Pregnant women in Kenya are using a text-message service to ask questions about their care without a smartphone or mobile data, extending health guidance to people who may have limited internet access. The PROMPTS chatbot, developed by Jacaranda Health, provides antenatal care (ANC) and postnatal care (PNC) support to close to four million enrolled mothers.
The service was designed to reduce delays in seeking maternal healthcare. Women can send questions in English or Swahili through two-way SMS, and PROMPTS combines automated replies with a clinical helpdesk. This allows the system to provide routine information while directing some concerns to health workers.
Its artificial intelligence uses natural language processing to identify the subject and potential urgency of incoming messages. It can flag possible danger signs, including bleeding, headaches or swelling. Those cases can then be escalated to human health workers for follow-up and referral.
The approach addresses a persistent problem in maternal care: women in rural areas can face information gaps and limited access to smartphones or reliable internet. SMS services can work on basic phones, making them a practical channel where more data-intensive digital health tools may be out of reach.
Research on text-message health programmes has found that SMS interventions improved ANC attendance, maternal health knowledge and health behaviours. They also increased the uptake of four or more ANC visits among pregnant women in low- and middle-income countries.
Evidence from Kenya includes the Mobile WACh NEO system, which used automated messaging and two-way communication. In a measure related to that system, skilled delivery attendance increased from 26.79% to 55.23%.
Across sub-Saharan Africa, SMS-based programmes were the most common digital intervention for adolescent sexual and reproductive health, appearing in over 40% of included studies. Their appeal has rested on their simplicity, affordability and broad reach, particularly in rural areas with limited internet connectivity.
Kenya’s government is also planning a larger artificial intelligence-driven platform, TaifaCare, to bring together information on pregnant women, mothers and newborns. The Digital Health Agency (DHA) will develop the platform, which is intended to unite Reproductive, Maternal, Newborn, Child, and Adolescent Health (RMNCAH) data now held across hospital systems, community health records and reporting platforms.
TaifaCare is planned to cover ANC, childbirth, PNC, immunisation, family planning and maternal death reporting. It will also include a planned WhatsApp channel allowing patients and families to engage directly with the platform for tailored information on pregnancy and child immunisation.
The proposed system aims to detect missed ANC visits and warning signs before they become emergencies. It is also intended to speed referrals and blood matching, and to make sure that births and deaths are recorded by health authorities and the civil registry.
Digital tools can improve the flow of information and help staff identify people who may need care quickly. Their limits are clear, however. TaifaCare cannot create an ambulance, provide a skilled birth attendant or fix an unreliable blood supply.
The available evidence shows improvements in care-seeking and attendance from SMS interventions, while leaving key questions unanswered about PROMPTS itself. The cost and sustainability of the service, current active usage, clinical outcomes, oversight of its advice, and retention rates are unknown. The timetable for TaifaCare’s full deployment, and whether it will connect with PROMPTS, are also unknown.
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