SkizaHealth

Globally, approximately 1 mother dies alongside with 40 under-five children every 2 minutes from preventable causes such as pregnancy related complications at childbirth, childhood diseases (e.g. pneumonia, malaria, and measles), neonatal causes, malnutrition and HIV/AIDS. With reference to Kenya Demographic Health Survey (KDHS) 2014, neonatal mortality rate stands at 22 per 1000 live births with under-five mortality at 52 per 1000 live births. Likewise, 99% of all maternal deaths occur in developing countries with more than half of these deaths being recorded in Sub-Saharan Africa. Worriedly, these deaths are highly recorded in women living in rural areas and low-resource settings with even much higher numbers among younger mothers especially adolescents of age 15 or below. Currently, Maternal Mortality Ratio (MMR) in Kenya stands at 367 per 100,000 live births. Major contributing factors of maternal and child mortality in low-resource settings include: Poverty, lack of proper health information and medical care from skilled health personnel, longer travel distance and poor infrastructure to the nearest health facility to receive proper antenatal or postnatal care, and inadequate health care services. Secondly, most mobile health applications have focused on SMS only in national languages to disseminate health information. This agony with the use of SMS only is that illiteracy is still a challenge in most rural areas/low-resource settings as some people cannot read, write or fluently speak in these national/official languages but can fluently speak, listen and understand any information in their local language. Thirdly, most mobile health applications currently target smartphone users (19%, Kenya) with little focus on the majority basic/feature users (63.6%, Kenya) hence denying them equal opportunity in accessing basic health information which most mothers in these settings greatly need.

SkizaHealth is a mobile application that disseminates customized health information to antenatal mothers, postnatal mothers and caregivers of under-fives through audio in their local language using low-cost basic phones. It also sends out customized reminders on key periodic health care services/visits based on the pregnancy phase and age of the child, and is integrated with a referral system for health cases through an interlinked network of community health service providers and accessible health facilities. It works by auto-calling the end-users to listen to the customized voice information and allows them to send their feedback via voice/SMS. The use of voice makes it easier to monitor on the platform whether the audio was listened to and for how long; while in SMS you can only be sure that the SMS was delivered but you can’t be sure whether it was seen, read or deleted immediately without being read.

Mothers

Caregivers

Health workers

Community Heath Extension Workers (CHEWs)

Community Health volunteers (CHVs)

We have set up a multidisciplinary team of skilled professionals, goal-oriented and mobile health enthusiasts to successfully deliver the innovation. We have four categories team: Management team, technical team, health content team and advisory team. The management team consists of a procurement officer with 4 years experience in the management of university funding and donor funding with previous experience as a finance officer and project manager who is experienced in project implementation, management and Monitoring and Evaluation. The technical team is composed of two (2) software developers who have previously worked on health startups using android platforms. The health content team consists of a nutritionist, medical doctor, public health specialist and content specialist who will consultatively work together to ensure quality delivery of health information. The advisory team consists of 2 experienced PhD holders in health matters, health projects implementation who will consistently advice on the right methodologies and approaches to producing great impact geared towards achieving overall goal.

Since our project intends to use down-top approach in disseminating health information to the underserved population, we will first establish partnerships with the county, community-based health facilities (Level 1, 2 and 3) and community frontline service providers (e.g. Community Heath Extension Workers, Community Health Volunteers). These local partnerships will make it easier to establish priority areas of focus for implementation, project feasibility, monitoring, mid-term evaluations, follow-ups, and handling of referral cases. The community health service providers will also be integrated in the SkizaHealth referral system which is an interlinked network of community health service providers and accessible health facilities for quick response to cases.

We totally believe that the more educated a mother, the less likely her child is to die (Leith Greenslade, Co-Chair of Child Health, MDG Health Alliance, September 2013).The major accelerating factor in maternal and neonatal preventable deaths is lack of right, timely and proper knowledge. Therefore, disseminating timely and right health information to persons in rural areas/low-resources setting through voice using the most affordable channel e.g. low cost basic phones in the local language of the end-users, is one of the most efficient, effective and reliable way of preventing maternal and neonatal mortality through knowledge dissemination. With majority (82.6%) of Kenyans having access to mobile phones with bottom of the pyramid (BoP) majorly in rural areas and low resources settings taking (63.6%), this presents a great opportunity for reaching and educating the underserved population lacking adequate basic health facilities. SMS are currently used a lot by mobile applications to inform people on health issues using the national/officials languages but in Kenya none or few if there any have focused on voice in local language since there still exist a huge cohort in the population who can’t clearly understand, read or write the official/national languages but can fluently speak, fully understand, read or write in their local dialects. Furthermore, with voice, it will be easier and more effective to monitor on the SkizaHealth platform whether the audio was listened to and for how long for purposes of Monitoring and Evaluation and follow-ups; but with SMS you can only be sure that the SMS was delivered but you can’t be sure whether it was seen, read or deleted immediately without being read. We believe that when a mother, caregiver or community is empowered with quality and adequate knowledge on health issues and how to prevent common causes of morbidity and mortality, the country will spend less resources on health budget hence this is one of the best ways of ensuring sustainability. This approach will be sustainable and impact even more much when local partnerships at community level is enhanced and strengthened with level 1 to 3 health facilities; and this is the approach we intend to adopt.

With the current mobile phones penetration rate in Kenya at 82.6% (Communications Authority of Kenya, 2014/2015), this provides a great opportunity for adoption and successful implementation of this mobile application as an efficient, effective, reliable and sustainable channel of disseminating targeted health information in these low-resource settings. This is further justified by the fact that majority (63.6%) of basic low cost phones owners are majorly in rural areas and low-resources settings. Moreover, the use of local language in audio makes health information delivery much more comprehensive and effective. Furthermore, local partnership with community-based (Level 1, 2 & 3) health facilities and personnel will make it more effective, timely and sustainable during the project implementation, cases referral, monitoring, evaluation and follow-ups. With this down-top approach, the mobile application presents a great leverage to impact as it intends to solve local problems using local solutions right from level 1 by building local partnerships, county and community level engagement.

SMS are currently used a lot by mobile applications to inform people on health issues using the national/officials languages but in Kenya none or few if there any have focused on voice in local language since there still exist a huge cohort in the population who can’t clearly understand, read or write the official/national languages but can fluently speak, fully understand, read or write in their local dialects. Furthermore, with voice, it will be easier and more effective to monitor on the SkizaHealth platform whether the audio was listened to and for how long for purposes of Monitoring and Evaluation and follow-ups; but with SMS you can only be sure that the SMS was delivered but you can’t be sure whether it was seen, read or deleted immediately without being read. We believe that when a mother, caregiver or community is empowered with quality and adequate knowledge on health issues and how to prevent common causes of morbidity and mortality, the country will spend less resources on health budget hence this is one of the best ways of ensuring sustainability. 

- Increase access to and utilization of quality maternal and newborn health services through improved health knowledge on maternal and newborn health, efficient referral system, timely access to health information and quality care

- Health system management strengthened to deliver quality MNH services through SkizaHealth efficient referral system and community units with functioning referral systems

- Percentage of mothers attending antenatal and postnatal services in health facilities

- Percentage of children fully immunized

- Percentage of health facilities offering maternity services certified by the Baby-friendly Hospital Initiative

- Percentage of mothers delivering at the health facilities

- Number of mothers/caregivers with a mobile phone

It is assumed that improving the mother and child’s health is a desired long-term outcomes in a Kenya and this will lead to the community's ability to adapt to use of improved mobile technology that will help reduce maternal and child deaths, thereby improving the primary healthcare services 

Key Activities to be carried out

Identification of project success

1.

Developing mobile application, hosting, prototyping, testing, launching and maintenance.

Efficient and fully functional mobile application which can timely disseminate health in voice through auto-calling the enrolled end-users.

2.

Recording, transcription and uploading of the audio contents in the platform.

Number of fully customized and transcribed audios uploaded in SkizaHealth platform.

3.

Enrollment of the target groups in SkizaHealth project.

Number of direct beneficiaries enrolled/registered in the SkizaHealth project and exists in the project database.

4.

Dissemination of health information.

Improved health knowledge on maternal and newborn health, Antenatal Clinic (ANC) attendance rate, Postnatal Clinic (PNC) attendance rate, Skilled birth attendance rate, Vaccination coverage, Place of delivery (At health facility), Exclusive Breastfeeding, Complementary feeding, Obstetric case fatality rate, child morbidity rate, Feedbacks from community health service providers and project direct beneficiaries, and their attrition rate.  

5.

Establishing partnerships, creating awareness, trainings and workshops.

Availability and accessibility of all necessary antenatal or postnatal records or data required for the registration of primary targets in the project, Number of active community health service providers enrolled and integrated in the SkizaHealth project, and Number of community units with functioning referral systems.

6.

Community outreach/field visits, monitoring, mid-term evaluations and follow ups.

Proportion of referred cases successfully responded to. Number and frequency of feedbacks from the community-based health service providers and project direct beneficiaries.

7.

Conducting baseline survey and end-term evaluation.

Reports of the baseline survey and end-line evaluation.

So far, we have set up a multidisciplinary team of skilled professionals, goal-oriented and mobile health enthusiasts, design the project website and are in the process of developing the application.  We intend to prototype and refine the mobile technology application. 

The Ministry of Health specifically the health facilities in the various counties in the country. 

There is a record system in every health facility that is linked to the Kenya Health Information System (KHIS)

We have set up a multidisciplinary team of skilled professionals that comprises of Management team, technical team, health content team and advisory team. The members will include persons from all genders, marginalized communities and persons with special abilities

SkizaHealth mobile application will be from 2022 to 2025, lay out a roadmap for providing maternal and newborn health information through a use of a mobile application approach. It will focus on Its focus on communication on maternal and child health. This will be fully aligned to the Ministry of Health guidelines on Maternal and Child Health and will make contributions to transformative result of “ending preventable maternal and child deaths.”

SkizaHealth will have three elements:

• Strategy to disseminate health information and evidence-based interventions to women of reproductive age and caregivers of under-fives in low-resource settings in their local language through audio.
• Sending reminders to the target groups on key periodic health care services/visits.
• Strategy to refer maternal and child related health cases which demand immediate attention through an interlinked network of community service providers and accessible health facilities.

The work will be funded through sustained donations from well wishers and  from our kitty that was established by members of the team

Team members kitty fund as majority of the members are earning an income