ORIGINAL RESEARCH article
Front. Digit. Health
Sec. Human Factors and Digital Health
Effectiveness of an Integrated Community and Hospital Digital Health Information System for Maternal and Newborn Healthcare in Northern Kenya: A nonrandomized Before-After Evaluation
Provisionally accepted
Elizabeth Adhiambo Ombech1*
Hellen Gatakaa1Enock Oloo1Micah Oduol1Patrick Ben Ang'ela1Peter Etee2Gertrude Nasike2Wycliffe Khamala2Bonventure Ameyo2
Sarah Lokaala2Samson Gwer1,3Moses Ndiritu1- 1Afya Research Africa, Nairobi, Kenya
- 2Turkana County Government, Lodwar, Kenya
- 3Kenyatta University, Nairobi, Kenya
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Background Poor access to antenatal care (ANC), skilled delivery, and postnatal checks within 48 hours of delivery are linked to adverse pregnancy outcomes. In Kenya, unequal use of these services has caused significant regional disparities, with 15 out of 47 counties being high priority. Objectives To evaluate the effectiveness of a digital health solution to improve maternal and newborn health (MNH) uptake. Methods From July 2017 to March 2019, we implemented an integrated community and hospital digital health information system, in ten health facilities and four community health units in Turkana County, Northern Kenya. We used a non-randomized before-after household survey. We assessed the proportion of mothers attending at least four antenatal visits, receiving skilled delivery, and receiving postnatal checks within 48 hours at baseline and 12 months post-intervention. Statistical comparisons included p-values and 95% confidence intervals, accounting for clustering at the CHU level. These findings were compared with data from the Kenya Health Information System for the study subcounty and Turkana County. Results Among a catchment population of 4,300 women of reproductive age (WRA), 692 and 608 women were interviewed at baseline and endline, respectively. STONE-HMIS® led to 5%, 23%, and 16% improvements in 4th antenatal care visits, skilled delivery, and postnatal checks within 48 hours, respectively. For the same period, subcounty and county data showed that 57.7% and 65.8% of WRA attended at least 4 ANC visits, 39.5% and 67.8% delivered with skilled assistance, and 23.5% and 24% had postnatal checks. Conclusions Integrating digital health systems at provider and community levels, aligned with health system priorities, showed marked improvements MNH indicators in an underserved, remote area.
Keywords: Antenatal care, skilled delivery, Postnatal Care, Digital Health Information System, Community health information systems, Turkana
Received: 27 Feb 2025; Accepted: 27 Nov 2025.
Copyright: © 2025 Ombech, Gatakaa, Oloo, Oduol, Ang'ela, Etee, Nasike, Khamala, Ameyo, Lokaala, Gwer and Ndiritu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Elizabeth Adhiambo Ombech
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