Screening Pregnant Teens' Mental Health at Ndilidau, Kenya – ACQUIRE QI Patient Safety Cohort 2 2026

Asha Abdi shares how the Ndilidau Dispensary team in Taveta Sub-County, Taita Taveta, Kenya is improving psychological screening among pregnant adolescents aged 13 to 19 attending antenatal care (ANC). Between January and May 2026, none (0%) of the pregnant adolescents attending ANC had a documented psychological assessment, so psychological concerns could easily go unidentified or unmanaged. With teen pregnancy a growing concern in Taveta, the team asked what they could do for adolescents who are already pregnant, using the resources the facility already has. They set out to raise psychological assessment from 0% to 70% between July and 30 September. A process map of the ANC workflow located the gap at the routine assessment step, and a fishbone analysis and a two-by-two impact-versus-effort matrix pointed to process and people causes and the quick wins to tackle first. The team matched each quick win to a countermeasure with a responsible person, including a change to the workflow, and screening reached 100% from the first adolescent client and stayed there. Internalising and simplifying the PHQ-9 tool took extra time in the first days. To sustain the change, they added a column to the ANC register, built the step into a workflow checklist and will monitor it in staff meetings and facility data reviews. Screening has already identified adolescents with psychological concerns who can now be offered counselling and referral, and the team plans to standardise when screening happens and roll it out to other age groups. Team member Caroline Kimathi described how the teenagers, many of them deeply affected, embraced the screening and finally had the chance to open up. Team leadership: Jecinta Malemba Sponsorship: Wycliffe Kibunyi Mentorship: Wycliffe Kibunyi Team: Asha Abdi, Brian Leshamta, Caroline Kimathi, Joseph Charo, Joyce Muthoni Chapters 0:00 Introduction 0:20 Problem statement 1:05 Target and baseline 1:34 Current state analysis 1:46 Root causes 2:12 Key drivers and interventions 2:25 Results 3:26 Sustain plan 4:03 Challenges and learning 4:24 Feedback and celebration This project is part of the 2026 ACQUIRE Quality Improvement-Patient Safety (QI-PS) Experiential Leadership Program, where frontline health workers across sub-Saharan Africa learn improvement science by leading real change in their own facilities. Quality takes a team! Learn more: https://acquirefrontline.org #QualityImprovement #PatientSafety #AdolescentHealth #MentalHealth #Kenya #ACQUIRE