Jacaranda Health: Scaling high quality cost effective maternal and new born child health services in Kenya
By 2016 Jacaranda Health had established services for mothers and babies before, during and after childbirth that were recognised as providing a very high standard of care and among the best outcomes in Africa. It was providing these services in two for-profit healthcare facilities at affordable charges for lower income families but high enough to cover direct costs. Although Jacaranda was providing excellent quality and affordable care, the model of care was not easily scalable so the benefits went to only a small number of mothers and babies.
EfD initial support in 2016
EfD engaged in an extended discussion with Jacaranda about ways to scale up its model of care to generate comparable benefits for a much larger number of mothers and babies. After both parties realised that they did not have the answer, EfD agreed to provide funding to explore possible options. The initial focus had been on entering into management agreements with private and public sector providers with a view to Jacaranda taking on responsibility for implementing its model of care in their healthcare facilities. It always seemed likely that this approach would raise insuperable difficulties and so it turned out. The outcome was a complete revamping of the approach based on finding ways to extend Jacaranda’s high quality model of care to public sector healthcare providers.
EfD support in 2018
The revised strategy involves Jacaranda working with County governments (who run all of the public health facilities and services in Kenya) to use Jacaranda tools and protocols to upgrade the quality of care of maternity services in publicly-funded healthcare facilities. The key programmes are a midwife mentorship programme that upgrades provider capacity to handle basic and emergency obstetric care and client-focused, lightweight mobile phone tools that encourage pregnant women and new mothers to seek appropriate care before, during and after childbirth. After an initial proof-of-concept stage a full-scale proposal was developed by Jacaranda and discussed with EfD. The aim of the programme was to enable health workers in public health facilities to provide the same quality of care as Jacaranda’s to many more mothers and babies; and also to multiply the impact by bringing about policy change and strategic partnerships with more Counties and public hospitals. EfD agreed in Q3 2018 to fund part of the cost of the initiative. The proposal approved by EfD is set out in this document.
In 2019 and 2020 updates from Jacaranda indicate that the programme so far is proving successful. Jacaranda’s plan is to continue to scale up its approach to many more public facilities across 10 Counties, thereby improving quality of care for over 1 million mothers and babies. A summary version of the plan is set out in this document.
Jacaranda develops a way to improve the supply of blood during obstetric emergencies in Kenya in their most recent blog post