Lodwar County Referral Hospital) to the UDC platform;
  • Mapped and registered about 1200 households in Loima Sub-County on the UDC platform;
  • Enrolled more than 400 pregnant women on UDC, allocating them unique identifiers and tracking them across service delivery points;
  • Conducted training on UDC for 120 health workers, 25 community health volunteers and 11 members of county and sub-county health management teams.

For more information about this project, contact:

Samson Gwer

Afya Research Africa

Kimani Karuga

Options Consultancy Services Ltd.