Addressing the Fourth Delay: Improving Community-Based Accountability for Maternal and Neonatal Health

We seek to address a critical fourth delay that sustains high rates of maternal and neonatal mortality in western Kenya: the delay in a community's accountability to its mothers and infants. We will develop an innovative information technology that fosters rapid communication and feedback between mothers, their communities, and their healthcare providers: The Mother-Baby Health Network. This information platform will accomplish three primary objectives: (1) Facilitate home and group-based care through Community Health Workers (CHWs) to improve collective advocacy; (2) Provide communities with the capabilities to activate an emergency alert system; and (3) Foster transparency in community and health system responsiveness to maternal and newborn health. CHWs will be equipped to use clinical decision-support on Android phones to correctly triage women and newborns for care. Integrated with SMS messaging, they will be capable of notifying healthcare providers, alerting nearby GPS-tracked Mother-Baby Taxis in an emergency transport system, and activating a personalized community of Mother-Baby Advocates to mobilize local resources.