Zubeda Abdalla went to hospital in June 2020 with symptoms she thought were for malaria or typhoid. This came shortly after a trip to Tana River, where the two diseases are common.

But during the visit, she discovered she was pregnant. Three months pregnant.

“I was directed to run some tests including a pregnancy test and it turned out positive,” the mother of one and a Lamu County resident said.

This meant she needed to attend the antenatal clinics. Zubeda is a casual laborer, and these clinic visits were a hard task. While she wanted to attend them, sometimes she would forget her clinic days as she would be going to work instead. Fortunately, there were community health workers who visited her, during one such engagement that she heard about TotoHealth.

TotoHealth utilises mobile technology to detect child development, abnormalities and improve access to maternal and child health. Shortly after signing up to the service, Zubeda received weekly text messages and was able to schedule and set reminders for clinic appointments.

“My husband also received the messages and he used to remind me whenever I needed to go for clinics,” she said.

The weekly messages also highlighted warning signs in pregnancy or a child’s health thereby enabling the recipients to seek timely care. The messages are sent every Tuesday and Thursday are free of charge.

On the eighth month of her pregnancy, Zubeda slipped in the bathroom while taking a shower. She was however able to control herself not to fall on her belly.

As a precaution, she visited the hospital, where she was assured that her baby was safe and sound and there was no cause for alarm.

She religiously checked TotoHealth for the reminders and how to prepare to welcome her baby.

However, her joy was short-lived when one morning in December, she started bleeding.

At first, when she felt warm liquid on her legs, she thought she had broken her water and was about to labor as her due date was within that month.

“TotoHealth had informed me that I was due in a few weeks. But, when I started bleeding, I knew something was amiss. I prayed to God to preserve my baby,” she noted.

Within minutes, she lost consciousness.

Efforts to rush her to hospital were hampered by Lamu’s terrain.

Zubeda’s husband and neighbors chose a boda boda but this plan failed. She could neither sit by herself nor was there any rider willing to ferry her in her condition.

They opted to carry her on a homemade stretcher for close to two kilometers from her home in Kandahari village to the King Fahad Hospital.

They managed to get to hospital, a few checkups showed a still birth and Zubeda had to be rushed to the theatre to surgically remove the baby.

“While it was sad that we lost the baby, I’m glad that TotoHealth helped me to monitor the progress of my pregnancy. TotoHealth walked with us throughout the journey, “she said.

TotoHealth service is one of the packages mothers and children enjoy following a partnership between Lamu County and Safaricom Foundation under the project ’Afya Uzazi Salama.’

According to Ben Wali, the Afya Uzazi Project Lead, the idea was to incorporate technology in maternal health.

Currently, Totohealth serves eight villages including Dide Waride, Witu, Hongwe, Bomani, Burahani, Kizingitini, Faza-tchundwa and Siyu Pate and has 5,123 subscribers.

According to Wali, trained community health volunteers move around the targeted villages to collect info of expectant couples and parents to children below two years.

As a result of the services there has been an increase of children immunization and more pregnant women attending antenatal clinics.

As part of the Afya Uzazi Salama project, the Safaricom Foundation spearheaded the renovation and equipping of King Fahad’s maternal unit. The mother and child unit is fully equipped with beds and incubators as well as the High Dependency Unit (HDU).

The Unit also has a nursery which has 10 incubators while the HDU has six oxygen cylinders. Now, expectant women with emergencies can undergo surgeries in the facility.

Prior to the upgrade, emergency cases had to be referred to Mombasa or Malindi using an ambulance or a bus.

And with the insecurities and the poor road infrastructure, the life of the mother and the baby lay on the balance.

Mothers who deliver at King Fahad Hospital are entitled to a free mama’s pack that contains diapers and mother’s sanitary towels, a baby basin, washing powder among other items needed when a mother delivers.

Abdulhakim Mzee, is one of the Lamu residents who is glad for the renovated unit. Mzee’s wife, Fatuma Boru, gave birth to a healthy baby boy in December at the facility.

However, a day later the baby developed breathing problems and had to be rushed to the HDU where he stayed for two weeks.

“The moment my son was rushed into the HDU, I could not stop thinking about what I would have done if these services were not available here. Would he have survived, or he would have died on the road?” he said.

According to Rita Okuthe, Safaricom Foundation Trustee, Afya Uzazi Salama project seeks to increase access and uptake of quality maternal and child health services by investing in training of health workers, improving healthcare infrastructure and referral systems, community education and community health outreaches.

The project advocates for access to maternal, neonatal and child health services and health financing to ensure communities have access to healthcare when they need it.

Lamu County is among those with highest rates of maternal, newborn and child deaths, according to the Kenya Demographic Health Survey of 2014.

According to County statistics maternal mortality stands at 676 for every 100,000 live births compared to the Kenya’s statistic of 362 maternal deaths out of every 100,000.

Okuthe said the foundation has invested KES 13million in the renovation and equipping of the new-born unit which currently benefits at least 4,000 women who depend on the facility.

“Some of the achievements within these first two years include skilled deliveries which have increased from 64 per cent to 92 per cent, 4th ANC visits increased from 53 per cent to 76 per cent and immunizations for under 5s increased from 53 per cent to 77 per cent,” said the Foundation trustee.

Jackie Mong’ena, head of the maternity unit at King Fahad says there has been an increase of hospital deliveries since the launch of the project at the facility.

As a result, she said 80 percent of pregnant women in Lamu, prefer giving birth in hospitals contrary to the initial rate which was below 64 percent.

“The project by Safaricom Foundation has also enabled us to retrain our health workers at the mother and child units and equip them with firsthand skills on how to respond to an emergency,” she said.

Sustainable development goal 3(SDG) seeks to reduce global maternal mortality ratio to less than 70 per 100,000 live births by 2030.

WHO also targets to end preventable deaths of newborns and children under the age of five years, with countries aiming to reduce neonatal mortality to as low as 12 deaths in 1,000 live births and under-5 mortality to as low as 25 per 1000 live births.