Technology is able to bridge some of those maternal care gaps, Vellenga said, adding that there’s a lot of investment going toward finding new innovations in Kenya — many of which are digital solutions developed through public-private partnerships. “If you look at the system in Kenya, how maternal care, reproductive health care, [and] primary health care is delivered, there [are] major areas for improvement where technology can play a role.”

He explained that this is where the private sector can come in.

“The [innovations] that don’t really add value or could be done better or more efficiently, I hope those will leave [the space]. I hope those who can really add value to the system — either financially or deliverywise — grow and flourish,” he said.

One example of a digital solution is iDeliver. Launched in 2017, the development of the decision-making support tool is funded by MSD for Mothers — an initiative working to make pregnancy and childbirth a safe and healthy experience — and implemented by Johns Hopkins University, Scope, and Vecna Cares, a charitable trust designing and deploying information management and technology solutions for healthier lives.

iDeliver is designed to be used by skilled birth attendants and aims to improve maternal care and lower the maternal mortality rate by supporting health care workers in triaging, prioritizing, diagnosing, managing, and referring the patient from the intrapartum period through to postnatal care. This is done by providing the birth attendant with information on each patient that includes an acuity scoring — a 1-5 scale of the level of nursing care needed — possible diagnoses, and input on the best next steps based on WHO guidelines.

Joyce Muraguri at her desk in Nairobi Women's Hospital using iDeliver.

The decision-making support tool, which is accessed on a hospital computer, even allows nurses like Muraguri to see the status of every patient during labor, collect and store obstetric patient history, and view treatment options in real time. While nurses shouldn’t have to be reminded of what to do and when, Muraguri explained that when the ward is at capacity and resources stretched, iDeliver allows the nurses to make quicker decisions, given the streamlining of information and access to all the information they need.

“If you have five mothers in labor, you know who to prioritize first because you know who the high-risk mother is,” said Muraguri, adding that the tool is particularly helpful for junior nurses who are able to see high blood pressure or a baby in distress at an early stage and take action before it becomes a serious complication.

“We’re able to give quality services and you note a complication before it happens. And if a complication occurs, you know what to do to save the life of this mother.”

Only in its infancy, the dashboard is being piloted in two of Kenya’s counties, but already the anecdotal feedback is extremely positive, said Jackline Cheruiyot, program manager at Vecna Cares. The plan is to scale it up to the eight other branches of Nairobi Women’s Hospital by the end of the year.

Jackline Cheruiyot talks about iDeliver and the organization's future plans.

One of the biggest challenges in rolling out the tool and improving the quality of maternal care is a lack of consistent staffing, said Cheruiyot — something Nairobi Women’s Hospital, like others, is constantly dealing with. Out of the 13 nurses originally trained on iDeliver, only six remained after eight weeks. Cheruiyot said this is a recurring problem, requiring frequent training sessions to ensure all staff know how to engage with and get the most out of the platform.

“The management is also tackling it by introducing more and more staff, and we are hoping that [the staffing issue] will come to an end,” said Muraguri, adding that once introduced to iDeliver, most staff easily adapt to the system. “I believe that those who have not adapted are going to adapt … When they get to know the importance, then they like it.”

Finding the time to get to grips or even just to input data into this system can also be a challenge, said Cheruiyot.

“For the private sector, staff turnover has been the main challenge, but for the government setup it's the workload. You find that you have 40 women who are admitted to labor and delivery while you have three to four nurses on duty, so most of the time we find data collection is the last thing on their minds,” said Cheruiyot.

But it is quick to do, she added, explaining that many mothers can be registered on the system at the same time.

Cheruiyot called for the government and private sector to allocate more resources to improve the staffing and invest in tools like iDeliver to help health workers make better and informed decisions.

While it is still too early to tell how big an impact the platform is having on maternal mortality, Cheruiyot said the feedback from users so far has been that it is guiding the way nurses are delivering patient care and potentially saving expectant mothers’ lives by identifying high-risk patients and prioritizing their care.

“I would recommend it because it is helping to save lives,” said Muraguri.