Enabling women to access quality maternal health care in Kenya

The challenge

Partner: PharmAccess Foundation
Healthcare costs constitute a significant household expenditure in Kenya, with over 2.6 million people driven to poverty by health costs and repeatedly failing to seek treatment due to inadequate financing. This assignment aimed to support PharmAccess Foundation in researching, designing and prototyping a financial solution that enables pregnant women to access quality health care. Through MomCare, PharmAccess Foundation supports mothers on their care journey with a digitally enabled contract. Women get the power to monitor their journey using their mobile phones.


● Understand women’s journeys through pregnancy. Their pain points, needs, goals and aspirations● Understand the challenges of health providers when serving women along their pregnancy journey● Design and prototype a solution that allows pregnant women in the informal segment to access quality healthcare.

Our approach

We used a combination of qualitative and quantitative methods to understand women and health facility needs, challenges and desires during the pregnancy journey. The research yielded insights which allowed us to create, test and iteratively refine MomCare prototypes.

  • Contextual interviews

    The research involved interviewing, observing, and carefully documenting attitudes and behaviours of potential users. We conducted the sessions to understand pain points and opportunities for improvement.

  • Participatory concept design sessions

    Co-design, prototype creation and testing around user needs, expectations and ideas on MomCare. The direct feedback received from participants informed the design of new prototypes as well as improvement of features, value propositions and incentives. The iteration process led to the overall creation of MomCare.

  • Key stakeholder interviews

    We interviewed health facility officials with differing levels of responsibility such as clinicians, administrators, receptionists and pharmacists. They have in-depth and expert knowledge of the health ecosystem and potential opportunities or pitfalls for MomCare.

Topic areas

Health, Maternal and Child Health, Financial Inclusion, Digital product design

Project type

Research, data analysis, prototype developing and testing, services

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MomCare aims to introduce a solution that enables pregnant women to access quality health care. To this end, it seeks to understand the challenges faced by women and the health providers who serve them during their pregnancy journey. The aim was to increase informal pregnant women's financial participation in accessing quality healthcare, resulting in better maternal and child outcomes.
In general, most women view their pregnancy journey as discrete stages of ANC, childbirth, and PNC - often only focusing on childbirth.

Financially able informal segment women recognize the value of building up reserves for their delivery expenses.
Health facilities are the key touchpoint for women during pregnancy. Several mid-size health facilities that serve informal segment women are often overwhelmed by their day-to-day workload.
The study examined women in the informal sector and facilities that serve them during pregnancy. We look at selected women and healthcare facility segments, detailing their pain points and opportunities for intervention.

Summary of women segments

Low income

The vulnerable81% of Kenyan Women (11 million)
according to FSD FinAccess Data

They have low income below KES 15,000 per month which are inconsistent. The segment is highly dependent on sparse social support systems (spouse, family, friends, groups) to get by. They are struggling to meet their financial obligations, get income generating activities & to maintain a steady cash flow. Have a low ability to save with research indicating many are not currently saving for their pregnancy journey. They prefer use of Linda Mama.

Low incomeMake up 6.7% of Kenyan women (922,998)

Approx. monthly income of KES 15,000 - 30,000. Do casual labor in unprotected jobs or low paying jobs. Have high income volatility in the segment.Prefer NHIF to meet pregnancy costs but struggle to make regular paymentsHave low ability to pay or save in the segment

“Informal” Middle income

Overall Segment Description: Make up 2.9% of Kenyan women (407,924 people). They have a monthly income between KES 30,000 - 70,000 which is more regular yet can be insufficient to meet pregnancy costs against competing financial needs such as household expenses, school fees, rent and cater for emergencies. Many women build reserves through social support systems. Have a higher ability to save and pay for their pregnancy journey. FSD data shows 72% of segment are currently using NHIF.

Middle income● Approx. monthly income of KES 31,000 - 50,000. Employed in low paying formal jobs, business owners & “hustlers” with diversified income streams (agriculture or other casual jobs)● Have access to technology and moderate internet use● Already saving small amounts for pregnancy in a chama & a mobile wallet in addition to NHIF

High income● Approx. monthly income of KES 51,000 - 70,000 Employed or own businesses e.g. shop● High access to and usage of digital technology● Aspirational - looking for high quality care during pregnancy & is willing to work/save to affording it.


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