Innovating with ultrasound to improve demand for skilled maternity care in Kenya

Jacaranda Health has a dual mission of providing affordable, high quality maternity services to low-income women whilst being a laboratory for integrating innovations for maternal health. We are a chain of maternity clinics in Kenya that provide deliveries, antenatal and postnatal care, and family planning.

Jacaranda proposes to test three promising options for using ultrasound in antenatal care to help drive demand for high quality maternity services. There is evidence emerging that basic prenatal ultrasound can be administered effectively and safely by nurses in low-resource settings. There have also been indications that ultrasound can increase demand for antenatal services and improve uptake of skilled care by women and their partners.

We hope to demonstrate that combined with appropriate market interventions and demand generation, ultrasound can result in (a) more women attending antenatal care at the WHO's recommended frequency, (b) women attending their first antenatal visit earlier in pregnancy, (c) higher proportion of women who receive ultrasound opting to deliver in a facility with skilled care, and (d) increased involvement of male partners during pregnancy and delivery. All of four of these factors have been linked to improved pregnancy outcomes.

Jacaranda is partnering with Dr. Dan Price, an international expert in ultrasound, who will lead training, serve as clinical advisor, and assist with impact evaluation. Jacaranda also has an ongoing monitoring and evaluation partnership with Drs. Jessica Cohen and Margaret McConnell of the Harvard School of Public Health, who will be leading the design of the impact evaluation.