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From Hospital to Home: How a Checklist Can Help Improve the Health of Mothers and Newborns

Ruth (*) came to a Jacaranda Health three days ago to deliver her healthy baby girl. When it was time to leave the hospital, Jacaranda nurses counseled Ruth- as they do for all of our mothers - to make sure she and her newborn had the best opportunity to stay healthy once they returned home in Kasarani, just outside Nairobi.

Nick Pearson is Founder and Executive Director of Jacaranda Health. Nick has worked at the intersection of business and global health in East Africa, Vietnam and India. Allison Ettenger is a Program Manager with Jacaranda Health, working on research and evaluation partnerships.


“Since you came home from Jacaranda Maternity, have you had fever or chills?” asks Sharon, a Jacaranda Community Health Worker (CHW).

Ruth* came to Jacaranda Health three days ago to deliver her healthy baby girl. When it was time to leave the hospital, Jacaranda nurses counseled Ruth –  as they do for all of our mothers – to make sure she and her newborn had the best opportunity to stay healthy once they returned home to Kasarani, just outside Nairobi.

But this is just the beginning of Jacaranda’s commitment to Ruth and her baby. Sharon’s question comes from Jacaranda’s Postpartum Home Follow-Up Checklist, a series of screening questions Jacaranda’s Community Health Workers (CHWs) ask once our mothers are leaving for home. This is part of an innovative strategy to ensure that mothers and babies delivered at a Jacaranda hospital safely transition from hospital to home. Our project was awarded a seed grant in 2012 by Saving Lives at Birth, a partnership between Grand Challenges Canada, the U.S. Agency for International Development (USAID), the U.K. Department for International Development (DFID), the Government of Norway and the Bill & Melinda Gates Foundation.

Jacaranda Health
Jacaranda Health

Jacaranda’s trained CHWs use the checklists to conduct a comprehensive follow-up to reduce risk in the potentially dangerous time after delivery. The checklists guide CHWs to identify and refer danger signs early, and to provide reminders for essential counseling on topics like breastfeeding and cord care. Community Health Workers counsel the new mothers on the importance of seeking timely care and troubleshoot common barriers low-income women face when seeking care, such as lack of transport, hospital fees, and decision-making with their husband around postpartum family planning.

Jacaranda’s collaboration with researchers at the Harvard School of Public Health ensures that we rigorously evaluate these innovative delivery approaches. The evaluation of this program is currently underway, but we are excited to share four early insights from our pilot:

When providing this care to Jacaranda mothers and their newborns, our preliminary findings show that we’re able to reduce health risks, promote healthy behaviour postpartum and ensure a safe transition home in these critical few days after delivery.

*Name changed for privacy


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