M-MIMBA: A Game-Changer for Pregnant Women in Hard to Reach Communities in Kenya

July 19, 2015

During a recent field visit in a remote rural area in Kenya, I had the opportunity to meet and talk with John and Naomi, two amazing and resilient people.

John lost his wife, Florence, at childbirth. Florence was a very dynamic woman in her early thirties and a devoted mother to two children. John and Florence had chosen to give birth with the help of a traditional birth attendant (TBA). As John mentioned to me, the TBA is close to the house, she is friendly, she knows how to provide pain relief massages and good advice to pregnant women in the village. Florence had been attended to by the same TBA for their two older children. This time, complications happened, and Florence had to be rushed to the nearest health facility. Unfortunately for Florence, it was late at night and no car was available. John, Florence and the TBA waited for two long and stressful hours during which Florence bled to death.  The twins Florence had given birth to, also died. Three lives were gone, wasted. Florence sadly became a statistic, 1 death among the 400 deaths per 100,000 births occurring annually in Kenya.

Naomi is a young, very active community health worker (CHW) passionate about her work. Despite the fact that she receives no meaningful monetary retribution, she tirelessly provides vital health information to households on antenatal care, maternal health, newborn care, family planning and management of diseases including HIV/AIDS and malaria. She lives in this remote area and her role is vital and helps save lives. She has to keep on doing what she does no matter the amount of work. Interestingly, what frustrates Naomi is not her intensive job or the fact that she receives no meaningful financial retribution.  What frustrates her is the fact that families do not always implement her life-saving advice. She is mostly frustrated by pregnant mothers who die under her watch because they still choose what she calls inappropriate birthing practices. She particularly remembers Doreen. Doreen chose to be attended to by a TBA during childbirth. Everything had gone well, Doreen and the baby were fine, alive! Unfortunately, Doreen learned at the health facility during a postnatal check that she was HIV positive and that the disease was transmitted to the baby during childbirth. The bouncy baby boy suddenly became a statistic, another child unnecessarily infected with HIV in a country with widely spread Prevention of Mother-to-Child Transmission (PMTCT) programs.

Listening to John and Naomi, I kept on thinking: What if John and his wife had a way to access emergency transport that night? What if they had a nurse on the phone during those two stressful hours to help (them and the TBA) with first aid? What if Naomi had some additional support in providing birth preparedness and complication readiness messages to pregnant women in her village?

It is at that moment, the idea of M-MIMBA was born.

I decided to send out a proposal to develop and test M-MIMBA, a mobile phone platform exclusively designed for pregnant women to provide innovative transport solutions and birth preparedness messages. This will be a platform designed for the purposes of:

  • Saving money for transport
  • Receiving birth preparedness messages and anecdotes
  • Point-of-care remote consultation
  • Timely linkage with pre-registered transport operators in emergency situations

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M-MIMBA is a potential gamechanger for all pregnant women in hard to reach communities in Kenya:

  • A unique tool to empower pregnant women and their families to save money. No more time and lives wasted in waiting for relatives or friends to “M-Pesa” money in emergency situations.
  • A unique platform to connect pregnant women to pre-registered transport operators in a timely manner. No more time and lives wasted in waiting for an improbable car or ambulance.
  • A gateway to long-lasting behavioural change and cultural adaptation for better birthing practices.

I will showcase this innovation on Monday, July 20 2015 in Washington DC at the 2015 Saving Lives at Birth Development×Change meeting. They call it an exciting meeting to showcase cutting-edge innovations with the potential to dramatically decrease maternal and newborn mortality. In my heart, I call it a unique opportunity to make M-MIMBA a reality for millions of potential Florence in Kenya. I call it a unique opportunity to make Florence’s death count, not as a negative statistic anymore but as an inspiring starting point to act in an innovative way to save lives at birth.

You can watch the showcase here.

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