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Tuesday, January 25, 2011

Healthier Lives for Mothers and Children in Kenya

After only four years of working among marginalized Pokot communities in the North Rift Valley of Kenya, HealthRight has made an impact:

  • Four times more women could name important danger signs to watch out for during pregnancy and twice as many women knew the signs of complications after delivery.
  • Dramatic increases were also seen in the utilization of postnatal care and neonatal care services.
  • Five times more women were breastfeeding exclusively.
  • Life-saving services like blood transfusions and antibiotics are now available in these remote areas because of HealthRight’s efforts.
  • Women now have the crucial information that they need to seek care during and after pregnancy.
  • Nearly three times more pregnant women were tested for HIV.


Background
Since 2006, HealthRight has been working to decrease the high rates of maternal and neonatal mortality and morbidity among marginalized ethnic communities in the North Rift Valley of Kenya. HealthRight worked with nine health facilities in the three rural Pokot districts to improve the quality of health services while also working with communities to encourage healthy lifestyles and promote healthy care-seeking behaviors.  Using the “Three Delays Model”, the program was designed to address the three critical delays that increase risk of maternal or neonatal death: delay in deciding to seek care, delay in reaching care and delay in receiving care.

Impact
After only four years, HealthRight’s work produced very positive results.  A recent evaluation showed that HealthRight has had considerable impact on access to basic and comprehensive emergency obstetric care for Pokot women. Life-saving services like blood transfusions and antibiotics are now available in these remote areas because of HealthRight’s efforts.  Along the way, the project filled essential needs in all of the health facilities by organizing a donation of medical supplies and equipment worth about $400,000.


HealthRight worked with the communities to increase health knowledge and promote healthy behaviors. HealthRight focused on using culturally acceptable and Pokot-language educational materials including a weekly radio program, three entertaining videos, a CD of songs from a popular local musician, and plays from youth theater groups.  In addition, HealthRight helped to train 250 community health workers responsible for working with families to attend to their priority health needs.

In August 2010, a household survey showed a statistically significant improvement for 81% of the project’s indicators over baseline and additional improvements in 67% of indicators since in 2008.  Most importantly, the evaluation results showed that HealthRight has provided women with the crucial information that they need to seek care safely during and after pregnancy. At the end of the project, four times more women could name important danger signs to watch out for during pregnancy and twice as many women knew the signs of complications after delivery. As a result, dramatic increases were also seen in the utilization of postnatal care and neonatal care services, and breastfeeding rates as seen in the graphs below.

Graph 1: Use of Neonatal Care Services in the Project Area

 

Graph 2: Use of Postnatal Care Services in the Project Area

 

Graph 3: Exclusive breastfeeding rates of children 0 – 5mos

Unfortunately four indicators, including women using skilled delivery services and antenatal care services, remained at 28%. However, health facility data shows a positive trend in the use of both of these services at the target facilities over the project period.

Table 1: Number of deliveries performed
at the nine facilities by month Sept. 2008 – June 2010

 

Equity
As a human rights organization, HealthRight works to ensure that all women have equal access to health care services and information. To measure this, indicators of socio-economic status were used to measure relative poverty in the communities and compare the level of knowledge and use of health services across all economic levels.  In health knowledge, there were minimal differences between the lowest socio-economic status level (poorest) and the highest socio-economic status level (richest), indicating equal access to health education messages across the entire population. HealthRight was also able to measure improvements in access to care for the poorest women in the communities. For example, in 2008, women at the highest socio-economic level were eight times more likely to deliver in a health facility than those in the lowest level. However, in 2010, women in the highest socio-economic status group were only four times more likely to deliver in a health facility than a woman in the lowest group. This shows more equitable use of facility delivery services than in 2008.