Increased Demand for Digital Health Tools Helps Bridge Healthcare Provision Gap During COVID-19 Pandemic
An Interview with Sathy Rajasekharan, Jacaranda Health
When the first COVID-19 cases began to spring up in Kenya, the government quickly responded with an array of infection prevention measures. While travel restrictions and curfews would help reduce the spread of the disease, there was a several-week gap that left pregnant women and new mothers confused on how to navigate care, while the Kenyan government created guidelines on how to safely provide care to those with ongoing needs.
At the same time, providers looked for ways to circumvent the healthcare service disruptions that were making it difficult to communicate with patients and deliver essential services. Fearing that maternal care would become jeopardized, it was clear a solution was needed quickly.
For Jacaranda Health, a non-profit organization that uses digital tools to improve maternal and child health outcomes, it was clear they were well positioned to overcome some of these challenges. Sathy Rajasekharan, Jacaranda’s Executive Director (Africa), explained that prior to COVID-19, the organization was already using a contactless approach to connect new and expectant mothers to care at public hospitals at the right time and place.
One of Jacaranda’s flagship products, the PROMPTS digital health platform, uses an AI-based triage tool to prioritize urgent health-related messages from mothers. These messages are then filtered to clinically trained help desk agents, who identify and refer high-risk mothers for care. Better yet, the platform is integrated into some health systems, enabling the help desk to link women to the care they need, while also alerting the clinics to the incoming patient.
As these novel needs arose, Jacaranda’s help desk agents were able to adapt and provide mothers with timely responses to their questions. This approach meant that, within hours, mothers obtained a response, and when necessary, high-risk mothers were identified and immediately referred to receive emergency care. Sathy noted that while chatbots are a valuable information-sharing tool, they often serve as a step toward human interaction, rather than replacing it. “A COVID chatbot is a way to get them information quickly, but every mother has a unique question and so we have help desk agents ready to follow-up and provide that unique guidance,” he explained.
In the midst of the COVID-19 pandemic, tools like PROMPTS are more critical than ever. As cases started to spread and healthcare services were still adapting to guidelines and precautions, the over 200,000 users could quickly turn to the platform to get answers to their pressing questions. Sathy explained that as the virus spread, they started to see a new set of questions that were COVID-19 specific, such as ‘how am I supposed to access services at night?’ and ‘can I deliver at home?’.
For emergency cases, the help desk agents will often call the mother directly and assist them in finding the closest facility to attend. They will also follow-up with the mother in order to verify whether she attended her appointment. In recent months, on average 95% of women who were referred to seek urgent care by PROMPTS did seek care at a facility.
On the provider side, Jacaranda’s Emergency Obstetric and Newborn Care (EmONC) mentorship program, which trains nurses in obstetric care skills, has since transitioned online. The Jacaranda team recognizes that despite the pandemic, the need for training on essential life-saving maternal health skills remains. Virtual platforms have enabled them to continue their work safely, reaching over 120 in-facility EmONC mentors across 70 government hospitals. Sathy recognizes that while there are limits to who the online training can reach, “people are really getting behind these digital solutions, recognizing the need for them, and seeing the potential role they can play in the current situation.”
As COVID-19 continues to disrupt ongoing healthcare provision, it is clear that digital solutions can play an instrumental role in bridging the gap. Now, Sathy says, he is seeing a shift in the acceptance of digital solutions – “there has been a widespread recognition that teleconsultation, telemedicine, telesupport – is incredibly helpful at this time – and so we are seeing an acceleration in people’s responsiveness to test these solutions.” A change in attitude could mean that in the future, barriers to the uptake and engagement with digital solutions could decrease.
The acceptance of digital health tools has already begun to translate to an increase in demand. This has meant new opportunities for Jacaranda; including a partnership with local start-up M-Shule, a mobile-learning system, to create an e-learning platform for our EmONC mentors; and Health-E-Net, a telemedicine provider, to help to accelerate referrals for high-risk mothers.
While challenges remain in integrating digital health tools into existing workflows, Jacaranda’s success has in large part been due to the unique position they were in when the pandemic hit. Sathy shares, “I think what’s important is that we had the infrastructure present; it was very maternal and newborn health specific, but we adapted that data and data sourcing to be able to respond to more holistic challenges that we were seeing, with the end goal of maintaining essential services for mothers and babies.”