In this guide
The journey in one table
Most facilities manage ANC, delivery, PNC and immunisation as separate services with separate registers. The mother experiences them as one relationship. When the relationship breaks at any point, you usually lose every visit after it, and often the next pregnancy too.
| Stage | Return visits | Where families are usually lost |
|---|---|---|
| Antenatal care | 8 contacts (WHO model adopted by Kenya) | Between the first visit and the second; late third trimester |
| Delivery | 1 admission | Mothers who did ANC with you but deliver elsewhere |
| Postnatal care | 4 visits: within 48 hours, 1 to 2 weeks, 4 to 6 weeks, 4 to 6 months | After discharge, once the mother feels well |
| Immunisation | Birth, 6, 10 and 14 weeks, then 6, 9 and 18 months | After the 14-week visit; the gap before 9 months |
Always follow the current Ministry of Health schedules in the Mother and Child Health Handbook. Schedules above are summarised for planning follow-up, not for clinical decisions.
Stage 1: antenatal care
Kenya follows the WHO recommendation of at least eight antenatal contacts. In practice many mothers make three or four. The first visit is where you win or lose the rest: if the mother leaves without a booked date, a clear reason to return and a way to reach you, the second visit becomes optional in her mind.
Read the full playbook: How to reduce missed ANC visits.
Stage 2: postnatal care
PNC is the most neglected stage. A mother who feels fine after discharge rarely sees why she should come back, and the danger signs of the first weeks (bleeding, infection, high blood pressure, depression, feeding problems) are exactly the ones she may not recognise.
Read: The four PNC visits and how to get mothers back.
Stage 3: immunisation
Immunisation is where private facilities keep families the longest, because mothers understand vaccines. The risk is the gap after the 14-week visit: nothing is due for months, contact goes quiet, and the 9-month visit happens somewhere closer to home.
Read: Defaulter tracing for ANC, PNC and immunisation and use the WhatsApp reminder templates.
The five numbers to track
- ANC 4+ rate: of mothers who booked ANC with you, how many reached four or more contacts.
- ANC to delivery conversion: of mothers who did ANC with you, how many delivered with you.
- PNC completion: of mothers who delivered with you, how many completed the 4 to 6 week visit.
- Immunisation on time: of babies due in the month, how many came within 7 days of the due date.
- Open defaulters: how many mothers and babies are overdue today, and how many of them someone has contacted.
How to calculate these from your register: six simple retention formulas. To put a shilling value on the gaps, use the lost patient revenue calculator.
Running it as one system
The facilities that keep mothers do three things. They book the next visit before the mother leaves, every time. They remind her in her language on the channel she reads. And one named person checks every morning who is overdue and follows up the same day.
You can run this with a register, a phone and discipline. HealthBridge's MCH system runs it for you over WhatsApp, from the first ANC visit to the 18-month vaccine, and sends the owner a monthly report of who came back and who is slipping away.
See the report owners receive every month
A real sample of the monthly retention report: returning patients, no-shows, ANC completion, immunisations and the patients slipping away. Fictional facility, real format. Free, no follow-up calls.