PROMPTS is used by patients at public health clinics across 24 Kenyan counties, according to a September 2026 NPR report. An artificial intelligence understands SMS questions from women, prioritizes them by urgency, and flags potential emergencies for medical staff. According to NPR, Jay Patel, technology director at Jacaranda Health, recalled that when he joined the service, fewer than 100 questions arrived daily. Today that number reaches 15,000 daily. The service grew out of an SMS appointment reminder system run by a network of Kenyan pregnancy clinics. When recipients began responding to messages, a back-and-forth exchange of questions and answers emerged. Patel emphasizes that the service operates over SMS, is free for users, and can be reached with a simple mobile phone.
How Emergency Routing Works
According to the underlying study, a natural language processing pipeline first assigns each incoming message to an intent and priority level. The system answers roughly 86% of cases with automated guidance. The remaining cases go to trained clinical staff who staff the helpdesk around the clock and respond to high-priority cases within one minute. According to Patel, any message flagged as potentially urgent bypasses all AI functions and enters a separate queue staffed by the support team, who can review the complete message history and call the mother directly. The system flags roughly 7% of messages as potentially urgent, according to NPR.
Why Speed Matters in Kenya
In Kenya, approximately 6,000 women die each year from pregnancy and childbirth-related causes, according to NPR. That equals 16 women per day. Nearly one-third of those deaths are associated with delays in seeking medical help, the same report notes. Lisa Mushega, health policy expert at HENNET (a healthcare provider coalition), explains that direct access to a skilled provider helps prevent such delays, according to NPR. Jacaranda Health itself is a member of the coalition. Mushega reports cases of women using PROMPTS to recognize signs of preeclampsia, and a mother who wrote about an apparently sick newborn and was advised to seek nearby care for suspected jaundice.
What a Controlled Trial Shows and Doesn't Show
A cluster-randomized controlled trial at 40 health facilities across 8 Kenyan counties, involving 6,139 pregnant women and starting in November 2021, examined what inviting women to sign up for PROMPTS achieved. Compared to the control group, the knowledge index and birth preparation index both stood 0.08 standard deviations higher, the routine care-seeking index was 0.07 standard deviations higher, the newborn care index was 0.09 standard deviations higher, and the postpartum care content index was 0.06 standard deviations higher. For the index on care-seeking for warning signs, no statistically significant effect emerged. The authors note themselves that results are based on self-reports and the trial was not designed to show effects on health outcomes. According to their disclosures, trial co-authors are employed by Jacaranda Health.
From Launch to Expansion
For the third quarter of 2024, Jacaranda Health reports 2.7 million mothers reached and 23 Kenyan partner counties for its core programs. In March 2025, the Rockefeller Foundation put the number of women who had contacted the service at three million women. By September 2026, NPR cites an estimated 700,000 users annually, a different metric than cumulative totals. In parallel, Jacaranda Health reported in June 2024 a partnership with eHealth Africa to pilot and expand PROMPTS with 25,000 mothers in Nigeria's Kano state.
Where Researchers See Limits
Javaid Iqbal Sofi, who researches AI policy at Virginia Tech University, asks according to NPR what happens if the system misclassifies an urgent message as routine, whether anyone would notice, and how quickly. Smisha Agarwal, director of global digital health at Johns Hopkins University, tells NPR such interventions work best where functioning health systems already exist. The NPR report names rapid handoff to a human care provider in emergencies as the critical factor, because medical emergencies leave little room for machine error. According to NPR, a team of 18 care staff monitors and reviews PROMPTS communication around the clock and answers questions. Jacaranda Health has expanded its operations to parts of Ghana, Nigeria, and Tanzania according to NPR, and is developing versions for speakers of Twi and Hausa. The Rockefeller Foundation reported in March 2025 the service was piloted in Eswatini, while women could register free of charge at public health facilities in Kenya. For the Nigerian context, the team adapted its language models for Hausa and Yoruba conversations and added content on common misconceptions about pregnancy. Patel emphasizes according to NPR that the same answer to a nutrition question does not fit Nigeria and Kenya without accounting for local context.