Maternal related deaths continue to take away thousands of mothers and their babies in Kenya and sub saharan africa region. This is simply due to late detection and reporting of maternal unwellness from fetal distress and preeclampsia during antenatal and delivery period. The delay is attributed to lack of fetal auscultation tools and maternal preeclampsia surveillance tools at the grassroots level that can transmit information across a network of medical experts for timely responses.The objective of this project ,therefore, is to develop a grassroot-level user friendly device for fetal heart rate monitoring and maternal blood pressure monitoring during critical stages of pregnancy then automatically transmit data in real-time to the server accessible by nurses and doctors at maternal care centres . Once data is transmitted on the server and digital partograph ,medical experts will be able to access this data through mobile application and be able tell the onset of a problem and order lifesaving interventions early enough.This targets to reduce high fetal, newborn and maternal deaths that come due to the unreported onset of the danger signs.
After winning a maternal-child health hackathon organized on August 2016,$1000 prize was awarded by Villgro kenya towards development of PregMum prototyping. We then embarked on problem data validation through through surveys, observations and literature reviews on the causes of high maternal and perinatal deaths in Kenya. We found that existing fetal monitoring devices are cumbersome and requires experience of medical practitioners making then unfit for hard-to-reach areas of Kenya which are characterized by understaffing, long waiting queues in maternity and antenatal units ,distant hospital facilities from the homesteads and low socioeconomic status of the women in these area. In addition, there is inconsistent fetal heart rate monitoring (FHRM) throughout pregnancy because mothers are not monitored during the period they are at home at village level and when they miss antenatal clinic (ANC) visits. Therefore, emergencies set in on the expectant mother and the fetus leading to complications which are not addressed in time thus it becomes difficult to save the life of mother or fetus from preventable complications. In addition, there is no preeclampsia surveillance system. Blood pressure is taken only during ANC visits and urine testing done only once throughout pregnancy which are deemed insufficient to predict and detect earliest onset of preeclampsia. This inadequacy of detecting preeclampsia onset before its advancements to eclampsia leads to the 19 % of all maternal deaths.
Findings from these observations shaped the design and the basis for the development of the pregmum concept currently under process of proofing the concept to suit the needs at grassroots level and busy health facilities in hard-to-reach areas of Kenya in Bungoma, Migori and Machakos counties. The proposed Pregmum device system is solution with user-friendly fetal heart rate monitor, BP monitoring and real-time data transmission from the grassroot level to the hospital databases for extended and remote monitoring. Using PregMum device,the community health workers at grassroot level can obtain fetal heart rate, fetal kicks and maternal blood pressure which are then automatically uploaded and stored in the mother’s profile created in the central server system accessible to clinicians through mobile applications for monitoring real-time data on the status of mother and the fetus . In case there is need for an emergency response, an alert is sent to the nearest paramedic and medical experts so as to facilitate timely life-saving interventions for the fetus and the mother.
This product will be introduced to the communities through a community awareness creation and involvement approach to address identified challenges at the grassroot level and hospital level.The use of pregmum device system will have massive benefits to the community health workers,mothers and the nurses at the hospitals. Direct and indirect benefits include reduced maternal deaths, reduced fetal and neonatal deaths, increased hospital deliveries ,increased collaboration between primary health care workers and medical experts at secondary and tertiary levels of care ,reduced overcrowding at hospitals among many others social benefits. The successful implementation of this project will be premised on partnership with research institutions and community organizations impacting in health care like Villgro Kenya , ILab Africa and Amref Kenya.