Project #7048

Child Survival and Development in Nairobi Slums

by Orphans and Vulnerable Children's Project in Africa

As it was initially reported, the problems noted in our Baby Care Centers (BCC) included congestion, food insecurity, inadequate play and play materials, poor hygiene, poor ventilation, poor sanitation, and poor food storage among other issues. Children ages 4 months to 3 years attend these Centers while their mothers are working or out looking for work. Among the 14 BCC that were selected, 85% have improved their physical and social environment, hygiene, and sanitation, and so forth. This has been best achieved through subsequent workshop meetings with caregivers, BCC owners and some parents.

We have taken on an additional set of 12 Centers in Mlolongo Village which were in bad condition. New problems were identified, like children who were poor eaters, fussy, irritating, withdrawn and passive, and with poor health status.  Most parents of these children were suffering from depresssion and stress due to high poverty levels. Some of the caregivers in these Centers were also stressed due to the high ratio of children to BCC and the fact that they are poorly paid.

Action Plan

Workshops with the hired caregivers, BCC owners and the parents have been the only way we could discuss the best ways to solve the problems affecting the children's development in the Centers and bring about solutions. Among the 12 selected Centers, each one had to provide one parent and one hired caregiver or owner to attend the workshop. This formed a group of 24 participants. I have divided them into 4 groups, each with 6 participants. Each group has been meeting once every week since mid December 2012. The attendance has been dependent on their commitment, receiving compensation for attending in order to pay a baby sitter. This has not been easy,  but they have tried to keep a quorum. Many child related issues have been discussed in the workshops such as food and nutrition, child rights and protection and child health. The main issues of discussion included:

1.  How can we promote warm, responsive interactions between caregivers/parents and their children in the Centers?

2.  What are the early interventions to be applied to promote better developmental outcomes for the children while in the Centers?

3.  How to overcome maternal depression which has negatively affected children in the centers?

4.  What should be required in Baby Care Centers settings?

The outcome of these discussions are being compiled from each group discussion and will be used to plan a way forward for improving the BBCs. The results and recommendations will be included in our next report. We wish to thank all donors for their continued support to this project that benefits Orphans and Vulnerable Children in the slums of Kenya.

Participants' Reactions

Overall, participants in the workshops cooperated well on the issues discussed, such as congestion, where caregiver/owners agreed to not take care of more children than was suitable for their room size; and problems with food security, where the majoriity had problems with insufficient and unbalanced food which was brought by the parents to their children. Others complained about parents who were in arrears in paying their fees and some who then transfer their children to another center without paying. Parents agreed to change their habits.

Caregivers/owners admitted to not letting the children play and instead had them sleeping all day. They did this  because of lack of play toys, open space and security issues. They were tutored on the importance of play and stimulation for growing children and some play materials  were supplied to them.

Both the caregivers and the parents were encouraged to practice good hygiene, especially in their immediate environment , prompt emptying of potties and keeping the dishes clean and dry. Parents requested that the center owners have a realistic caregiver-to-child ratio to avoid poor social contacts and get better interactions which would promote more positive responsiveness from the children. The parents requested the centers' owners to employ qualified caregivers with skills for taking care of children, especially in limited spaces.


There is a need for empowering the caregivers who take care of the children in the Baby Care Centers through training programs undertaken regularly, as well as laying down a comprehensive and consistent follow-up system of visits to check levels of compliance. Donations of playthings, balls and an assortment of toys would go a long way in alleviating the level of inactivity and sadness apparent in most of the children.

In addition, that the centers with extreme cases of want, be assisted with donations of fortified flour and other growth and health boosting products whenever resources are available. That partnerships with local churches and other well wishers be formulated in order that church members and other individual donors can donate fruit and fresh vegetables regularly to benefit the children.


The distance covered thus far, concerning the training of both parents and caregivers with funds from the Westminster Presbyterian Church in Charlotteville, Virginia, has had a noticeable effect. Areas concerning hygiene, cleanliness and child play have registered near instant improvement. The hardest part and the most challenging remains the balanced diet and availability of adequate food stocks. This is an immediate and long term goal for us. We are currently in the process of negotiating with millers in order to get supplies of fortified flours at a low price. 

This report is a brief summary of visits and workshops in the three slum villages in Mavoko Municipality during June and July 2012.

Visits and Data Collected     A total of 14 out of 70 centers were visited in the first phase of our Upgrading Program. Six centers in Mlolongo, 4 centers each in Sophia and Bondeni communities. Seven Community Health Workers (CHWs) participated in the visits. Each CHW was responsible for 2 centers in addition to their usual work.

Each center had a total number of 9-15 children. The children's ages ranged from 3 months to 3 years. The total number of children in the 14 centers was 176. Some of the problems reported from the centers are:

  • Congestion
  • Food insecurity
  • Inadequate play material and space to play
  • Poor hygiene
  • Poor ventilation
  • Poor sanitation
  • Poor food storage
  • Lack of storage containers for dirty clothes
  • Uncarpeted cold floors
  • Children with bare feet
  • Inadequate number of mattresses for children to sleep on
  • Shortage of potties
  • No program of activities

Action Plan    The action plan was to conduct workshops with baby care center owners and hired caregivers as well as parents who were available. Two workshops were conducted in the three villages: one in Mlogongo and the other one combined for Sophia and Bondeni. The theme of the workshop was "Together in Upgrading our Baby Care Centers." The topics presented by the health professionals, assisted by Racheal Nduku, Project Coordinator, in relation to the problems faced in the centers were as follows:

1.  Food and Nutrition for infants and babies--- Food safety, food storage, food preparation and feeding, balanced diet from inexpensive locally available foods and promotion of exclusive breast feeding for babies up to six months. 

2.  Children at baby care centers and their physical and social environment--- Taking care of the center's physical and social surroundings, building good relationships/secure attachments with the children in the center for good cognitive development.

3.   Childhood diseases, accidents and injuries---  Signs and symptoms of various childhood diseases, how to prevent them and what to do in case of emergencies, how we can avoid child accidents and injuries in centers.

4.   Child health---  Improving centers hygiene and sanitation for the best child health care practices in the centers.

5.   Activities and stimulation---  Physical activities and stimulating projects included in the schedule of the center to promote positive early child development and proper time management in the center.

A program was developed in which the participants had the opportunity to discuss in small groups the issues of the baby care centers. The results of these discussions will be included in the next report of the OVC Project in Africa.

Collaborators Special thanks goes to faculty members and students of the Child Development Departments of Kenyatta University, Nairobi, Kenya and the University of Tennessee, Knoxville, TN, USA for their help in participation in this project and consultations in their specific area of expertise.

Additional Workshops

We want to provide workshps to the staff/parents of all 70 Baby Care Centers in the three slum communities and it costs about $300. per workshop.  Therefore, we are asking for funds to conduct 4 more Workshops. As we continue this work we will also determine the needs of each Center to upgrade it with supplies, equipment and modest furnishings. 

In our last report about Working Moms and their Babies, we stressed the need for improving the Baby Care Centers (BCC) where the children ages 4 months to 3 years received day care. Since reporting the survey results of the poor conditions of the Centers in the three slum communities outside of Nairobi, Kenya, the OVC Project staff has developed plans for upgrading the Centers. We have received a donation to begin this work from our church in Charlottesville, Virginia and started working with 14 BCCs--- 6 in Mlolongo, 4 in Sophia, and 4 in Bondeni. Visits to these BCCs by the Community Health Workers (CHW) have shown the problems and needs of the Centers. Workshops for the BCC caregivers have begun. In put and participation from two of our collaborating universities, Kenyatta University and University of Tennessee, Knoxville has been very helpful in planning and carrying out the caregiver workshops. These workshops will be followed up with workshops for the parents of the children in the centers. In our next report, details of the contents and participants reactions to the sessions will be included. As you might imagine, to help all the BCCs (over 60) that want to participate in this program will take more money than we have on hand and we are therefore, seeking donations from our friends through GlobalGiving.

This report is coming from Nairobi, Kenya where we have just completed a 4 day conference with representatives of the Orphans and Vulnerable Children's Project (OVC) directors and staff, the University of Tennessee, Knoxville departments of Public Health and Child Development and Kenyatta University departments of Public Health and Child Development.

These three organizations are developing a collaboration that will provide expertise and strengthen the work of the OVC Project and give faculty and students the opportunity to obtain field work in their fields of study.

At the same time the OVC project is making plans and beginning work to help improve conditions in the over 70 Baby Care Centers in our three communities of Mlolongo, Sophia and Bondeni. Your most recent generous donations will be used in the Helping Moms and their Babies project that we reported on in our last report. The next report will have more details about the work that is proceeding in the Centers.


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Organization Information

Orphans and Vulnerable Children's Project in Africa

Location: Nairobi, Eastern Province - Kenya
Website: http:/​/​
Project Leader:
John H. Bryant, MD
Project Director
Charlottesville, Virginia United States

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