Our Recommendation
Jacaranda Health is a high‑potential maternal and newborn health organization with a clear Theory of Change, strong partnerships with government, and increasingly robust measurement of both care‑seeking and quality‑of‑care improvements. It already shows encouraging intermediate and some ultimate outcome gains (for example, higher antenatal care visit completion and reduced neonatal deaths in pilot hospitals).
Jacaranda Health's Fierce Certification score is 110/100 based on our criteria:
✔ Has Ultimate Outcome Goals (50 pts)
✔ Measures Intermediate Outcomes (10 pts)
✔ Measures Ultimate Outcomes (15 pts)
✔ Shows Continual Learning & Adaptation (25 pts)
✔ Measures Intermediate Counterfactual (5 pts)
✔ Measures Ultimate Counterfactual (5 pts)
The Social Problem
Jacaranda is focused on preventable maternal and newborn deaths and complications in under‑resourced public health systems, especially in Kenya. Most underserved mothers and babies receive care in public facilities where delays in care‑seeking and gaps in clinical quality lead to avoidable morbidity and mortality. Women may start antenatal care late, miss visits, or not recognise danger signs, while overburdened nurses lack ongoing mentorship, systems for respectful care, and real‑time data for quality improvement.
The Solution
Jacaranda’s solution is a package of low‑cost, government‑embedded digital and in‑facility interventions built around a simple Theory of Change: outcomes improve when mothers seek care at the right time and receive high‑quality care on arrival. PROMPTS is an AI‑supported SMS service that sends tailored messages, reminders, and two‑way triage to guide mothers to timely, quality care. MENTORS is a nurse mentorship and training program that builds lifesaving obstetric and newborn skills and strengthens respectful care. These solutions are co‑designed with mothers, frontline nurses, and government partners so they fit local contexts, can be delivered at scale through public systems, and together shift both demand‑ and supply‑side behaviors that drive outcomes.
Key Outputs
Key outputs that frame Jacaranda’s work:
- Geographic and system reach: Jacaranda works with 22 county governments and Kenya’s national Ministry of Health, and is piloting PROMPTS with Ghana Health Service, indicating integration into public systems rather than standalone clinics.
- Digital engagement: in one deployment, 65% of mothers actively engaged with PROMPTS, 94% attended scheduled visits after reminders, 74% followed advice to seek care, and PROMPTS is scaled across districts reaching thousands of mothers.
- Provider training and mentorship: MENTORS supports frontline nurses in emergency obstetric and newborn care, with recent reports citing an 89% average emergency obstetric and newborn care performance score in participating facilities.
- Evaluation infrastructure: Jacaranda produces quarterly and annual impact reports and technical resources, using routine data, pre‑post facility assessments, and PROMPTS analytics to monitor and refine its model.
These outputs show a lean organization that punches above its weight by operating through public systems and combining digital with clinical quality improvement.
Key Intermediate Outcomes
Measured intermediate outcomes (behaviors, service use, and quality):
- Care‑seeking and service uptake: PROMPTS has increased completion of key services; 88% of PROMPTS mothers reported 4+ antenatal care visits versus 57% nationally, and 74% of those advised to seek care did so, supporting more timely, appropriate care.
- Identification and referral of high‑risk cases: a five‑month trial combining PROMPTS with a help desk identified 102 additional complications (e.g., hypertension, breech pregnancies, other high‑risk cases) that might otherwise have been missed, and 82% of high‑risk mothers referred by the help desk received care.
- Provider skills and adherence: impact reports note “substantial increases from baseline” in neonatal care knowledge and resuscitation skills, improved emergency obstetric and newborn care scores, and greater confidence among providers to manage critical cases on‑site.
Key Ultimate Outcomes
Jacaranda’s ultimate outcome evidence is promising but still developing:
- Neonatal outcomes: in three pilot hospitals, the 2024 Annual Impact Report states that neonatal deaths fell alongside increases in neonatal care knowledge, resuscitation skills, and on‑site management of critical newborns. This is a direct ultimate outcome, though currently limited to pilot sites and presented as pre‑post without controls.
- Maternal outcomes and complications: Jacaranda and SafeCare report that their interventions have had a “positive impact on clinical outcomes, translating to fewer preventable complications,” suggesting reductions in some maternal and newborn complications, though detailed, disaggregated maternal‑mortality or morbidity metrics are not yet public across the network.
Continual Learning & Adaptation
Jacaranda shows a strong learning orientation aligned with our cycle:
- Theory‑of‑Change‑driven design: their model explicitly states that improving both timely care‑seeking and facility quality is necessary to move outcomes, and they have packaged solutions that map tightly to these levers.
- Iterative adaptation with governments: Grand Challenges Canada’s write‑up describes a “test, adapt, and test again” approach, highlighting how Jacaranda adjusts PROMPTS content and MENTORS training to provider and mother feedback and to new geographies like Ghana.
- Data‑driven product improvement: recent impact reports mention that product improvements are “already yielding measurable shifts in care‑seeking behaviors and skills improvements among providers,” reflecting regular evidence reviews and refinement of both digital and in‑facility components.
Against our four‑step framework, Jacaranda is strong on (1) problem‑grounded theory, (2) intervention design linked to that theory, and (3) intermediate and emerging ultimate measurement, and is actively working on (4) feeding evidence back into decisions about scale, content, and partnerships.
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