IMPACT REPORT - Jacaranda Health
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IMPACT REPORT 2017
HIGHLIGHTS
2017 was an exciting year
with a few big transitions
for Jacaranda.
Highlights include:
Spinning our award-winning maternity
hospital, Jacaranda Maternity, into a social
enterprise, and raising initial investment funds
to build a sustainable venture.
Expanding our public sector partnerships to
improve maternal healthcare in government
hospitals from 8 to 17 facilities, with strong
commitment from local partners, and
significant expansion afoot in 2018.
Exciting validation of the impact on quality
of care from the innovations and tools we’ve
been rolling out in public sector hospitals.
TWO SISTER
ORGANIZATIONS
In 2017, we officially launched Jacaranda Maternity as a standalone
social enterprise. Our nonprofit, Jacaranda Health, continues its
ambitious strategy of improving maternal health delivery at scale
in the public sector. The two organizations work closely together,
sharing resources and expertise and common values.
• Social enterprise with a replicable • Nonprofit with proven impact
low-cost model
• Adapts and replicates innovations in
• Highest quality maternity hospital public hospitals to improve quality of care
in East Africa
• Low-cost and sustainable in public
• Can return capital to investors health systems
• Scaling into Kenya’s biggest maternity • Scaling for regional impact though
chain through investment government and donor partnerships
IMPACT IN 2017
2017 JACARANDA MATERNITY HIGHLIGHTS Our Kahawa hospital achieved SafeCare Level 5, the highest quality rating of any hospital in East Africa, while maintaining a cost of $150 per delivery. Increased volumes and annual revenue from clients to $600,000—almost double our 2016 numbers, nearly breaking even. Maintained outcomes and patient satisfaction during 2017’s six months of government nursing strikes while public hospitals closed and our volumes spiked to over 150 deliveries and 2,000 clients per month. Successfully set up a separate entity and raised a seed round of capital to reach breakeven in 2018.
26,104
60%
FEWER MATERNAL
62%
LONG-ACTING
1,123
CONTRACEPTIVES
AND NEWBORN
OUTPATIENT VISITS COMPLICATIONS
from moms and babies than nearby hospitals
FAMILY
PLANNING
2017
VISITS
90%
MOTHERS
JACARANDA MATERNITY
BY THE NUMBERS 90%
EXCLUSIVELY
BREASTFEEDING PATIENTS
at six months REPORTED
BEING HIGHLY
SATISFIED
WITH CARE
8,636
BABIES
1,519 SAFELY
DELIVERED
CHILD WELLNESS VISITS
JACARANDA MATERNITY
PLANS & GOALS
2018
Our Kahawa hospital becomes fully self-
sustaining with client revenue by end of 2018.
Raise investment to expand to two
additional, 40-bed center of excellence
hospitals in 2019 and 2020.
INNOVATION & PUBLIC PARTNERSHIPS
WHY WE WORK WITH THE PUBLIC SECTOR Jacaranda Health’s vision is a world where all women and their families experience childbirth safely and with dignity. In Kenya, births in facilities have gone from 40% to 60% in the last 5 years, yet maternal and infant mortality rates are still amongst the highest in the region. The majority of Kenyan women deliver in public facilities Most of the maternal and newborn deaths in those facilities are preventable through provision of better skilled care before, during and after childbirth. Jacaranda Health is using the innovative tools and approaches we have developed as the region’s highest quality maternity provider to improve quality of care in public hospitals.
OUR APPROACH TO IMPACT AT SCALE
Design better systems Adapt and validate Scale tools and
We build and borrow tools and We work with public hospitals to approaches
best practices for delivering high- adapt our tools to their unique We partner with government
quality, low-cost maternal care setting, rigorously test the impact health systems to scale our most
— codesigning with mothers and on health outcomes, and iterate successful, cost-effective tools and
frontline providers. and improve. multiply impact across the country.EXPANDING GOVERNMENT PARTNERSHIPS At the end of 2017, Jacaranda was working with 17 public hospitals, serving 30,000 mothers and babies. At the request of several counties, we have begun to work through the county government health systems, deploying our tools to improve maternal and reproductive health outcomes. In 2018, we formally launched projects in three counties, including Bungoma County in Western Kenya. Most of these partnerships focus on our successful mobile health and nurse mentorship programs.
SCALING ACCESS
WITH MOBILE HEALTH TOOLS
Jacaranda Health is validating a
set of low-cost mobile tools and
messages that significantly improve
linkages to care and outcomes for
women and babies.
33% of KENYAN 42%
of PREGNANT KENYANS
result from MATERNAL DO NOT
DELAYS IN
SEEKING CARE DEATHS ATTEND
FOUR ANTENATAL
CARE VISITS
The Challenge: Kenya continues to have large gaps in
quality and continuity of maternity care. The majority
of women have access to a cell phone which can be
47% DO NOT HAVE
POSTPARTUM VISITS
during the HIGHEST RISK PERIOD AFTER CHILDBIRTH
an ideal channel to empower women to make the best
decisions during pregnancy, birth and beyond.
90%
of MOTHERS
have an UNMET NEED
FOR POSTPARTUM FAMILY PLANNINGMOBILE HEALTH
IMPACT
Rigorous evaluation demonstrated that
our mobile health tools had dramatic
impact in changing critical behaviors:
48%
IMPROVEMENT
88%
in POSTPARTUM
FAMILY PLANNING
UPTAKE
IMPROVEMENT
in KNOWLEDGE OF
To date >3,000 mothers across 30
73%
DANGER SIGNS of women who
received SMS
hospitals have used our pregnancy and recommendation
to seek care
postpartum SMS messaging service. REPORTED VISITING A
HEALTHCARE PROVIDERJacaranda deploys a team of experienced nurse coaches to work alongside facility staff to provide ongoing guidance. These mentors use a combination of tools — on-site education, simulation drills, quality improvement workshops — until they document significant and sustained improvement quality of care. SCALING QUALITY CARE WITH NURSE MENTORS Nurses attend to ~90% of the deliveries in facilities. Yet maternal health nurses in Kenya scored under 50% on skills related to emergency obstetric care and newborn care (EmONC), with significant gaps measured in patient-centered care. Inadequate skills and monitoring were strong factors in more than 50% of maternal deaths.
NURSE MENTORS
IMPACT
Our mentors are coaching public
providers to deliver life-saving care.
Overall Delivery Score
50% 88% PERFORMANCE OF
200+
PROVIDERS
Mentors review and score every delivery
IMPROVEMENT
in NEWBORN ESSENTIAL STEPS FOR MENTORED at NINE FACILITIES they witness in real-time using an app. The
RESUSCITATION SKILLS A SAFE DELIVERY mentorship team then adjusts their approach
to focus on key gaps.“I no longer have fear for delivery.
I know how to take care of myself
when expectant. I feel supported
by the society.”
— GROUP ANTENATAL CARE PARTICIPANT
RESEARCH & INNOVATION Social support through
GROUP-BASED CARE group antenatal care
Jacaranda is now adapting its successful
group antenatal care curriculum for use in
public facilities that are overcrowded and
faced with staff shortages. Almost 100
pregnant women have started their Group
ANC journey at two public hospitals, with
the support of seven nurse facilitators who
completed training at Jacaranda.RESEARCH & INNOVATION NEW mHEALTH PLATFORMS Using social platforms to improve health outcomes during pregnancy and the postpartum period. In partnership with Duke University and Brigham and Women’s Hospital, Jacaranda has been evaluating the use of WhatsApp and Facebook as a means of strengthening the engagement with mothers in low resource settings during pregnancy. We are now exploring the use of artificial intelligence to answer questions asked by mothers during the pregnancy continuum by building a digital assistant, or chatbot.
Through 2020, we have ambitious goals to
VISION improve care for over 400,000 women and
babies, and have a significant impact on the
maternity landscape in Kenya.
JACARANDA MATERNITY & JACARANDA HEALTH
Expand Maternity to 3 centers of excellence • By focusing on five key counties by 2020, we can
with ~100 beds address challenges that affect ~40% of maternal
and neonatal deaths in Kenya. Our targets:
• >100,000 patient visits / year
• Work in 50 public hospitals and improve
• 10,000 safe deliveries / year management of ~180,000 deliveries per year
• Lay the foundation for becoming the largest • Transition to sustainable county management of
maternity hospital chain in East Africa programsYou can also read
