Making Maternal Health More Affordable in sub-Saharan Africa with Trimester Save

The AfriHealth Innovation Xchange (AIX) platform is dedicated to collaborating with and empowering Africa healthcare innovators to succeed at scale by providing them access to a universe of learning and exchange with global innovation experts and resources. Our first feature on AIX innovators spotlights Dr. Elvis Kuma Forson, founder of Trimester Save, an initiative that is breaking down barriers to make maternal health services affordable and accessible in sub-Saharan Africa. Dr. Forson's story is not just one of medical innovation but also of profound social impact, as he takes us through his journey from a youth inspired by medical dramas to a changemaker in women's healthcare in sub-Saharan Africa. Find out more in the conversation below.

Dr. Elvis Kuma Forson, Founder of Trimester Save

Frederick Sowah: Dr. Kuma Forson, I want to welcome you and Trimester Save to the AfriHealth Innovation Xchange (AIX) platform, where we collaborate with and empower innovators like yourself to solve the toughest healthcare problems in sub-Saharan Africa. Your journey is quite inspiring. Could you share with us your experiences growing up and what led you to the field of medicine and eventually to start Trimester Save?

Dr. Kuma Forson: Thank you, Frederick. I grew up in Ghana in an era without PlayStations, but rich in social integration. Influenced by medical TV series, I was drawn to medicine from a young age. My undergraduate studies in zoology and conservation further fueled my passion. After completing medical school, I observed firsthand the critical health issues affecting pregnant women in Ghana during the OB/GYN rotation of my medical internship. This experience, combined with the realization of the social determinants of health, such as financial constraints, inspired me to start Trimester Save.

Frederick Sowah: Your healthcare venture, Trimester Save, stands out as a transformative solution that addresses affordability and quality challenges facing maternal health in Ghana. How does it address the healthcare issues faced by pregnant women in Ghana?

Dr. Kuma Forson: Trimester Save is dedicated to tackling the financial and medical challenges that pregnant women face. In Ghana, conditions like pregnancy-induced hypertension and eclampsia are prevalent. Many women miss crucial antenatal sessions and timely medical intervention due to financial constraints. Our solution bridges this gap with a tech-enabled savings platform. Unlike traditional savings, Trimester Save offers defined savings targets for healthcare needs, transaction history, and withdrawal flexibility. We're innovating in areas like ride-hailing for maternal visits, premium services that offer second medical opinions, and baby products.

Frederick Sowah: Can you tell us more about eclampsia and how it impacts maternal health in Ghana and other parts of the world?

Dr. Kuma Forson: Certainly. Eclampsia is a serious condition that can occur during pregnancy, characterized by the onset of seizures, often following a diagnosis of preeclampsia, which involves high blood pressure and protein in the urine. It's a leading cause of maternal and infant morbidity and mortality, particularly in Ghana. Eclampsia is not limited to Ghana, as it also disproportionately affects African American women compared to other ethnic groups in the United States. After 20 weeks of pregnancy, regular monitoring and early intervention become crucial. However, many women in Ghana, especially in low-income settings, can't afford frequent hospital visits or extended stays necessary for managing their condition.

Frederick Sowah: Given Ghana's national health insurance coverage for pregnant women, why are expectant mothers not attending these crucial visits as much as needed? And how is Trimester Save addressing this?

Dr. Kuma Forson: That's an important question, Frederick. While it's true that Ghana's national health insurance does provide coverage for pregnant women, there are several factors limiting the utilization of these services. Firstly, even though the insurance covers basic antenatal care, there are often additional costs that are not covered, such as certain tests and medications, particularly for conditions like eclampsia. These additional costs can be a significant financial burden for many women. In fact, these out-of-pocket payments can be as much as 40% of the total costs of having a baby.

Moreover, there's the issue of accessibility. Many women, especially in rural areas, face challenges in reaching healthcare facilities due to transportation costs or distance. Even when they can afford to travel, the availability of healthcare services can be inconsistent, with overcrowded facilities and long wait times, discouraging regular attendance.

Trimester Save aims to address these gaps by not only helping women save for the uncovered costs of pregnancy but also by exploring innovative solutions like partnering with ride-hailing services to improve access to healthcare facilities. Our goal is to ensure that financial limitations never stand between a woman and the life-saving antenatal care she requires. Through our innovative platform, we're not just tackling a health issue but also addressing a social injustice, ensuring equitable healthcare access for all mothers.

Frederick Sowah: Can you share some of the impacts and achievements of Trimester Save?

Dr. Kuma Forson: Certainly. We've positively impacted over 4,000 women, helping them plan financially for pregnancy and beyond. Our partnerships with organizations like UNICEF and UNDP have been instrumental in scaling our impact and reaching more women. We have also attracted interest from stakeholders in Uganda, Kenya, and South Africa who are seeking to implement solutions based on the Trimester Save model.

Frederick Sowah: What challenges did you face, and what lessons have been learned?

Dr. Kuma Forson: Our pilot phase brought several challenges, including resistance to transaction fees and adapting technology to local needs. We learned valuable lessons about user behavior, leading to innovations in our model, such as integrating credit scoring and exploring partnerships with ride-hailing services for transportation.

Frederick Sowah: And how are you leveraging technology to create scalable solutions?

Dr. Kuma Forson: Technology is at the heart of our approach. By using SMS-based USSD codes, we're able to reach expectant mothers even in the most remote areas, ensuring that Trimester Save is accessible on the simplest mobile phones. This scalability is crucial in a country where advanced smartphones are not yet the norm.

Our platform is not just a savings tool; it's an integrated suite of services that addresses the financial and health needs of pregnant women. It combines savings plans and microinsurance with digital health services, creating a comprehensive ecosystem for maternal health.

Additionally, we're incorporating family planning resources into our platform, recognizing the importance of giving women control over their reproductive health. By doing so, we empower women to make informed decisions about their pregnancies, which is a fundamental aspect of their overall well-being. This holistic approach ensures that every mother has the support she needs, not only during pregnancy but also in planning their families and futures.

Frederick Sowah: Looking forward, what are your goals for Trimester Save?

Dr. Kuma Forson: Our medium-term goal is to reach up to 100,000 mothers representing 10% of Ghana's annual births, with a long-term vision of transforming maternal healthcare in sub-Saharan Africa. We're focusing on partnerships with financial institutions and using Application Programming Interfaces (APIs) for scalability, aiming to offer a comprehensive suite of services that support women throughout their pregnancy journey.

Frederick Sowah: Finally, what call to action would you give to readers, the new AfriHealth Innovation Xchange (AIX) platform, and other potential partners?

Dr. Kuma Forson: Join us in our mission. Whether through investments, partnerships, or advocacy, your support can catalyze the expansion of Trimester Save, fostering sustainable and inclusive maternal healthcare solutions.

I am quite excited about your new AfriHealth Innovation Xchange platform. There's a tremendous opportunity for partnership and strategic collaboration to scale Trimester Save to a wider population, ensuring we reach more women and provide sustainable, inclusive solutions.

Frederick Sowah: Thank you, Dr. Kuma Forson, for your insights and the impactful work of Trimester Save. We're excited to collaborate and advance our shared mission of improving healthcare outcomes in sub-Saharan Africa.

Dr. Kuma Forson: The pleasure is mine, Frederick. Here's to a future where every mother and child has access to the care they need.

---

Please watch video to learn more about the impactful work of Trimester Save in sub-Saharan Africa