A network of clinics for pregnant women in Kenya set up an automated text messaging service to send out appointment reminders. But when the moms received the texts, they started to write back. Some asked if it's safe to eat avocados during pregnancy (you can!).
Others asked if certain symptoms they were experiencing, like swelling or headaches, are normal during pregnancy. "At the time I joined I think we were getting less than 100 questions a day," recalls Jay Patel, director of technology for Jacaranda Health. "Now it's 15,000." At first, Jacaranda hired nurses to answer questions one by one.
But over the years since 2020, developers have created a program that uses artificial intelligence to understand patient's questions, prioritize them and flag when a user may need immediate medical care. It's called PROMPTS — and is used by patients visiting public clinics in 24 Kenyan counties. For women without a smartphone, cell reception, or easy access to the internet, a text to PROMPTS may be the fastest way to get a question answered.
Other times, it's a reliable way to determine if a long trip to a hospital is necessary. "If a mom in a rural part of Kenya starts bleeding at 2 a.m., she can't just Google it," Patel says. "But this service runs completely over SMS.
It's completely free to the user, and it's accessible to anyone who has a basic phone." About 7% of messages are flagged by the system as potentially urgent. These are routed directly to a nurse. "It bypasses all AI functionality and gets straight to the help desk, into a special queue," Patel says.
"They can pick it up immediately, look at the mom's question history and call her." That kind of quick response is critical in Kenya, where about 6,000 women die each year from childbirth or pregnancy-related causes. Almost a third of those deaths are believed to be related to delays in seeking care. Lisa Mushega, a policy expert for HENNET, a Kenyan coalition of health care providers, says PROMPTS helps prevent these delays by giving women a direct line to a health professional. (Jacaranda Health is a member of the coalition).
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