Can an AI chatbot save lives by answering texts about pregnancy?
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chatbot → save → pregnancy
It started with an accident.
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It → start → accident
A network of clinics for pregnant women in Kenya set up an automated text messaging service to send out appointment reminders.
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network → set → reminders
But when the moms received the texts, they started to write back.
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they → receive → texts
Some asked if it's safe to eat avocados during pregnancy (you can!).
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you → ask → pregnancy
Others asked if certain symptoms they were experiencing, like swelling or headaches, are normal during pregnancy.
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they → ask → pregnancy
"At the time I joined I think we were getting less than 100 questions a day," recalls Jay Patel, director of technology for Jacaranda Health.
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Patel → join → Health
At first, Jacaranda hired nurses to answer questions one by one.
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Jacaranda → hire → one
But over the years since 2020, developers have created a program that uses artificial intelligence to understand patient's questions, prioritize them and flag when a user may need immediate medical care.
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user → create → care
It's called PROMPTS — and is used by patients visiting public clinics in 24 Kenyan counties.
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It → call → counties
For women without a smartphone, cell reception, or easy access to the internet, a text to PROMPTS may be the fastest way to get a question answered.
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question → get → PROMPTS
Other times, it's a reliable way to determine if a long trip to a hospital is necessary.
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trip → determine → hospital
"If a mom in a rural part of Kenya starts bleeding at 2 a.m., she can't just Google it," Patel says.
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Patel → start → it
"But this service runs completely over SMS.
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service → run → SMS
It's completely free to the user, and it's accessible to anyone who has a basic phone."
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who → have → phone
About 7% of messages are flagged by the system as potentially urgent.
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% → flag → system
These are routed directly to a nurse.
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These → rout → nurse
"It bypasses all AI functionality and gets straight to the help desk, into a special queue," Patel says.
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Patel → bypass → queue
"They can pick it up immediately, look at the mom's question history and call her."
That kind of quick response is critical in Kenya, where about 6,000 women die each year from childbirth or pregnancy-related causes.
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women → pick → childbirth
Almost a third of those deaths are believed to be related to delays in seeking care.
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third → believe → care
Lisa Mushega, a policy expert for HENNET, a Kenyan coalition of health care providers, says PROMPTS helps prevent these delays by giving women a direct line to a health professional.
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PROMPTS → say → professional
"It's a referral," Mushega says.
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Mushega → say → ?
"[PROMPTS] is data driven and can improve the quality of care — informed by the voices of mothers themselves."
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PROMPTS → drive → mothers
Mushega says she has met women who used PROMPTS to correctly identify signs of pre-eclampsia, a life-threatening condition that can start with swollen legs.
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that → say → legs
Another new mother used the system when her newborn seemed sick, and she wasn't sure how to calm him.
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she → use → him
"She was told to go to the nearest health facility, because her baby was actually having jaundice," Mushega says.
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Mushega → tell → jaundice
"It really comes in handy.
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It → come → ?
At a time when the use of artificial intelligence is drawing existential concerns and calls for regulation, a program like PROMPTS demonstrates its potential value, says Smisha Agarwal, director of global digital health at Johns Hopkins University.
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Agarwal → draw → University
Historically, most public health messaging is one-sided: Public service advertisements, billboards or automated messages written by health authorities and disseminated to the public.
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advertisements → automate → public
"That conversation is really bounded by what a health system decides a mother should know," Agarwal says.
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Agarwal → bound → what
Artificial intelligence sets a different course: "What the LLM really changes is the direction of conversation.
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changes → set → conversation
Because now we can center it on what the mother actually wants to know, and in a private space on her own phone.
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mother → center → phone
In Kenya, PROMPTS understands messages in English, Swahili and Sheng — a popular dialect in Nairobi that is a mix of the two languages.
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that → understand → languages
Jacaranda has also expanded to parts of Ghana, Nigeria and Tanzania, building versions for speakers of Twi and Hausa.
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Jacaranda → expand → Twi
"There's local context," Patel says.
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Patel → be → ?
"If there's a question about nutrition in Kenya, and you give the same answer from a question about nutrition in Nigeria, you're going to get laughed out of the room.
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you → be → room
Jacaranda Health is also using PROMPTS to help doctors identify areas of need, based on anonymous feedback from some of the estimated 700,000 users each year.
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doctors → use → users
"Lots of mothers are reporting that they're getting blood pressure checks, but very few report getting breast exams," says spokesperson Laura Down.
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Down → report → exams
"It gives mums more agency in the health system — as well as a better understanding of their pregnancy history.
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It → give → history
In other cases, Down says the questions mothers are asking can help doctors understand what's happening in their own community.
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what → say → community
…and 20 more, not listed.
The Aporia
