Health  Kenya Project #25829

Maternal and Child Health Clinics

by Village Hopecore International Vetted since 2011 Top Ranked Effective Nonprofit
The new cohort with the MedTreks trainers
The new cohort with the MedTreks trainers

Over the next two years, 2018 and 2019, we aim to implement a far-reaching community health worker program. We will train each of these neighborhood community health volunteers (primarily women) to be agents of change in their community. They will conduct outreach to homes, monitor women’s pregnancies, and ensure our schools are participating in healthy behavior.  

Each of these NCHVs are equipped with a mobile phone. HopeCore has developed a mobile application for both data collection and training purposes. The NCHVs have, at their fingertips, a huge amount of health information that will support them as they offer services to the women in their community.

In January, HopeCore launched the above program to support the overarching maternal and child health program. We are so excited to share the details of the training of these health promotors. The training was offered over 6 days. 

The training objectives for the 6 day training were 1) to have competent NCHVs; 2) To be the first line in combating poverty in the community; 3) To build connections with others in the community; 4) To explore the importance of partnership in improving community health. 

Day 1: Introduction, purpose of NCHVs, HopeCore's objectives, governance of NCHVs within HopeCore's existing strutcutres, roles and responsibilities of NCHVs, leadership qualities of a community leader, communication skills, counselling skills. 

The first session on the concept of NCHVs was a word visualization exercise where the participants were asked to say out loud the first words that came their minds upon hearing the words neighborhood community health volunteers. At this point the participants were already so eager to strategize and plan that the agenda be adjusted and we have more time for this sessions. The topics were well structured and captured the main basics that the NCHVs needed to know for the day.

Communications skills were greatly emphasized during this day towards focusing on the approach we give to our clients in the community, while delivering our services for the success of our programs. Qualities of a community leader were also echoed on day one training, considering the fact that our NCHV are the lead ambassadors who will act as change agents in our community through their leadership qualities. 

Day 2: First Aid and CPR

On day 2 of the training, our neighborhood community health volunteers were trained by the MedTreks team. The trainees were very attentive during this session, after realizing that this is something that can be of help, not only in HopeCore but in the community and in their homes. Most of the trainees are parents and were very grateful to MedTreks Nurses for giving them an opportunity to learn how to handle most of the accidents at home or at work, through first aid and other emergencies.

Day 3: Preconception care, focused antenatal care, individual birth plans, breastfeeding, family planning

Day 3 started with a recap of the previous days in which the NCHVs remembered 95% of what they had previously covered. The topics here were of particular interest to the NCHVs and they have requested additional trainings on these topics. 

Day 3: Nutrition, malnutrition, growth monitoring, deworming, and Vitamin A

The trainers used the morning sections to cover malnutrition, vitamin A and deworming, summing it up with a description of the HopeCore's health hotline. After lunch the trainers jumped to tackle growth monitoring and nutrition assessment, which took bit of time to show the practical part in growth monitoring and filling in the forms, which took much time for the trainees to comprehend the whole procedure. The trainees will need refresher trainings on how the NCHVs are doing the growth monitoring in the field.

Day 4: Introduction to sexual and reproductive health, STIs, HIV/AIDS & PMTCT, tuberculosis, youth counseling and referals, value clarification, data collection

Day 4 was very successful and we are expecting a great impact based on the training topics we trained especially on youth matters from the villages, churches, homes and community at large

Day 5: Malaria, diarrhea, oral rehydration therapy, coughs and colds, skin and eye infections

Today, emphasis was put on diarrhoea and oral rehydration therapy administration in order to curb the number of diarrhoea case in our community. Malaria was too emphasized and the importance of using a mosquito net was shown to be essential in curbing the spread of malaria.

Day 6: Water, hygiene, and sanitation, data application training

The NCHVs were trained on the importance of drinking clean water and encouraging hand washing in their communities. We discussed the impact dirty water and lack of hand hygiene can have on the health of children. Additionally, the mobile application for data collection and education was introduced, but there needs to be significant additional training on the application. This additional training will be done during the monthly refresher trainings that will come in the future. 

The whole team looks forward to integrating these neighborhood community health volunteers into HopeCore's maternal and child health programming.

This year is the year of education at HopeCore which is why we have focused so heavily in describing the training in this report. We will have monthly refreshers for the NCHVs and will continue to build their knowledge base and skills. By empowering community members with health information we are stopping the spread of misinformation, acting as a resource to the community, and imbedding accurate health information providers in homes around Maara Sub county. 

Home visits around Chogoria
Home visits around Chogoria

Our health program continues to demonstrate impressive successes. The team held an average of 30 maternal and child health clinics and 36 mobile clinics each month, reaching over 7,000 mothers with health education.

We are helping mothers and youth plan their lives through health education and provision of family planning.

Our clean drinking water program continues to be successful in 200 schools, reaching 45,000 children. With 12 new schools being built over the last 3 years, we were able to install clean drinking water tanks and hand washing stations in each of them this year. Additionally, we continue to deliver soap for hand washing to schools each term to reduce the stomach illnesses in children and their teachers.

HopeCore's health services are now offered to over 100,000 women and children in and around Chogoria.  

Here are some more 2017 highlights: 

  • Distributed over 2,000 long-lasting, insecticide treated mosquito bed nets
  • Had almost 2,000 visits to the office-based Youth Center
  • Distributed 460 reusable and disposable sanitary pads to girls, and provided health education to each one of them

We have big plans for 2018! Below are some of our new goals: 

  • Recruit, train, and manage 50 new neighborhood-based community health workers
  • Establish HopeCore Health Coordinator teachers in 170 schools in Maara Sub County, ensuring health messages are constantly reinforced and children are healthier
  • Ensure 70% of children in schools are drinking clean water and washing their hands before and after meals
  • Distribute 5,000 long-lasting, insecticide treated, mosquito bed nets
  • Establish a learning resource center for the community at HopeCore's Chogoria office

Links:

Have you been wondering who HopeCore helps through our Maternal and Child Health program? Or how we decide what our programming should be? 

We are looking to expand our maternal and child health clinics to be a comprehenisive program that supports women from their child's conception through the first five years of the child's life. We are currently looking for partners to support us in this effort, but in the meantime have done some research into the experiences of childbirth and pregancy of women in our community. Read through the stories below to hear directly from the women in Maara Sub County! 

Nancy is a 35 year old mother of 4. Her children are age 17, 10, 7 and 5. This means she had her first child when she was 18 years old. All of her pregnancies were planned except for the fourth one. Also, they were all born by the same father. Nancy received support from her sister, husband, and her grandmother. However, she did not receive any support by her bothers which was caused strife in the family. During the birth of her first child she had malaria, and pneumonia because of this she could not breast feed. The first child was feed formula. She was also able to visit the dispensary six times during the pregnancy, and she delivered this baby at a hospital. For her next child she was able to breastfeed but began to introduce solid food at three months. Then her last two children after learning from her own experience she breast feed for six months before giving them solid food. She found this method better because her last two babies were not getting as sick as the first two. Even though she visited a dispensary four times with the rest of the pregnancies most of her learning came from her own experience. Her advice to others is to give birth at a hospital like she did for each of her children in case of complications. Lastly, she encourages mothers to get tested for different illnesses before getting pregnant.

Betty is 24 years old and from Gakth. She is married with two children ages 7 and one and a half. Her 7 year old child attends school, and her and her husband are both farmers. Both children were planned and it was her own decision to get pregnant. She did not speak to anyone else for advice. She was very excited each time she found out she was pregnant and was not scared. She went to a dispensary three times for each pregnancy. She felt like the second pregnancy was much easier and she prepared for each child’s arrival by being less active in the last trimester. Her first child was born at home by her grandmother who had lots of experience with being a midwife. Betty was able to go to the hospital the following day for a checkup. Her second child was born in the hospital which she felt was a better experience,  because of the care she received. Both children were breastfed and introduced to solid food at six months which was advised by a doctor. She advises others to deliver at hospitals because of the complications, and better care at them too.

Lucy is 38 years old and has four children. The children are ages 13, 10, 5 and 2 and a half. She is from Kigui. The first three pregnancies were planned, and she did have complications with her second pregnancy. With her second child the position of the baby caused her to not be able to work at all. This caused a financial burden for her family. Everything turned out okay and the first three children were born in the hospital. There she had support from her whole family. Her fourth pregnancy caused the most strife for her family. She did not have any support from home, felt financially unprepared, and did not know her due date. Because she did not have support from her husband or family her fourth child was delivered at home with the help of neighbors. After delivery she went to a dispensary right away. All four children were breastfed. the first one was introduced to solid foods at three months and the second one was introduced to solid foods at two weeks. the next two children were introduced to solid foods at six months.

Christine is 30 years old. She has three children, ages 18,13 and 6. her first pregnancy was not planned and she was not married. she was still living in her parents home. that child was delivered in a hospital as her parents were able to afford the hospital bill. Her next child was born on the way to the hospital but since she lived so far away she was not able to make it there on time. her friends helped deliver the baby and she went home immediately after. she had not visited a hospital until two weeks later. Her 3rd child who was also born at home with the help of the neighbors. she was able to visit a hospital two weeks later. Sadly, Christine was not supported very well especially by her husband, and so the financial burden was on her as well as taking care of the children.her first born was not able to attend secondary school because it was too expensive. She is hoping her 2nd child will be able to attend next year. She advises future mothers to visit the hospital when they can, eat a balanced diet, and find way to support the family.

Mercy is 20 years old with one 2 month old child. She was able to visit a true hospital twice while pregnant as well as deliver in a hospital. She did not spend much time at the hospital after the delivery and has only returned for immunizations. Thankfully, Mercy has had much support from both sides of the family and plans to stick to the advice she has been given to breastfeed and introduce solid food at 6 months.

Lydia is 30 and has 5 children ages 18, 11, 8, 6, and 2 and a half. Her three oldest were born to her first husband and the younger two were born to her current husband. With each child she was able to visit a dispensary 3 times during the pregnancy. The first child was born at a hospital in Nairobi, but because she could not afford the hospital, the rest were born at home. Each of the first 4 were breastfed and the last was not because he refused to. Because of this he was started on solid foods much sooner than the rest to limit the cost of formula. Lydia advises women to deliver in the hospital if possible and to make regular hospital visits during pregnancy.

Stella is 28 years old and has two children ages 3 and 3 months. Her husband is a builder. Both of her pregnancies were planned and she hopes to have more kids in the future. During her first pregnancy she was not able to eat well because she did not have an appetite. She ended up losing a lot of weight. During her second pregnancy she was able to eat better. She ate a lot more greens as she had been advised by the doctor. After her second child was born she developed a food allergy and needed to stay in the hospital for several days after delivery. Thankfully, for both pregnancies she was able to visit the hospital several times. Also, both kids were delivered in the hospital. Unfortunately, Stella’s family kept their distance after the children were born for fear that she would ask for financial assistance.

 

 

Also! We recently published a video of our work in Maara Sub County. Click below to learn more. 

Links:

This is the story of Ednah. Ednah’s story is a sad one, and highlights the importance of HopeCore’s Sexual and Reproductive Health Program and the Maternal and Child Health Program, and the need for the youth in this region to be more aware of the consequences for having unprotected sex. Ednah is 16. Upon hearing of her pregnancy, the father of the child, and her mother, rejected her. Ednah found herself homeless and pregnant.

Ednah gave birth to a healthy, happy baby boy in July 2016 year in Nairobi. But during labor, she was injured. The perineal wall was torn, and she suffered from feces passing through on both sides of the wall. Not wanting to return to school where the other children would mock her, she chose to live in squatters’ quarters at a tea farm. Due to the extreme pain caused by this tear, Ednah reached out to the family of a HopeCore nurse, who brought her case to our attention. It was believed that Ednah was suffering from a fistula. HopeCore identified St. Mary’s Hospital in Nairobi as one that would offer fistula surgeries free of charge. Once Ednah was actually examined at St. Mary’s, it was discovered that it was a torn perineal wall instead of a Fistula. She was operated on and was back at home within the week.

It is stories like these that demonstrate the need for the maternal and child health workshops, because who is going to teach Ednah how to care for her child if her mother has abandoned her? Furthermore, it demonstrates the need for our health hotline. Some women and girls have no other resources and therefore, the health hotline becomes even more necessary. From this experience, we highlight the intersection between our sexual and reproductive health program, and our maternal and child health clinics.

Below are some other quotes from women who have participated in our clinics: 

"The lectures that you offer are of great benefit to us. The family planning services and treatment offered also saves us from travelling far to get them."

-Stella, Murunga Primary School

"I came so that I could learn about how my child is growing and have my child be treated by HopeCore's nurses. Today, I learned that it is important to take my child to the clinic regularly for growth monitoring and family planning. I am very very happy with the services you have offered. Please come again soon."

-Annrita, Kieni Primary

Hello friends of HopeCore, 

While the basis of our programming is prevention and community health, every once in a while, we come across individual cases that we are compelled to act on. A few of these cases have been documented in the past through our website and blog

Each of these special cases is unique and comes with a new set of complications. In Kenya, the doctors were on strike for over 100 days in the first 3 months of this year. With doctors on strike, all public facilities were closed and community members had nowhere to turn. Now the doctors are back, but the nurses are still on strike in Tharaka Nithi County, where HopeCore operates. Therefore, the patients we have identified as needing specialized care need to travel further for treatment. 

At the same time, we also need to find out if our patients have national health insurance. If they are not registered, it takes up to 3 months before they can use their benefits. In addition to these two complications, patients seek many other barriers to quality care. 

In the month of March, through the assistance of a HopeCore friend and our mobile maternal and child health clinics, we identified two children with congenital cataracts, one child in need of surgery for an eye tumor, and another child with a massive tumor in the abdomen. Each of these patients will be transported to appropriate facilities to seek quality care in the month of April. 

We will keep everyone updated on their progress! 

 

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Organization Information

Village Hopecore International

Location: Chogoria, Eastern Province - Kenya
Website: http:/​/​www.villagehopecore.org
Project Leader:
Anne Gildea
Managing Director
Chogoria, Eastern Province Kenya
$6,158 raised of $75,000 goal
 
73 donations
$68,842 to go
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