How One Organization is Transforming Maternity Care in Africa

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Jacaranda Health

Today we have Faith Muigai, Chief Medical Officer for Jacaranda Health. Faith will share what keeps her motivated to bring great value to the maternity care within Kenya through international and local partners.

 

Would you like to share with us a little on your background and why you moved from the United States to Kenya after twenty years?

I believe that the change I want to see begins with me and I am at a pivotal time in my life where I am able to apply the tools and resources availed to me to impact positive change, particularly to underserved populations.  I serve as Chief Medical Officer for Jacaranda Health, and my mission is to carry out work that positively impacts affordable health care delivery, with the goals of providing evidence-based quality care, decreasing fragmentation, and enhancing quality of life.

My journey has been an interesting one — an ambassador’s daughter who lived a privileged lifestyle, who then moved to the US at the tender age of 17 and started from the ground-up as a minimum-wage nursing assistant putting herself through school who aggressively mapped out a path to develop professionally.

Armed with a Master’s degree and diverse experience and mentorship from leading organizations such as the Johns Hopkins Institutions, I began taking on management and executive leadership roles. It was an 18-year journey of which my tipping point was to reflect and affirm the need to move back to East Africa and positively affect change.

There was an intrinsic motivation to assess what I have had, combined with the need to give based on values my parents have instilled. That, and witnessing the reality of individuals in desperate need based on inequity, lack of access and overall knowledge deficit have all motivated me to commit myself to my mission.

 

How did you end up being the Chief Medical Officer (CMO) for Jacaranda Health?

I believe that hard work pays off. In less than four years in this position, I have been a part of the design and operational team of two Maternity hospitals. I have strategically mapped out the organization’s direction in providing affordable quality health services in Kenya, and managed donor relations and secured key stakeholder relations with Ministry of Health, County health leadership and international partners.

I have accomplished this by driving high performance and productivity from a dedicated and dynamic team. The transition from Clinical Director to Chief Medical Officer is a reflection and recognition from Jacaranda Health’s founder of my having achieved set goals in driving the organization towards achieving our mission to provide quality health services.

 

Employees are the key assets to the organization. Can you share with us your thoughts about staff development, training, and consensus building?

I stand proud as a nurse in leadership. In some countries in the developed world, this is a role that has been significantly stereotyped and not awarded the strength that it has in impacting outcomes in the healthcare system. But our roles are not limited to the bedside. We are active clinicians, educators, researchers, and administrators.

This was my reality in the United States and I strive to bring this opportunity to the team I serve.  My goal is to create pathways to strengthen skills and influence and support vertical progression. I believe that I am actively demonstrating this as one of my original nurse midwives has progressed to take on an administrative role as a hospital manager.

The strength in execution relies on a motivated and engaged team. Building structures to involve teams in decision making and problem solving is critical to increasing ownership and driving productivity.

In comparison to the United States, I feel there is a great need to be strategic in mapping out staff growth within our local health system and to arm health care providers with tools to succeed in roles they chose or have been designated.

 

Children of Kenya (photo credit - Alan Bazzani)

Children of Kenya (photo credit – Alan Bazzani)

 

You obviously came from a place where you get the chance to experience top-notch medical facilities.  How would you describe the current patient care in Kenya?

Kenya’s healthcare landscape is in a dynamic phase.  I feel that the current devolved government structure have led for counties to take greater ownership of their own healthcare systems. County leaders are now taking a greater stride in accessing innovation and building stakeholder relations to improve health services.

The healthcare system comprises of both public and private players. Lower income populations, which make up the majority, predominantly access the public sector, and this places a great strain on the quality of care. But the devolved government structure has strengthened dialogue between the public and private players and is placing a large emphasis of service delivery and the mutual responsibility to providing equitable, affordable, quality health services in the communities we serve.

Jacaranda Health has active partnerships with the public sector in building frontline capacity to apply quality improvement methodology to improve maternal and newborn health outcomes.

 

Why the focus on rural area pregnancy and childbirth issues and not hospitals in the city?

Every year in Africa, over 250,000 mothers and 1 million babies die in childbirth — 250,000 women who will never be able to care for their children, generate income for their families, or contribute to their communities.

Most low-income women in East Africa deliver at home or in under-equipped public facilities where conditions are grim. Postpartum beds are shared, lifesaving drugs are absent, and staff-to-patient ratios are extremely low. In the peri-urban communities (commonly referred to as slums) of Nairobi, for example, rates of maternal mortality are over a hundred times higher than they are in Europe, and a woman has a 1 in 40 chance of dying during childbirth.

What makes this issue so pressing is that we know what needs to be done: Mortality can be cut 75% by improving access to reproductive health services and ensuring that childbirth happens with skilled providers.

Meanwhile, researchers and clinicians have proven that low-cost interventions to reduce mortality are feasible and effective. Jacaranda’s goal is to package these innovations into the region’s first truly sustainable and scalable service delivery organization.

 

Can you tell us more about the primary clients of Jacaranda Health?

Jacaranda’s clients are the women of urban areas: Hardworking women who are often are the primary breadwinner for their family. They work in the informal sector as domestic help, vegetable sellers, factory workers, or shop owners. They are busy and cost-conscious women, who must carefully balance the demands of pregnancy and visits to clinics with taking care of their families and their livelihoods. They desire and deserve access to high quality, friendly, affordable health care.

pregnent-woman

The population we serve is large, growing and poorly served. Peri-urban areas — sprawling low-income areas on the outskirts of cities — are the fastest growing population centers in the world. In Nairobi alone, over 2 million people live in low-income areas like these, where health conditions and availability of medical services is poor.

Meanwhile, the socio-economic and family landscape is fractured. Poor environmental and sanitary conditions are the norm, incidence of gender violence and adolescent pregnancy are high, and the healthcare landscape is confuddled by unlicensed private providers.

Jacaranda’s approach is to provide high-quality, patient-centered maternal and reproductive health services in low-resource settings.  The core of our model is to set up Jacaranda Maternity Hospitals: Well-designed, modern facilities that offer respectful and affordable obstetric care, safe delivery, family planning, and postnatal care.

In addition providing high-quality, low-cost health services, Jacaranda utilizes some of the most exciting innovations in maternal and child health. We are incorporating innovative practices from around the world — in mobile health, evidence-based medicine, electronic medical records, and financial and marketing innovations — and measuring their impact on quality of care and health behaviors.

 

Could you share one of your most memorable encounters while working with these people?

Everyday equates to a memorable encounter. I am humbled to be able to positively change the story of a woman who has the opportunity to have a respectful and memorable birthing experience and to follow her child as they grow and develop in the community. These stories extend to the larger communities we serve.  I feel that I am making a difference — and it feels good!

 

How would you describe the ideal situation in healthcare in Africa within the next five years?

Public and Private Partnerships (PPP) are the next frontier.  Innovative models will bridge gaps by sharing human resources, closing gaps in supply chain, and creative financing models will increase access to care. These will need a collaborative approach to build a strategy, but the need is the development of a realistic, time bound implementation plan with key measures of success.

I also see a shift in patients becoming increasingly informed and demanding quality health services. This will place greater pressure on health organizations to focus on data to drive practice and will hopefully lead to positive outcomes.

 

About Jacaranda Health

Jacaranda Health is an organization dedicated to changing the way that maternity care is provided in Africa.

Jacaranda Health combines business and clinical innovations to create a self-sustaining and scalable chain of clinics that provide reproductive health services to poor urban women. It strives to become the largest provider of affordable maternity care in the region, and a laboratory for innovation in maternal health.

The team are proving the concept in Nairobi with two maternity hospitals, then aim to expand to cities across East Africa over the next five years. To date, they have built a world-class team, developed critical partnerships and support within Kenya, sparked the interest of the global maternal health community, and received awards for our model.

Jacaranda Health launched its first mobile clinic in 2011 and began delivering babies in its first maternity hospital in 2012.  The team’s model of care has been exceptionally well-received by expectant mothers and their families.

Photo credits – Jacaranda Health