By Randy Rosenthal
BGR has partnered with Helen Keller International to strengthen the health system and reduce maternal and child mortality in densely-populated Kakamega County, in western Kenya.
Malnutrition is a major problem in Kenya, where nearly half of the population lives in poverty. That’s why Buddhist Global Relief has partnered with Helen Keller International on a three-year project to improve access, delivery, and utilization of essential nutrition-related services in Kenya. HKI is working with the Kenyan Ministry of Health and Action Against Hunger (AAH) to address Maternal, Newborn and Child Health (MNCH) and to combat poor nutrition outcomes in five Kenyan counties. BGR is supporting HKI’s ambitious effort to strengthen the health system and reduce maternal and child mortality in densely-populated Kakamega County, in western Kenya. The grant from BGR sustains HKI’s Kakamega program in its entirety.
The grant from BGR this past year—the second year of the project— enabled HKI to train 1,745 health workers and directly serve over 34,000 children (17,771 girls and 16,236 boys). This happened mainly through vitamin A screenings that detect early malnutrition. These screenings were part of the biannual “mother and child days” (Malezi Bora). These events sought to increase the number of children under five receiving vitamin A supplementation. Properly administered, vitamin A capsules can greatly decrease the risk of childhood mortality and blindness in areas where vitamin A deficiency is prevalent. Indirectly, through the support of the local health system, the project has served over 97,00 adult women and 64,00 children under the age of five.
Another positive result of the project is a large increase in the number of women receiving pre-natal and post-natal care. Iron folate supplementation was given to 40,603 women in June to December 2017, while 76,768 women received the supplements between January and July 2018. The project also enabled HKI to address the underlying structural and managerial weaknesses of the Kakamega health system that prevents mothers and their children from receiving the care they so desperately need.
Yet while these benefits are significant, the project was unable to meet the targeted numbers, mainly due to political unrest. For instance, there was a nationwide nurses’ strike from June to September 2017, as well as episodes of violence around the presidential elections from August 2017 through January 2018, both of which made it difficult for HKI teams to work. Cultural obstacles are also difficult to work around, specifically the traditional preference for home births and unskilled birth attendants. It was also reported that many pregnant women do not show up for appointments, and many pregnant teenagers hide their pregnancy, avoiding care.
To face these serious challenges, HKI works with the Kenyan Ministry of Health to develop a series of meetings and workshops with local communities, such as maternity open days, which raises awareness of Maternal, Newborn, and Child Health by inviting community members to health centers and learn about the available reproductive health services.
In addition to the Mother and Child week screenings, another component of the project is the baby-friendly hospital initiative (BDHI), which has as a goal support for the early initiation of breastfeeding. Women that attend these sessions can then share what they learn with their communities. Such crucial information includes how to hold a baby while breastfeeding, and the importance of exclusively feeding a baby breastmilk at least during the first six months of life.
The project also supported HKI’s assessment for improving the health system, audits that have helped determine gaps in data. The project trained health workers in forty-two health facilities on topics that improved the workers’ knowledge specifically in the gaps the project identified, specifically with lack of performance of immunizations.
In sum, BGR’s partnership with HKI has been instrumental in improving children’s nutrition, lowering mortality rates, and strengthening the Kakamega County health system. Continued funding of this partnership will allow these accomplishments not only to persevere, but continue to improve.
Adelaide is a first-time mother who has directly benefited from the training from the newly trained health workers. She said: “My name is Adelaide Aliko, we are a family of three: myself, the baby’s dad, and our baby. My baby is one month, one week old. I normally go to Kakamega General Hospital, about two kilometers from here. When I visited the hospital after delivery I was taught how to breastfeed the baby, how to position him, how to support him, and I was told the baby should be exclusively breastfeeding for six months, without giving him any other food. Before I received the education at the hospital I knew my baby would need to be breastfed, but I didn’t know it should be exclusive up to six months without any other food. I also didn’t know how to position the baby while breastfeeding, which we were also taught. They also taught me that I should eat at least four meals per day so that I can make milk for the baby. I am thankful for the health workers who gave us this information because so far, my baby is doing well and I have also regained my health.”
Catherine is the County Immunization Coordinator, and she was part of the team carrying out the Data Quality Audits (DQAs). From the DQA exercise, she was able to assess the causes of poor immunization coverage in the county. She developed action items to address this issue, including staff trainings (“On Job Trainings”), the use of correct registers, and a recommendation for holding meetings to review data before submitting data reports. She said that the project gave her “an opportunity to look at how they [health workers] store, arrange and manage their vaccines when I visited the health facility. The vaccine arrangement was not proper; some temperatures were abnormally low because of lack of knowledge on adjusting the thermostat. I felt if we got an opportunity to go through a training it could increase the knowledge among the health workers. I appreciated SETH [System Enhancement for Transformative Health] for the idea of incorporating immunization into the nutrition activities for me to go down and see what was wrong. Before that I did not know what was wrong with immunization and why we were performing so poorly.”
Randy Rosenthal teaches writing at Harvard University, where he recently earned a Masters of Theological Studies, with a Buddhist Studies focus. His writing has appeared in The Washington Post, The Los Angeles Review of Books, and many other publications. He edits at bestbookediting.com.