Jacaranda Health; An Ambitious Plan to Transform Maternal Health Care in East Africa

For a year now, Nick Pearson has been preparing the launch of his first model, mobile maternal health clinic in the slums of Nairobi, Kenya, where 100,000 women give birth each year. Most deliver at home with an unskilled birth attendant or go to a public facility where conditions are often appalling.

“Our ambition is to change the way maternity care is provided for the more than one million poor women giving birth each year in urban East Africa,” said Pearson, the founder of Jacaranda Health. “We aim to become the largest provider of affordable maternity care in the region, and more importantly raise the standard of care among other private and public providers.”

Jacaranda Health seeks to fight the injustice of maternal mortality and ensure that its approach to high-quality care can be replicated by other private and public health providers. Pearson is tackling this challenge with the tenacity and rigor of an experienced and hardened businessman.

His enthusiasm is contagious as he talks about researching how to build an effective health care system, including electronic medical records and inventories, robust supply chains, improved human resources, and training standardization for clinical staff. For Pearson, it is not the medical technology itself that will be the main factor in saving African women’s lives, but putting efficient systems in place to provide safe, accessible, respectful, and affordable maternal and antenatal care.

Jacaranda health has been selected as a winner in the Healthy Mothers, Strong World: The Next Generation of Ideas for Maternal Health competition.

Slums are the fastest growing population centers in Africa. Most women there deliver at home with an unskilled birth attendant or go to a public facility where conditions are often appalling. Women giving birth frequently encounter shared labor beds, delivery on the floor, understaffing, or under-equipped public facilities without basic lifesaving supplies. As a result, as many as one in 40 women die during childbirth and many more experience life-threatening complications.

In search of a solution to these tragic statistics, Pearson, alongside a team of 15 women with public health backgrounds, conducted focus groups in eight parts of Nairobi to substantiate some of the assumptions about why a variety of women delivered at home and what they thought of public health facilities. “The saddest thing about the anecdotes we collected is that women tell these stories and then the group of their peers laughs about them," he said.

"Not maliciously, but because they can all relate, they've all been through something like that. They all recognize it as unfair and inhumane, but accept it as their lot as poor, lower-class women. And that's really unacceptable to us.”

Zainabu, a young mother of three, living in the slum of Korogocho, is one typical example. She had her first child was when she was sixteen. The father moved away to avoid taking responsibility and provided no financial support. She was giving birth in the middle of the night, a dangerous time in the slums, and had to walk through the settlement to a small private clinic.

Zainabu exhibited some signs of preeclampsia, a life-threatening condition, and the clinic turned her away at the door, fearing that she might die. She walked to a second clinic, and was turned away and told they did not have the right equipment. Finally she was directed to a third and delivered there, hours later. The experience of being refused service and walking through the night in labor to find a safe place to give birth was so traumatic that she took the risk of delivering her next child at home with a neighbor in attendance.