Kitui, Kenya–She was 14, pregnant with her first child and reluctant to talk about her situation. But that didn’t deter community health worker Mary Johnson from seeking out the teenager when she visited homes in the community of Kyondoni. Johnson, the mother of two children, knew the challenges and risks of giving birth, and the increased risks faced by pregnant teens.
“Kalekye (Mukungi) was in denial of her pregnancy and ran away each time I brought up the topic. But I never gave up,” Johnson said.
As a community health worker, Johnson goes door to door, educating women on prenatal care, safe birth practices and the importance of giving birth with a skilled provider at a health facility—all in an effort to reduce maternal and newborn deaths in this rural farming region in southeast Kenya. Trained through the APHIAplus KaMili project—funded by the U.S. Agency for International Development (USAID) and led by Jhpiego—Johnson and her fellow community health workers also discuss with pregnant women the topics of maternal and postnatal care, nutrition and family planning.
This community outreach in Kitui County is particularly important because women’s attendance at prenatal care clinics has been poor; less than 30 percent of women give birth at a health facility and maternal mortality rates are high. In addition to building the capacity of community health workers, the APHIAplus KaMili project also provides technical support to health facilities to strengthen services, enhance the quality of care and improve recordkeeping so more women will choose to give birth there.
“Doors were closed on our faces [initially]. However, we did not give up,” said Johnson. “We talked to expectant mothers and emphasized the importance of delivering with a skilled birth attendant.”
With Kalekye, Johnson’s repeated visits to her home and the health worker’s good-natured persistence paid off. “She agreed to attend her antenatal clinics as long as I accompanied her,” said Johnson, and Kalekye went on to give birth in a hospital to a healthy baby girl named Regina.
This young mother will not soon forget Johnson’s help.
“Mary is a lifesaver. If she had not intervened, I would have delivered at home. I could not have had the courage to go to the hospital as I was too embarrassed to be pregnant at my age. After Mary talked to me, I was able to deliver in a hospital with a nurse, exclusively breastfeed my baby and ensure she gets all her immunizations. I am also on a family planning method as I do not want to get pregnant again,” Kalekye said.
Inspired by Johnson’s support, Kalekye is now serving as a peer mentor and advising other young women about family planning and the importance of receiving antenatal care and delivering at a health facility. With the dream of becoming a teacher, Kalekye cannot wait to share the information she’s learned from the APHIAplus KaMili project.
“I do not want any girl my age to become pregnant due to lack of knowledge,” Kalekye said.
To date, the APHIAplus KaMili project has trained more than 1,900 community health workers in 38 community units across Kitui County. In addition, the number of women visiting the local health facilities for antenatal care and deliveries has increased dramatically.
The work in Kitui County is just one aspect of APHIAplus KaMili’s comprehensive and innovative approaches to building the capacity of health workers, strengthening health systems and engaging communities in “sustained improvement of health and well-being for all Kenyans.” This partnership of nine organizations works in collaboration with the Ministry of Health to improve maternal, newborn and child health and increase access to HIV/AIDS prevention and treatment services.