How toll-free m-mama seeks to tame maternal deaths

A new programme that brings an emergency transport system for pregnant women has been launched in Kenya.

Dubbed m-mama, the innovative mobile technology service links emergency referral systems and transport pregnant women and newborns facing complications to health facilities.

It is apartnership between the government, USAID, Vodafone and M-Pesa Foundation. A clinically trained dispatcher manages referrals and confirms facility availability to ensure women and newborns in emergency situations are promptly managed.

The programme will recruit and train local car owners and taxi drivers to provide emergency transport when ambulances are unavailable. The service will be accessible through a toll-free number and drivers will be reimbursed instantly using M-Pesa.

The partners are contributing $18 million (Sh2.5 billion) in one-time set up costs to implement m-mama in Kenya. So far, $14 million has been committed, with USAID providing $5 million (Sh650 million) and Vodafone and M-Pesa Foundation providing $9 million (Sh1.1billion).

Free calls

The service will be accessible through a free landline and mobile phone number. Kenya has made significant progress towards improving maternal and child health, with 90 cent of pregnant women delivering in health facilities.

Health experts agree that efforts need to be accelerated to reach the Sustainable Development Goal target of 70 deaths per 100,000 live births by 2030. Currently, about 6,000 women and 35,000 newborns die annually from complications during birth.

One of the challenges is lack of timely referrals and transport for pregnant women to reach facilities that can provide quality services without unnecessary delays.

Safaricom CEO Peter Ndegwa said they will leverage technology to prioritise health interventions, raise awareness, and map all pregnant women in high-burden counties, as well as communities in hard-to-reach areas, to promote positive maternal health outcomes, achieve near-zero maternal and infant mortality.

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“In addition, along with technology, we will set up infrastructure projects such as maternity wings, newborn units and high-dependency units. And to dovetail these facilities, we will equip health centres with ambulances for mobility and accessibility of services. To address the skills gap, we will empower community health workers/volunteers to boost safe deliveries in the counties,” said Mr Ndegwa.

Drop in mortality

He noted that m-mama can help reduce maternal and newborn deaths by 30–40 per cent. The CEO added that in the last 20 years, the company has been keen on strengthening health outcomes, including maternal and child health, as part of its purpose to transform lives.

He said their commitment as a company is to continue investing in the healthcare sector as a philanthropic initiative and through their products and services.

“As a result, our two foundations have made a difference for mothers and children through various initiatives in almost all 47 counties to the tune of close to Sh1.8 billion, reaching over 500,000 women, children, and the men in those communities through providing health services, supporting the construction of maternity and newborn units,” the CEO said.

USAID Administrator Samantha Power said the ambitious project is aimed at making the community better to save lives. She said a woman dies every two minutes in the world from child birth-related complications.

Ms Power said despite Kenya's best efforts, maternal mortality remains stubbornly high with 17 mothers dying in childbirth every single day, along with 50 babies.

“In a single year, that's more than 6,000 mothers, for whom creating new life is lethal, and more than 18,000 babies who may not live long enough to know that they are alive. We will work together to cover 100 per cent of emergency response in rural areas in the next five years,” said Ms Power.

Partners praised

Council of Governors chairperson Anne Waiguru commended the partners for being at the forefront of maternal and child health initiatives. She said the county governments are fully committed to being critical drivers of good health.

The Kirinyaga governor noted that emergency referral of mothers remains a big challenge due to poor road infrastructure, coupled with insecurity, especially for mothers who deliver at night, as well as the high transport costs.

“We are all aware that for many maternal and newborn complications, there is a short time window for emergency response before death. This is why the m-mama initiative is very critical,” she said.

The governor noted it is not all gloom as evidenced by the recently released Kenya Demographic and Health Survey 2022 results, which show the country has made remarkable improvements in health. According to the survey, nine in every 10 mothers now give birth under the care of trained healthcare workers, up from 66 per cent in 2014.

The under-five mortality rate has improved from 52 deaths per 1,000 to 41 deaths per 1,000, and the infant mortality rate from 39 to 32 deaths per 1,000.

Health Cabinet Secretary Susan Nakhumicha said the government is committed to ensuring that women enjoy their reproductive life, including safe motherhood as envisioned by the International Conference on Population and Development.

“We must promote women's reproductive health and rights and not preside over women and children dying from preventable maternal and perinatal causes,” said Ms Nakuhmicha.

The CS said deaths of mothers and their babies are due to delays in making decisions to seek healthcare intervention, delay in reaching the health facility due to transportation challenges, and delay in receiving timely healthcare interventions.

“We must not delay our mothers at any stage to access the much-deserved quality healthcare services. Ensuring safe pregnancy, delivery and post-delivery period is key to our attainment of Universal Health Coverage, which is a key agenda for our government,” she said.

Funding commitment

USAID announced it will provide up to $5 million to set up m-mama while Vodafone Foundation and M-Pesa Foundation will inject an additional $9 million.

M-mama has been shown to contribute a 38 per cent decline in the number of maternal deaths in pilot locations in Africa. Some of the countries where the programme is being implemented are Tanzania and Lesotho.

Since it was established by Vodafone Foundation and USAID in 2013, m-mama has transported over 28,000 women and newborns and is conservatively estimated to have saved over 900 lives. Vodafone Foundation created it in 2013, initially operating in Tanzania's Lake Zone, including the Shinyanga region.

The initial focus was renovating maternity wards, constructing maternity waiting homes, and providing training for community healthcare workers. However, research conducted by the Touch Foundation found that concentrating on emergency transportation was the most efficient use of funds.

In rural areas in sub-Saharan Africa, pregnant women and new mothers encounter challenges accessing hospitals during emergencies. Before the introduction of m-mama in Tanzania, local medical facilities struggled to afford ambulances, resulting in only one ambulance being available for every 10 emergency calls.

Vodafone Foundation recruited drivers and coordinated ambulances through a dispatch centre.

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