Abstract
In Kenya, early coronavirus disease (COVID-19) modeling studies predicted that disruptions in antenatal care and hospital services could increase indirect maternal and neonatal deaths and stillbirths. As the Kenyan government enforced lockdowns and a curfew, many mothers-to-be were unable to safely reach hospital facilities, especially at night. Fear of contracting COVID-19, increasing costs of accessing care, stigma, and falling incomes forced many expectant mothers to give birth at home. MomCare, which primarily serves communities in remote areas and urban slums, links mothers-to-be with payers and health care providers, following a standardized pregnancy program based on World Health Organization guidelines at a predetermined cost and quality. Expectant mothers gain access to care through a mobile wallet on their feature phone (voice, text, and basic internet), and providers are paid after appropriate care is given. Within the first 3 weeks of the pandemic in Kenya, the following services were added to the MomCare bundle: emergency ambulance services during curfew hours, extended bed allowances to encourage early care, phone calls to check on mothers approaching their delivery dates and to promote the generation of a birth plan, SMS messages to inform mothers of open facilities and COVID-19 protocols, and training for clinic staff in managing COVID-19 patients and infection prevention. We compare data collected through the MomCare platform during the 6 months before the first confirmed COVID-19 case in Kenya (September 2019-February 2020) with data collected during the 6 months that followed. This study shows that care-seeking behaviors (enrollment, antenatal/postnatal care, skilled deliveries) increased for mothers-to-be enrolled in MomCare during the COVID-19 lockdowns, while quality of care and outcomes were maintained. Public health practitioners can promote interactive, patient-driven technology like MomCare to augment traditional responses, quickly linking payments with patients and providers in times of crisis.
| Original language | English |
|---|---|
| Article number | e2100665 |
| Pages (from-to) | 1-12 |
| Number of pages | 12 |
| Journal | Global health, science and practice |
| Volume | 10 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 30 Aug 2022 |
Bibliographical note
Publisher Copyright:© De Sanctis et al.
Funding
Medical writing and editorial assistance were provided by Jodi Rintelman, PharmD, of Churchill Communications (Maplewood, NJ). The MomCare program is funded and supported in part by funding from Merck through its Merck for Mothers program. Merck for Mothers was not involved in the design, collection, or analysis of data. Merck for Mothers is known as MSD for Mothers outside the United States and Canada. Complementary funding was provided through the Netherlands Ministry of Foreign Affairs. Acknowledgments: Medical writing and editorial assistance were provided by Jodi Rintelman, PharmD, of Churchill Communications (Maplewood, NJ). The MomCare program is funded and supported in part by funding from Merck through its Merck for Mothers program. Merck for Mothers was not involved in the design, collection, or analysis of data. Merck for Mothers is known as MSD for Mothers outside the United States and Canada. Complementary funding was provided through the Netherlands Ministry of Foreign Affairs. Funding: Medical writing and editorial assistance was funded by Merck Sharp & Dohme Corp. Competing interests: M. Etiebet is an employee and stockholder of Merck & Co., Inc. Some of the activities in this publication were supported in part by funding from Merck through its Merck for Mothers program, known as MSD for Mothers outside of the United States and Canada. Merck does not have any commercial stake in MomCare and was not involved in the data collection or analysis. PharmAccess does not have any commercial stake in MomCare. W. Janssens reports personal fees from PharmAccess Foundation during the course of the study. T. De Sanctis, N. Spieker, M. van der Graaf, C. van Montfort, and E. Waiyaiya have no conflicts to disclose. None of the listed authors have a commercial stake in MomCare.
| Funders | Funder number |
|---|---|
| Churchill Communications | |
| Netherlands Ministry of Foreign Affairs | |
| Merck | |
| Meso Scale Diagnostics | |
| Merck Sharp and Dohme |
