Like many women residing in Syumile Community Unit in Makueni county of Kenya’s Eastern province, Stella Mutuku gave birth to Dennis Musyoki Mutuku at home on April 2, 2011, with the help of a neighbour who’s only experience with child birth was the fact that she too had delivered her children at home.
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Malnourished baby Dennis before admission to Makindu district Hospital |
At birth, Dennis Musyoki appeared small and cried constantly due to the fact that his malnourished mother could not produce adequate breast milk for him.
Stella, a mother of three had lost her husband after a long period of ill health in December 2010. After the death of the family’s sole bread winner, Stella found herself in a new role but with no livelihood. Her only source of food was her small farm where she had planted a few food crops, but due to the semi arid climate in the region characterised by frequent rain failure, she has not harvested any food to feed her family. Stella and her family depend on food donations from neighbours and well-wishers.
With all residents of this area feeling the brunt of the drought, these food donations are sporadic hence Stella and her children often sleep hungry.
Three weeks after birth, Dennis had not put on any weight and that is when Stella suspected that something was wrong with his health.
“During my pregnancy, I had interacted with a community health worker, Jacinta Kimolo, who would visit me weekly to find out how I was getting along with the pregnancy. During one of her routine visits, Jacinta noted that Dennis was not putting on weight normally and gave us a referral note to Makindu District hospital for further examination. At Makindu, Dennis was diagnosed with severe acute malnutrition and was immediately admitted and put on nutritional support.”
Upon discharge from Makindu, Jacinta referred mother and son to Syumile Dispensary to access nutritional care where they received food supplements.
At six months, Dennis has improved, though not optimally. He weighs close to five kilograms and Stella admits that according to the growth chart, Dennis is not growing as he should
“I would love to see my son grow into a healthy boy but the reality is that I still do not have enough to support him and the other children. I however want to appreciate the role played by Jacinta Kimolo as a community health worker; otherwise Dennis would not be alive today!”
CHWs like Jacinta play a vital role in transforming the health of communities at the household level as stipulated in the Community Strategy.
Using the Community Health Strategy to achieve Lasting Health Change in Africa
As part of the implementation of the second National Health Sector Strategic Plan (NHSSP II), the Ministry of Health developed a Community Strategy to provide a policy guide for the delivery of the Kenya Essential Package for Health (KEPH) at the community level.
The community-based approach set out in the community strategy is the mechanism through which households and communities take an active role in health and health-related development issues. The initiative outlined in the approach targets the major priority health and health related problems affecting all cohorts of life at the community and household levels – level 1 of the KEPH-defined service delivery. Through KEPH, it is envisioned that households and communities will be effectively involved and enabled to increase their control over their environment on order to improve their own health status.
In order for this to happen, communities require continuous updating of knowledge and skills through familiar, reliably informed community health workers (CHWs) and community extension workers (CHEWs). The CHEWs are professionally trained health workers whose role is to supervise and monitor the progress of health care at Level 1, while the CHWs are the volunteers closest to the families and communities.
CHEWs consequently share their knowledge and skills with the CHWs and community health committees (CHCs).
AMREF has been instrumental in bringing the Community Strategy to life, especially in Makindu, Kibwezi and Nzaui Districts in Makueni county through the Africa Responds II Project, an integrated intervention targeting to bridge the gap between communities and the formal health system through strengthening them to increase and improve the quality of services and empowering communities to take care of their own health.
The project in partnership with the Ministry of Public Health initiated and supported implementation of the community strategy by building the capacity of 4 community health units (CHUs) with 200 CHWs to provide health education, first-line/primary care and referrals.The project has developed the capacity of 200 CHWs like Jacinta, in growth monitoring and nutrition to detect malnutrition within the community using Mid Upper Arm Circumference (MUAC) tapes
One key lesson learnt from the implementation of the Africa Responds II Project is that with political will, the community strategy can improve the health status of communities through the motivation of CHWs who are at the very heart of the realisation of the strategy.
More about the Africa Responds II Project
