Leveraging high-impact scalable innovations, in the public health sector, to enhance maternal and newborn survival.

Despite many initiatives in Kenya, maternal and newborn mortality remain unacceptably high at 355 maternal deaths per 100,000 live births and a neonatal mortality rate of 21 per 1,000 live births (Kenya Demographic and Health Survey [KDHS], 2022). Thus, about 15, mostly young women, die daily due to pregnancy related causes, that are largely preventable.

Leading causes of maternal deaths include postpartum hemorrhage (40%), obstructed labor (28%), and eclampsia (14%) while newborn deaths’ top causes are prematurity, birth asphyxia, and infections (KDHS, 2022). These causes are amenable to various medical interventions, delivered in a timely and effective manner. Preventable deaths are a violation of the most fundamental human right of women and newborns. Other major drivers of maternal and newborn deaths include poor quality of care, insufficient skilled personnel, and inadequate emergency services. The tragedy is worsened by deep-seated inequities, where disparities in access to quality care, driven by regional, economic, and sociocultural barriers, result in unequal health outcomes.

Photo credit: World Economic Program

The World Health Organisation has identified effective skilled care as the single most important factor in averting maternal and newborn deaths (WHO, April, 2025). Whereas skilled delivery attendance increased to 89% by 2022, maternal deaths did not show corresponding decline, raising concern on the effectiveness of the care (KDHS, 2022). Prerequisites for quality care capable of averting maternal and newborn deaths include adequate and proficient health care providers who are supported by an enabling environment. Such a conducive environment includes availability of Life-Saving Interventions that are embedded within and supported by functional and robust health systems and infrastructure.

Providing quality care requires resources, which regrettably are scarce and poorly allocated. However, appropriate and cost-effective health innovations that are strategically deployed have the potential to bridge health system gaps, and contribute to the reduction of maternal and newborn mortality and morbidity within the constraints of our Kenyan context. The private sector has over the years leveraged innovations more than the public sector due to various challenges (see findings of innovations scaling landscape assessment report –https://drive.google.com/file/d/1pRVuM4vl4_G9Cc6td8s5oMP3m9Cum8X4/view ). Given the importance of the public sector in providing maternal and newborn health services for most Kenyans and particularly the vulnerable, it is prudent to prioritize and invest more in deploying and scaling innovations within the public healthcare system.

Critical factors for successful scaling of health innovations in the public sector include; putting communities and public health sector leaders and managers in the driving seat of identifying priorities and potential interventions and carefully matching the innovation demand with available, effective and scale ready innovations. Experience using the Mountain Model (MM) Framework reveals that participation of community health representatives and front-line health care workers in articulating innovation demand, having an open and transparent process of identifying suitable innovations and, having meaningful engagement between the innovators and the government are critical success factors for sustainable public sector adoption of the innovations.

Photo Credit: Forbes Africa

The mountain model is a framework for promoting and strengthening public sector scaling of health innovations. It was developed following a robust innovation scaling landscape assessment that identified critical challenges facing successful and sustainable public sector scaling of innovations; the MM is a six-stage model designed to overcome the identified challenges. It has been implemented in Kajiado and Makueni counties and is currently being implemented in the Lake Region Economic Bloc (LREB).  Suitable health innovations, that will contribute to the reduction of maternal and newborn mortality and morbidity, have been identified by the County teams with support from Insight Health Advisors and the LREB secretariat.

The innovations include; Ambulensi; supporting cost-effective, efficient, quality and timely emergency patient transfer services to significantly reduce delays in accessing lifesaving emergency medical care; Neoguard; A Smart wearable device for continuous  multi-parameter vital signs monitoring of newborns, providing an alert at the earliest sign of distress; Mapema AI; an AI enabled Point of Care Ultrasound to enable the early detection of risks and complications among pregnant mothers; Health X; a transformative telemedicine platform, for primary Health Care services as well as specialists’ consultations; Mom Connect; a maternal and child health and adolescent education and product access platform capable of delivering tailored messages; Maisha Mothers by Thalia Psychotherapy; an online mental health screening platform with AI triage and therapists to support pregnant and postpartum women with counseling and group support and offer referrals linkage.

Given the protracted crisis of unacceptably high maternal and newborn deaths within a resource constrained environment, we call upon all stakeholders to prioritize, invest in and embrace transformative and cost-effective life-saving health innovations. The mountain model is an evidence-based and flexible framework that promotes ownership, relevance, transparency, effectiveness and efficiency in the public sector scaling of innovations.

References

1) Enhancing Public Sector Demand for & Scaling of Health Innovation, A new approach to integrating innovation to strengthen public health systems, 2021. (innovation scaling landscape assessment report; https://drive.google.com/file/d/1pRVuM4vl4_G9Cc6td8s5oMP3m9Cum8X4/view )

2) KNBS and ICF. 2023. Kenya Demographic and Health Survey 2022.

3) World Health Organisation; Maternal mortality Fact Sheet. 7 April 2025. Retrieved from. https://www.who.int/news-room/fact-sheets/detail/maternal-mortality