Support for Contraceptive Continuation: mHealth Innovation to Improve Postpartum Family Planning Outcomes and Healthy Birth Spacing

Jacaranda Health
Organization Location: 
Nairobi, Kenya
Project Location: 

Healthy birth spacing is strongly associated with improved perinatal outcomes. In Kenya, half of all pregnancies occur before the recommended 24-month birth-to-pregnancy interval, in part due to discontinuation of modern family planning methods. A study in two of Nairobi’s slums found that almost half of women discontinued a method of family planning within 12 months of initiation (Mumah et al., 2015). However, relatively little investment has gone into innovation in this area. Jacaranda Health is building and testing two options for mobile platforms: An SMS-based mobile counseling platform, and a data-enabled phone platform which will use WhatsApp or similar message service to support postpartum contraceptive continuation. This proposal intends to leverage Kenya’s high mobile penetration to deliver ongoing contraceptive care in a mode that could be more accessible, acceptable, and personalized than facility-based care alone. Jacaranda intends to use human-centered design to develop and refine a shareable SMS-based mobile platform that will promote acceptability and satisfaction along the continuum of use, including method-specific counseling, expected side effects, method options, and educational messages to clients. Additionally, the platform will have options for “private” check-in language, where women who opt in will receive coded messages which enable them to reach out for more information on their schedule. Program impact on health outcomes and cost-effectiveness will be rigorously evaluated and packaged to share with the global maternal and child health community. This proposal is unique in its focus on providing family planning care that extends beyond initial method uptake to support long-term health outcomes.