Use of ICT to Improve the Health of Preterm Infants in Kenya

Neonatal mortality remains a key issue of public health concern in Kenya and currently stands at 22 per 1,000 live births [2]. Premature births (less than 37 completed weeks of gestation) accounts for 12% of all under 5 mortality in Kenya and approximately over 180,000 infants in Kenya are born prematurely every year [3]. Preterm infants need admission to a Neonatal Intensive Care Unit (NICU) where care is mainly focused on infants thus neglecting the role of mothers. Most mothers of infants born prematurely often suffer from depression, grief, and guilt, which are rooted in not giving birth to a healthy baby [1,10]. Extended periods of separation from the baby, the absence of information or lack of understanding, loss of parental roles, fear of possible outcome and lack of communication with health care providers aggravate the difficulties experienced by mothers regarding prematurity [9, 10].

Kenya’s Ministry of Health has adopted various initiatives to prevent deaths of premature infants. These initiatives include Kangaroo Mother Care, promotion of breastfeeding for at least six months and they also plan to spearhead a breast milk bank. However, challenges still remain, with new mothers often feeling disconnected from their newborn when they are unable to travel on a regular basis to visit the baby in the NICU. Research has revealed that mothers of hospitalized infants experience job and income loss, shattered confidence in parental role, shame as a social stigma, loss of control, are overwhelmed with uncertainties which leads to stress induced physical and emotional problems [7].
To manage these stressors, they rely heavily on health professionals to provide information and other forms of support [8]. However, neonatal nursing is still challenged with supporting mothers in adaptation to the birth of the preterm infant. Even though family-centered NICU care is common practice, many hospitals struggle to provide effective information to these mothers. Interventions to improve infant’s overall well being often take precedence over educating and training mothers on specialized infant care [6]. There is thus a need for parental support programs where educational and emotional aspects are simultaneously covered to ensure these mothers understand their infant’s health rights.
To enhance the design and implementation of the existing interventions, it is important to explore the potential role of Information and Communication Technology (ICT) to improve the health of preterm infants as well as to support their mothers. Increasingly, ICT is facilitating health care information provision and service delivery, enabling solutions that benefit patients as well as healthcare professionals [4]. Indeed, increase in the number of mobile phone and internet users, as well as decline in the price of devices and services has triggered the interest of health program implementers and policy-makers to explore  how ICT could be used to improve healthcare [5].
Working with Kenya Medical Research Institute (KEMRI) and African Population and Health Research Centre (APHRC), ICT4Democracy in East Africa Academia fellow Wanjiru Mburu is researching how ICT platforms can be used to educate mothers of preterm infants on their health rights in Kenya. Preliminary survey findings indicate that most mothers of premature infants in urban areas suffer from stress due to the health condition of their infants. These mothers use social media platforms such as Facebook and Twitter to share their daily ordeals in the NICU. On Facebook, we identified that individual Kenyan mothers share their stories to educate others of the challenges they face while their infants are hospitalized. However, there is no group that supports these mothers and that prompted the creation of  “Preemies Mothers in Kenya” group that aims to provide parental education to mothers of premature infants. On Twitter we identified “Still a Mum” group that supports mothers who have gone through pregnancy and infant loss. As part of the study, a “PreemieCare” account has been created on Twitter with a specific focus on supporting mothers who are currently taking care of preterm infants in the NICU.
Meanwhile, in rural areas, mothers of preterm infants often do not return for follow-up care after being discharged from hospital. This is mostly due to the long distance to the hospital and lack of access to transportation and or their inability to afford transportation cost. As a result, the health care providers are not able to monitor the child’s growth progress. One approach to reach these mothers  is  through the use of radio programs to educate mothers on the importance of attending check up appointments. In addition, scheduled tailored SMS can be used to remind mothers about appointments. For instance, mThrive is an interactive mobile platform designed to ensure follow-up care and monitoring of the progression of preterm infants in Migori county. Such initiatives should be deployed in other rural areas to ensure that the health of preterm infants is monitored.
The ongoing project will work to identify information relevant to preterm infant mothers and disseminate it through existing platforms to help educate them on their health rights. This will ensure delicate infants enjoy the highest attainable level of health care and their mothers are empowered to be more involved in making difficult care decisions.
[1]     Aagaard, H. and Hall, E.O.C. 2008. Mothers’ Experiences of Having a Preterm Infant in the Neonatal Care Unit: A Meta-Synthesis. Journal of Pediatric Nursing. 23, 3 (2008), 26–36.
[2]         Bailey, S. 2012. Kangaroo mother care. British journal of hospital medicine. 73, (2012), 278–81.
[3]      EveryPreemie 2014. Profile of Preterm and Low Birth Weight Prevention and Care.
[4]    Gajanayake, R. et al. 2014. Accountable-eHealth Systems : The Next Step Forward for Privacy. 8, (2014).
[5]   Healy, J.-C.J. 2008. Implementing e-health in developing countries: Guidance and principles. 2008
[6]    Heidari, H. et al. 2015. Neglecting the Parent in Neonatal Intensive Care Unit: The Communicational Factors that Increases the Iranian Parents’ Stress. British Journal of Medicine & Medical Research Neonatal Intensive Care Unit University Hospitals Leuven, Belgium. 7, 12 (2015), 45–51
[7]     Heidari, H.H. 2012. The Iranian Parents of Premature Infants in NICU Experience Stigma of Shame. 66, 1 (2012), 5455.
[8]   Jones, L. et al. 2007. Effective nurse parent communication: A study of parents’ perceptions in the NICU environment. Patient Education and Counseling. 69, 1–3 (2007), 206–212
[9]    Kim, H.N. et al. 2015. Paternal and Maternal Information and Communication Technology Usage as Their Very Low Birth Weight Infants Transition Home From the NICU. International Journal of Human-Computer Interaction. 31, 1 (2015), 44–54.
[10]   Lindberg, B. and Öhrling, K. 2012. An internet-based intervention program for supporting families with prematurely born infants. Open Journal of Nursing. 2, (2012), 72–78

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