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App aims to cut time would-be mothers take to access hospital

By Milliam Murigi
Wednesday, October 14th, 2020
Pregnant mother. Photo/Courtesy
In summary

Millliam Murigi @millymur1

Every two minutes, a mother in the world dies in childbirth, many others suffer pregnancy-related complications.

This is despite that such deaths and suffering are preventable by women gaining quality healthcare at the right time; a component of which is reaching the hospital facility in time.

Now, a new solution that uses telemedicine to provide prompt access to healthcare for pregnant women in emergencies is set to change this narrative.

Dubbed  Wheels for Life, this solution seeks to have women use a mobile phone to call a toll-free number to reach a doctor, who triages and dispatches a vehicle either a taxi or ambulance using a mobile app.

The patient is then picked from home and transported to the hospital in under 30 minutes. 

Public transport

“This solution could see the reduction in time taken for a decision to be made to reach the hospital and the time taken to access a facility, thereby reducing first and second delays in accessing health care.

This would significantly reduce maternal morbidity and mortality and help attain universal health care,” says Dr Jemimah Muthoni Kariuki, an obstetrician-gynecologist resident, studying at University of Nairobi, Kenyatta National Hospital and the brainchild behind Wheels for Life.

According to her, while Kenya has ensured free antenatal and delivery service in public hospitals, minimal measures have been outlined to reduce the second delay: access to health care.

“Wheels for Life presents as a solution to this problem by providing prompt triage and possible diagnosis through telemedicine and fast dispatch of emergency transport either by taxi or ambulance dependent on urgency by use of a mobile application,” she explains.

Many women currently rely on public transport to hospitals in case of obstetrics emergency or labour.

Covid-19 pandemic and measures in place to prevent spread in the country including curfew revealed severity of this problem.

Dr Jemimah Muthoni Kariuki, founder Wheels for Life. Photo/PD/ MILLIAM MURIGI

Pregnant women were crippled with anxiety and lack of transport, especially at night, resulting in a significant rise in-home delivery, neonatal death and maternal morbidity, and even death.

Free mechanism 

“Maternal mortality is one of the biggest challenges in maternal healthcare. Such deaths could be prevented if the three-delay model outlined by Thaddeus and Maine were addressed.

These delays have been identified as delays in decision to access healthcare, identification of- and transport to- a medical facility, and delay in receiving quality healthcare,” she elaborates.

Once a patient dials the toll-free number, 1196, they are immediately transferred to the doctor on call.

The doctor then determines the patient’s priority conditions and give advice or dispatch a vehicle depending on urgency.

The taxi service uses a mobile application in which the doctor inputs the patient’s location and contacts.

Both driver and patient get details of each other as a text message.

The driver picks the patient from home and takes them to the nearest hospital, or hospital of choice.

The ambulance also uses a system that identifies the nearest ambulance to the patient and dispatches it.

It then heads to a hospital that can handle that level of emergency (based on triage). A doctor receives a report once the patient is admitted to a facility. 

“This is a technology-based solution as it uses a mobile application to gain access to taxi drivers and connect them with the hospitals.

The ambulance also uses flyer technology to identify the nearest ambulance and track it to the hospital,” Dr Kariuki says.

The solution is developed to serve pregnant women across the country in need of consultation especially during curfew hours or at night.

It fills the gap of lack of access to hospitals and ensures women can still gain medical advice and reach hospital in case of need for specialised care. 

Of key interest are women of low social economic status who even without curfew are unable to reach the hospital due to financial constraints or vulnerability in the community and long distances to hospitals. 

“We seek to ensure access to hospital is not an additional stress factor to women in labour or undergoing any emergency. 

That using their mobile phones they can easily gain not only medical care but also be taken from home to hospitals and at little or no cost,” Dr Kariuki adds. 

Women who receive the service are called in under two weeks for a qualitative review that shapes the intervention and evolution to meet women’s needs at various capacities.

The feedback mechanism has enabled the team to increase vehicles in more target areas, improve communication, increase driver remuneration to ensure women gain quality access, and feel safer in the process.

Currently, the platform is working with different organisations and partners to give service to women. So far it has received more than 5,000 calls and delivered around 690 babies safely.

Although it started with Nairobi Metropolitan Area, it has expanded to  Kiambu, Nyeri, Nakuru and Uasin Gishu, thanks to the European Union. Plans are underway to expand to Machakos. 

“Our solution is free. Public partners and corporate donors are covering costs. So far, about nine other doctors have joined us and we are looking for more to come onboard,” says Dr Kariuki in conclusion.

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