The Saving Women and Pre-term babies Project (SWAP) project is improving the survival of small and sick newborns and mothers likely to deliver pre-term babies through mobile technology. The Protecting Infants Remotely by SMS (PRISMS) which is a mobile technology application is designed to streamline and standardize newborn care in low-resource settings.
The Ministry of Health, Kampala Capital City Authority, E-Wall technologies and Save the Children through the Saving Women and Preterm Babies project (SWAP) deployed PRISMS, which at its core provides frontline health workers, often nurses and midwives with a structured framework for clinical assessment and instant management plans. It also serves as a digital medical records tool, automatically collecting and aggregating data to improve quality of care, program planning, and surveillance.
The application enables real-time data entry and retrieval, allowing clinicians to update and access newborn health records instantly. Automated alerts and reminders flag critical conditions, prompting healthcare providers to take essential actions such as administering oxygen therapy, providing feeding support, or implementing infection control measures. The digital platform also enhances teamwork and coordination, ensuring seamless communication among nurses, doctors, and support staff.
World Health Organization (WHO) recommends a level II newborn care unit to have a nurse-to-patient ratio of 1 nurse to 3 newborns. The reality in most health facilities in Uganda is 1 nurse to over 10 babies. Records and data use have been a long-standing challenge affecting data driven quality improvement at all levels of care. The PRISMS application is moving the lever of change towards improving quality of care and data use for decision making, one newborn at a time.
Before PRISMS, the neonatal unit relied on manual record-keeping, a system plagued by errors, misplaced files, and incomplete documentation. Tracking the progress of small and sick newborns was a constant struggle, and ensuring continuity of care after discharge was nearly impossible. Healthcare workers often lacked access to real-time patient information, leading to delayed interventions and missed opportunities to save lives.
For Dr. Nandaula, the paediatrician at Kawaala Health Centre IV, the impact has been profound. “From August 2024 to date, we’ve managed 951 neonates using PRISMS,” she says. “The system has greatly improved our outcomes. It provides evidence-based prompts, and our nurses are more vigilant and proactive in monitoring patients. PRISMS is not just a tool, it’s a teacher, ensuring that protocols are followed even when I’m not on the ground,” Dr. Nandaula.
Since its implementation, PRISMS has led to remarkable improvements in neonatal outcomes. Early detection and intervention have significantly reduced neonatal mortality rates, giving more premature and critically ill newborns a fighting chance at life. Healthcare providers now make faster, data-driven decisions, leading to better patient outcomes. The digital system has also improved documentation and reporting, providing reliable data for research and policymaking. With better communication and guidance from healthcare providers, caregivers are more confident in their ability to care for their newborns after discharge.
The success of PRISMS at Kawaala Health Centre IV is extensive and today, the application has also been deployed at Wakiso Health Centre IV and Mukono General Hospital, where it is transforming newborn care in similar ways. As the system continues to be scaled up to more health facilities, its impact will only grow, saving more newborn lives and empowering more healthcare workers. PRISMS is proving that innovation and collaboration can bridge some of the resource gaps towards newborn care.
“PRISMs is more than just an application it is a promise of a healthier generation as we build our human capital. In the neonatal units of Kampala and beyond, this digital lifeline is rewriting the narrative of newborn care”, Dr. Douglas Akii Bua-Program Manager SWAP.
The Uganda Health information and Digital Health strategy 2020/21- 2024/25 intends to ensure timely and secure availability and utilization of data at facility level for quality improvement. Together with other interventions, PRIMS will not only be a catalyst to achieving this strategy but also contribute to the achievement of Every Newborn Action Plan (ENAP) 2030 targets and overall prevention of newborn deaths.
