This is part of an occasional series of articles on the impact of MCHIP, the U.S. Agency for International Development’s flagship Maternal and Child Health Integrated Program, which is led by Jhpiego.
Bondo, Kenya–Beryline Okoth, 20 years old and very pregnant, is perched on a wooden stool outside of her tiny mud hut, scrubbing pots. Francisca Aluoch, a community health worker, has been visiting this house every month since she discovered Beryline was expecting. On this early April day, after a brief exchange of pleasantries, Beryline invites Francisca into her tidy home to discuss her progress. During today’s visit, Francisca will talk to Beryline about malaria, the symptoms to look out for and how to protect herself and her unborn baby from this disease that is especially dangerous for pregnant women.
Francisca has been visiting families in her community every day for the last seven years. Her journey to become a community health worker began with a personal tragedy. “My last-born son died of malaria when he was only two months old,” Francisca remembers. “We lived too far from the hospital and my mother-in-law was against hospitals,” she recounts, her voice quivering. “My baby died in my arms. I was depressed for a very long time; if I only knew then what I know now, my baby would still be alive.”
Francisca is one of 363 community health workers trained under the U.S. Agency for International Development’s flagship Maternal and Child Health Integrated Program (MCHIP) in Bondo to improve the health of women and their families. The project is led by Jhpiego. In Kenya, as well as 14 other countries, Jhpiego is building the capacity of community health workers to prevent and treat malaria in pregnancy, as well as using comprehensive, innovative approaches to strengthen health systems and defeat malaria.
The community health workers learn about environmental control, malaria health education and how to hang insecticide-treated mosquito nets to engage communities in caring for their own. “The skills I have received [from MCHIP] are what make me most proud. I know what I am doing and I am confident. Even if a client challenges me, I know what to tell them,” Francisca says.
MCHIP also works to increase the knowledge of health care providers on malaria case management and how to administer lifesaving, anti-malarial drugs during pregnancy to ensure that mothers are well cared for.
“I don’t want what happened to me to happen to other mothers,” Francisca insists, “so I will always go out of my way to ensure that the expectant mothers in my community get the care they need.”
MCHIP’s partnership with government health officials extends the impact of preventing malaria in pregnancy in Bondo beyond this one dedicated health worker. Although malaria remains the leading cause of death among children and pregnant mothers in Bondo, district health officials have seen an increase in the numbers of women accessing potentially lifesaving health services.
Dr. Julius Oliech, the District Medical Health Officer, says that three years ago the health indicators in Bondo District were very poor; only 19 percent of pregnant women accessed the minimum of four antenatal care visits. Today, 50 percent of women access antenatal care. The lifesaving malaria drugs that mothers take during these visits play an essential role in reducing the impact of malaria in Bondo. Oliech says that there has been a big reduction in the number of patients coming in for malaria treatment: “Previously, our wards were filled with malaria patients; now, we are seeing less malaria cases. This improvement in health indicators is a direct result of MCHIP’s interventions at facility and community level.”
The role of community health workers in Bondo has been very important because of challenges in understaffing. Oliech says the community health workersare able to sensitize the community and refer patients to health facilities where they can receive specialized treatment and help defeat malaria.