Welcome to Health Systems Pathways - Population Services International's health system strengthening podcast - making it easier for people to navigate complex health systems.

Insights to inform, influence, and inspire!

In this episode, your host, Marina Dalton-Brown, is focused on digital tools and technologies that help people access the care they need. This includes Digital Health Locator Tools which helps direct people to health information and services, much like how Google Maps guides you through unfamiliar streets.

For this episode, Marina went to Kenya to experience first-hand how digital technology is revolutionizing the way people interact with the broader health system.

We learn about the connection between mobile money and digital health tools. We hear about PROMPT for Mums, which is helping over 2 million mothers in Kenya access the antenatal care they need, in the context of Universal Health Care. We touch on Jali, a WhatsApp platform that is aiming to reach the 11 million WhatsApp users across the country with health information on COVID-19, cholera, breast cancer, mental health and wellness, among other health-related topics.

In the next episode, we delve deeper into Jali, as Marina discusses the tool with Ministry of Health leaders and consumers at the October 20th Mashujaa Day Celebrations. We learn about the benefits and the vision for Jali, and the impact of digital health tools in the country.

For more information;

• HSS Insights Series : PSI - To access Population Service International's blogs and policy briefs, visit our health systems insights website.

Health Systems Pathways is an SCL Agency Production

Marina Dalton Brown: Hi, welcome to Health Systems Pathways.

Thanks for tuning in.

This podcast is designed to share insights that inform, inspire, and invite discussion about what's being done to make it easier for people to navigate complex health systems in different parts of the world.

I am Marina Dalton Brown, and I am pleased to be your host for this two part episode on digital health, with a focus on digital tools that help people in locating the care they need.

Let's get into it.

Have you ever used Google Maps or another mobile locator application to help you get to a specific place?

In Trinidad, I grew up simply asking for directions and clarifying the path from actual humans along the way if I got lost.

I still think it's a nice way of connecting people, but I admit that sometimes just putting in the pin for the destination and following the voice or the arrow on the map can be far more efficient.

So, kind of like Google Maps helps guide us through unfamiliar streets and paths.

Digital health tools might help direct users to the care they need.

This is called digital signposting.

For this episode, I went to Kenya to experience first hand how digital technology is revolutionizing the way people interact with the broader health system to find the care that they need.

As I travelled from the metropolis of Nairobi to the tea highlands of Kericho, a few things became very clear to me.

One, along with the genuine kindness of so many people I met, the beauty of the land is utterly breathtaking.

And two, I noticed the way that people use their smartphones to transact business.

Of course, they use it for other things, but that part really struck me.

From the hotel reception attendant to the roadside market vendor, every person I interacted with selling either a product or a service could seamlessly transact their trade using mobile money.

Kenyans are connected.

All right.

So pull back a bit.

What do Google Maps and mobile money have to do with navigating the health system?

My first guest, Christine Oduor, is the Head of Program Management in the Digital Health and Monitoring Department at PSI.

She sets the context to answer that question.

Over the past couple of decades, we have globally witnessed a boom in technological advancement.

There has been a sharp increase in mobile phone access, including in low and middle income countries, with over 5.

4 billion people globally subscribed to a mobile service by the end of 2022.

The technology boom and rise in mobile penetration has been capitalized by different sectors redefining how they do business.

For example, many low and middle income countries have witnessed a financial services revolution driven by mobile banking.

Kenya, for instance, world's market leader in mobile money, has more cell phone subscriptions than adult citizens, and more than 80 percent of those with a cell phone also use mobile money, commonly referred to as M-Pesa.

This has brought about an unprecedented shift in money management, particularly for the lower wealth quantiles, who were previously left behind by the banking sector, now have an avenue to save and enjoy cashless transactions via their mobile phones.

In the same vein, mobile technology provides an opportunity to expand digital health reach to those who need it most, leaving no one behind.

In recent years, digital health has begun to gather momentum globally.

It presents a great opportunity to reimagine health, both in terms of increasing access for citizens, as well as improving efficiency and quality of service delivery by health care providers.

That said, digital health still falls short of a revolution given that it is a crowded space with many actors and digital solutions, many of which fail to achieve scale, sustainability, and true integration to national health systems.

PSI looks to support governments to make sense of this crowded space and make choices regarding which solutions have adoption, scale, and sustainability potential.

Marina Dalton Brown: As Christine notes, the technological foundation that was laid many years ago in Kenya to stimulate economic growth through a major telecommunications network company and the government, help to provide a solid basis for digital signposting tools to be developed.

Javan Waita, gives one example of such a tool that helps over 2 million Kenyan mums find the care they need.

My name is Javan Waita working in Jakaranda Health Solutions as the head of programs.

I lead the implementation of two main projects and a digital health platform.

We call it PROMPTS which aims at empowering moms with information in terms of where to seek care and when to seek care and a training program, we call it EMOC mentorship, which empowers healthcare workers with the skills and knowledge in terms of managing maternal and neonatal complications within healthcare facilities.

So, uh, as Jakaranda Health, we work within the maternal and neonatal health space, and we recognize the gaps within MNH in terms of delays in seeking care and also access to quality health care services, which contribute to poor outcomes in terms of maternal and neonatal mortality.

PROMPTS is a simple digital SMS platform, which shares messages to moms, which shares a gestation specific messages to moms, in terms of where to seek care and when to seek care.

So it empowers them with information, during pregnancy to enable them to make choices, uh, during the pregnancy period.

It's an interactive platform which ensures moms are also able to ask questions and as well, give feedback in terms of the experience of care within the healthcare facility.

What this means is, apart from asking questions, the platform is also able to ensure mom's voice is brought in, in terms of improving the quality of care, as well as health systems improvement within the provision of care.

Additionally, our platform is also AI enabled.

And what this means is, um, the AI is able to triage questions and issues raised by the moms within the platform and is able to give high priority to issues that have danger signs and ensure they are handled and those clients are linked to care as soon as possible.

And that means we are able to redirect, uh, high risk moms, moms who have danger signs to seek care as soon as possible.

And that means we are able to avert maternal and neonatal complications as early as possible.

Our PROMPTS platform currently has a reach of about 2.

5 million moms within the country.

We are currently within 22 counties, uh, of the 47 counties in Kenya, and our reach is about 60% of all the moms delivering within the country.

So in terms of acceptance in terms of user friendliness, our platform is user friendly and accepted and we are looking forward into reaching every mom ,within the country.

And that means we have a bigger, bigger goal in the next two to three years by 2025 to ensure every mom is part of the platform.

Our goals are aligned with the UHC goal of ensuring every Kenyan or, in this case, I would say every mom, is being reached with information, is being empowered with information.

And we are working, uh, closely with the Ministry of Health at county level and also national level to align with UHC, UHC plan.

We are leveraging on CHV or the community health promoters, who are fully supported by the government in terms of collaborating to ensure they enrol moms to the platform and every mom is receiving information.

Marina Dalton Brown: While many health sector digital tools are often workforce facing, meaning that they are tools that support health providers and administrators with training and data management, Javan reminds us of the importance of direct consumer facing digital tools, which help to elevate client voices and support the establishment of direct pathways to information and care, while simultaneously strengthening the health system.

He also mentions Universal Health Care, which is a global goal that Kenya, from a national level, is taking seriously.

Universal Health Care, which is sometimes shortened to UHC, was actually the theme at this year's Mashujaa Day celebration.

Mashujaa Day is a Kenyan holiday celebrated on October 20th each year, commemorating national heroes of the country.

In seeking to learn more about how UHC is brought home to citizens for this year's celebration, I travelled to Kericho County, where Mashujaa Day celebrations were well underway.

The atmosphere was charged with activity and excitement with colorful, interactive tents and booths from the Ministry of Health and many organizations set up along the Kericho Green Stadium.

There, I met Gladys Mugambi, who shared more about how the interaction and integration of digital tools and social media at the national level helps the citizens of Kenya

. Gladys Mugambi: I'm Gladys Mugambi.

I head the directorate of health promotion and education, ministry of health in Kenya.

In Kenya, after realizing that we have those challenges, we decided to embrace issues of technology to help us get the information that we require about people and, uh, if they are sick and what they need is being done to them.

We used to use paper to keep record, but now we are going digital.

Even in communication, we've realized that people are moving from the printed, uh, paper to getting information online.

So we are also trying to see that we introduce technology, even in communication on health.

So that people are able to get information that they require to take care of themselves.

, One of the areas we have embraced is the use of, uh, social media and digital media to communicate to people concerning health, and we've got support to come up with the JALI chatbot.

The chatbot provides information to the Kenyans or any Kenyan, uh, it's a self service process whereby we got a, a unique number 0700 719 719.

So that is a number that when, uh, any Kenyan saves it on their phone, they're able to chat through WhatsApp and they're able to get information on various diseases.

What to do when they get sick, how to prevent them.

And then it also provides information on where their facilities are.

Somebody can click using the locator.

And they are able to use the Google map and see where their nearest facility is, wherever they are, so that they can just go and get a service.

It's also providing an opportunity for us to keep improving on the messaging.

When we want to change a message, we can go in there and change it, rather than going to withdraw a message that had already been printed.

So we find it easier when we do it digitally.

We already have a lot of information in it.

And Kenyans are able to now save that number and use it to access information on health.

So we shall be using it to warn people when there is a disease outbreak.

We are able to put the new information there.

And then the information on mental health, diabetes, nutrition, anything that we need to do on health.

We can be able to put it there and Kenyans will get it without us struggling.

And we'll what we'll do is to market it so that people know about it.

They will not be looking for information anymore.

Marina Dalton Brown: As another digital health locator tool, the JALI WhatsApp platform is helping Kenyans get the information they need to locate the services they require for their health and well being.

In the second part of this episode, we learn more about JALI and hear directly from citizens about how this tool is helping them, and what's on the horizon for this innovation.

Thanks to my guests for sharing their perspectives and insights on how we can make it easier to navigate complex health systems.

To learn more about this topic, head to PSI.org.

There, you can read blog posts and technical briefs and watch short videos about this theme and other topics related to health system strengthening.

Also, follow and share this podcast and get in touch to share your ideas and your insights.

Now, tune in for the second part of this episode of Health Systems Pathways.

Take care and stay connected.