LEVERAGING TELEMEDICINE TO IMPROVE MNCH UPTAKE IN KENYA: A COMMUNITY-BASED HYBRID MODEL

EDNA ANAB^1*Tabither Gitau²Erick Kiprotich Yegon¹Nzomo Mwita¹Marlyn Ochieng¹Alice Koimur¹Rhonnie Omondi¹Stephen Smith³Harriet Andrews⁴David Oluoch¹Rosebella Amihanda¹Moses Lwanda¹Erina Makhulo¹Godfrey Sakwa¹Phanice Akinyi¹

• ¹Living Goods, Nairobi, Kenya
• ²Individual Consultant, Nairobi, Kenya
• ³Health X Africa, Nairobi, Kenya
• ⁴Former Living Goods Senior Manager – Strategic Innovations, Living Goods, Nairobi, Kenya

Kenya continues to face major challenges in delivering timely and equitable maternal, newborn, and child health (MNCH) services, especially in rural and underserved regions. Key barriers include inadequate infrastructure, a limited healthcare workforce, and financial constraints. These systemic gaps contribute to low utilization of essential services such as antenatal and postnatal care, ultimately leading to poor health outcomes for mothers and newborns. Telehealth has emerged as a promising solution to bridge geographic and access gaps by enabling virtual consultations, remote monitoring, and timely interventions, especially in hard-to-reach communities. This study evaluated the "Better Data for Better Decisions: Telehealth" initiative, funded by the Children’s Investment Fund Foundation (CIFF) and implemented by Living Goods in collaboration with Health X Africa. The project aimed to integrate telemedicine into Kenya’s community health system by supporting Community Health Promoters (CHPs) with digital tools to extend MNCH care access. Specific objectives included increasing the uptake of antenatal and postnatal care services, improving the efficiency of primary healthcare delivery, and contributing to policy change. The intervention was piloted in Teso North, Busia County, targeting ten community health units. A mixed-methods quasi-experimental design was used, incorporating routine health records, key informant interviews, and focus group discussions. Data collection occurred across three phases: design, implementation, and evaluation. The project surpassed expectations by enrolling 388 households and 551 clients. Half of the clients engaged in virtual consultations with Health X doctors, with 88% preferring the hotline service. The intervention led to a significant increase in postnatal care visits within six weeks postpartum, averaging 4.99 visits in the intervention sites compared to 3.96 visits in the control sites (p = 0.003). Additional outcomes included improved risk identification, referral completion, and behavior change at the household level. This hybrid telehealth model, merging virtual services with CHW engagement, demonstrated strong potential for improving MNCH service delivery in low-resource settings. By leveraging both technology and community infrastructure, the intervention expanded access to care in the last mile. Continued research is needed to explore long-term health system efficiencies and the model’s influence on policy development.