Huduma Poa Health Network Kenya: Who are we and What do we do?

Huduma Poa Health Network is a social franchise ran by Kisumu Medical and Education Trust-KMET through the support of USAID in partnership with PS-Kenya and the Ministry of Health. The franchise was officially launched on January 30th 2013.

The network is currently made up of 80 privately owned Health Facilities serving urban and rural undeserved population with 63% rural and 37% urban distribution.

Huduma Poa operates in 15 counties drawn from the former Nyanza, Western and Rift Valley Provinces.

The network aims at harnessing skills and energies of private health providers to integrate health services & ensure their facilities are a one – stop shop for the target undeserved communities.

To realize this, the Franchise builds capacity of healthcare providers through workshops, quality assurance and on job training based on Ministry Of Health Standard operating procedures to enable them offer:

  • Family planning method mix;
  • HIV counselling & testing;
  • HIV care and treatment
  • Prevention of mother to child transmission of HIV/AID
  •  Cervical cancer screening,
  •  Integrated management of childhood illnesses
  • and TB case detection, treatment and follow-up

The franchise has an established demand creation component comprising of 160 community health workers and 5 demand creation officers mandated to forge linkages between the facilities and target communities to promote demand for and access to the health services in line with Ministry Of Health’s community strategy.

Within a period of 2 years Huduma Poa has reached to 143,000 women of reproductive age with integrated Reproductive health services and information through:

Huduma Poa Service Delivery Points, Huduma Poa Days, Community Health Promotion Sessions & Outreaches.

For more info, visit our website KMET.

By Emmanuel Oyier  Twitter: @owyier

The Dilemma of Abortion in Kenya

abortion infograrhSixteen year old Truphena discovers she is pregnant two months after schools re-open from the April holidays. For the second time she has missed to see red.
The form two student lives with her aunt and uncle in Luanda, a small town in Western Kenya. Her boyfriend with whom she has gone intimate in a few occasions is a form one student at a boy’s boarding school in Siaya County.
Truphena a total orphan is disinclined to keeping the pregnancy because she does not want to disappoint her family. She fears that her uncle who has struggled to support her and her two siblings throughout her childhood may stop paying school fees or might even send her away from home.
She can’t imagine living through the ridicule she anticipates from her peers and the unkind words from teachers in school. She confides in a friend from her class who offers to help her out.
Truphena is referred to an old lady- a herbalist, a short distance out of town. She is given about a litre of what she describes as hot mixture of herbs to take. “You will experience some bleeding for one to two days then you will become a girl again,” the old lady tells her.
Three days later Truphena is still bleeding and begins to experience backaches and abdominal pains. She gets terrified recalling a few stories she had heard from the village of girls dying from such encounters. Her friend offers no help and she is left with no option but to talk to her aunt.
I had the opportunity to meet Truphena a week later when she came to a health centre in Kisumu where I work as a communication and marketing officer. She came to thank the nurse who attended to her for saving her life and for a counselling session on contraceptive options for the youth.
According to Celestine Gambo, the Nurse in charge of the KMET Youth friendly Clinic, had Truphena’s family delayed, she would have developed septicaemia; a condition that results from the body cells being infected as a result of decomposing products of conception in the womb. She would have lost her womb or worse her life.
Truphena is not an isolated case, she forms part of the over 300,000 unsafe abortion that Kenya records in a year yet the emotive abortion debate goes on and on with little or no tangible interventions being adopted by the ministry of health.

The kind of discourse we engage in with regards to abortion deals with the rights and wrongs within moral corridors and the confines of the laws of the land. Questions like: is abortion morally wrong? What does the Kenyan law rule on abortion? How does a health provider determine a woman’s life is in danger because of the pregnancy, and how do we decide whose rights should prevail? Shall never be concluded.
However the government and partners in the private sector can make sure that every Kenyan woman does not find herself in a predicament that elicits such questions by jointly implementing the national guideline for provision of adolescent, youth-friendly services drafted in 2005, to bolster sexual reproductive information which has been kept under the rags for long.

Taming costs in accessing quality health services

Community Health workers assist in regestering ckients at Ahero Medical Centre

Community Health workers assist in registering clients at Ahero Medical Centre

Prohibitive costs often affect access to quality healthcare services. In public health facilities where the costs of accessing care is relatively lower as compared to the private sector, congestion and higher patient to doctor ratio causes general apathy for clients accessing services thus leading to more time being spent on long queues and exhausted medical staff. This may compromise quality of services in these facilities.
In private health facilities, accessing quality healthcare is a function of one’s ability to afford the same. Huduma Poa health facilities being in this category of private facilities are also faced with the same challenge. Apart from corporate clients who can access healthcare with the support of health insurance covers, the rest of the clients who visit these facilities pay for services directly from the pocket.
When KMET established the Huduma Poa social franchise, the goals towards which this vehicle was driving, were; access to healthcare; Quality in service provision; Equity, and Cost-effectiveness. The costs of accessing healthcare is increased by different factors, key among them being cost of labor (staff), procurement of commodities and rent for facilities that do not have permanent structures.
KMET has sought to link its network of providers to the Ministry of Health to procure commodities for the supported services or directly to KEMSA.
Ahero Medical Centre has embraced a strategy that ensures its clients get intra-natal and family planning services at subsidized rates. Unlike in most private facilities countrywide where the cost for utilization of long acting and permanent contraceptive methods (LAPMs) range from Ksh200 to Ksh 5000, the Output Based Activity (OBA) cards used at Ahero Medical has made access for easy. Clients only pay registration fee of Ksh 100 to utilize the integrated reproductive health services.
Huduma Poa community health workers from two community units (Kakmie and Kobong’o) help in the mobilization of clients and recruitment of clients to acquire the OBA cards. The use of these cards have greatly improved the access to long acting methods of family planning at the facility among other reproductive health services. Prohibitive costs are no longer a challenge in the provision of quality family planning services at Ahero Medical Centre. The use of the OBA cards is a revolutionary strategy
Joshua Adhola
Program Officer, KMET

More teens seek for long acting and reversible contraceptives to avoid dropping out of school


In a village, 30 kilometers away from Migori town, a mother and her daughter of 15 years walks into a dispensary for family planning services.
Benta Aoko, a housewife and mother of eleven children visits Kopanga Dispensary after getting word from Huduma Poa Community Health Worker that there is a health event offering reproductive health services.
Benta’s worry is not only her expanding family but her 15 year old daughter who she believes is sexually active and may end up with a pregnancy.
“My daughter is in class seven and I would not like her to drop out of school, please talk to her,” she appeals.
The Daughter-Immaculate Achieng is the second born of eleven children while the first born, a boy aged 17, had dropped out of primary school.
The nurse counsels Benta who settles on a non-hormonal IUCD for birth control saying that she likes the fact that it can help her avoid pregnancy for over 10 years.
The daughter while having a separate session with the nurse confesses that she has a boyfriend having a sexual relationship.
Immaculate and her boyfriend who is also a student haven’t been using any contraceptive.
She says, she knows of friends who use injectable contraceptives but she has never tried it herself. “Some girls around here go for Depo but I haven’t tried it,” she acknowledges.
After undergoing a pregnancy test and counseling on sexual reproductive health, Immaculate also chose an IUCD as her preferred method of contraception.

gau and client

“I am happy because I know I will give birth only when I want and I thank the nurse for talking to the girl,” Benta beams.
She however, expresses fears that her husband would not be pleased to find out that their daughter is on birth control.
Elsewhere in Siaya County, 16 year old Consolata Adhiambo walks into Ngiya Dispensary purposely to get a contraceptive. Like her counterpart in Migori County, she has ever had that talk with her mother regarding early pregnancies.
Consolata Adhiambo is a form two student and says she has seen a number of her peers drop out of school never to resume again due to pregnancies. She does not want to go down that path. She wants to complete her studies uninterrupted and one day become a teacher though she has a boyfriend.
She tells me that her mother has always insisted that prevention is better than cure and advised her to come to the dispensary and seek for a birth control method. 38
Consolata is lucky because on the particular date, a team of health providers from an indigenous NGO, Kisumu Medical and Education Trust had come to the Dispensary to support provision of family health services and reproductive health education.
She was attended and chose on an implanon to prevent her from conceiving for 3 years.
According to the 2008-2009 KDHS data, 42% of women aged 15-19 years in Migori County have begun childbearing while at least one in ten (10 per cent) women aged 15-49 years have had a live birth before age of 15 in Siaya County.
Each year worldwide, an estimated 13 million births take place among young women between the ages of 15 to 19. In Kenya every year up to 13,000 girls leave school due to pregnancy. In fact, teenage pregnancy is one of the reasons why girls leave school in many parts of this country.

By Emmanuel Oyier,

Huduma Poa Holds Review Meetings in Kisii, Kisumu and Homabay

Members of the KMET Huduma Poa Health Franchise have come together in the third quarter of the year to jointly reflect on their combined efforts and contribution to the USAID Health Communication and Marketing (HCM) program deliverables.

The reviews focused on facility and community performances for a period of 1 year (year 3 of HCM implementation) bringing together community health workers, health providers and members of the Ministry of Health who focused their discussions on demand creation and quality of service delivery data generated from various communities and franchise facilities.

During experience sharing in three of such review meetings in Kisii, Kisumu and Homa Bay regions it came out strongly that health providers need to nurture and sustain a good working relationship with Community Health Workers (CHWs) for successful referral of clients and creation of demand for health services.

The Huduma Poa Health Network uses CHWs to reach out to members of the community with health promotion messages, to mobilize their communities during health events and to refer clients to the franchise facilities.

Members of the Ministry of Health lauded KMET for actively involving CHWs in the private health sector and training them on key health messages tailored for the communities they serve.

“I am happy that community health workers in my area are well equipped with information aides like family planning counselling bags for community health education. Good work KMET,” exclaimed Joel Milambo the Community Focal Person, Bondo Sub County.

In order to strengthen the synergy between the MoH and the private health sector, social franchise providers were prevail on to continuously submit their performance reports, forecasts and commodity order reports to the ministry of health to ensure reliable and continuous supply of health supplies to the private sector.

KMET Huduma Poa has harnessed the relationship between the ministry of health and the clinics within the Huduma Poa network so that they are able to get free contraceptive and other medical supplies from the government for free provided they document and report those services.

Huduma Poa is yet to hold the last of its review meetings this year for the Western Kenya region on 31st October.

amos onderi








By Emmanuel Oyier

Ziba Ufa Launch

KMET in partnership with Simavi yesterday launched the Ziba Ufa project in Migori County, a project which intends to reach the youth with sexual reproductive health information in Kisumu, Migori and Siaya counties.
While launching the project, the Migori Deputy Director, Wafula Nalwa said the project is very relevant and timely since youth are getting lots of sex information via the media and there is need to equip them with the right information.
“Our youth today have a lot of sexual reproductive health challenges because of the messages they get from the media. We must step in and help them because if we don’t, someone will.” Said Nalwa
Nalwa added that the telemedicine concept that the project will be employing to reach the young people with the SRH information is well thought of because, majority of the youth today are IT informed, hence can willingly and frequently access services.
Migori Women Representative, Eunice Bosco ,appreciated KMET’s efforts in reaching out to the youth and said that the use of telemedicine gadgets, would enhance confidentiality and reduce the stigmatization youths have when they to walk into facilities to seek RH services.
Caro Nyandat, KMET’s Reproductive Health Coordinator pointed out that the project intends to set up three youth friendly model facilities in Uriri, Migori and Awendo sub-counties.
She noted that with the incorporation of telemedicine, there should be improved uptake of voluntary counseling and testing services, access to STI treatment, safe delivery, contraceptives ARVs and above all, information on SRH to the youth.
A demonstration on how telemedicine works graced the day as the audience got amused when one of the youth was able to connect to and get services from a provider in Kisumu.
In attendance were stakeholders from the Ministry of Health, Ministry of Education, student leaders from Rongo University College, students from nearby primary and secondary schools and youths from various youth groups.
By Lynette Ouma

 A demonstration of how the telemedicine technology works

A demonstration of how the telemedicine technology works

Breast cancer fight begins with you and me……get screened now!


October is a profound month in the medical world. It’s tagged the Breast cancer awareness month. It’s normally a period to take stock and reflect on the fight against breast cancer in the world.
If you have lost a dear one, the feeling, the agony is tormenting. Seemingly if you have seen some you know suffer this ailment, you can relate.
Breast cancer is normally associated with women compared to the male folk. In the United States this cancer is most common in women aside from skin cancer.
The self-help literature and media like videos always tip to a lump on the breast, you and I can attest to this.
What is breast cancer?
It’s a malignant tumour that grows in one or both of the breasts. It develops in the ducts or lubes (the milk producing areas of the breast)
Why do women develop breast cancer more often?
The hormone in a womans body that is estrogen and progesterone increases the development.
Estrogen triggers cancer cells to double. Interestingly, estrogen can cause the breast cancer cells to double every 36 hours. Progestron triggers the cells known as stromal cells to send signals for more blood supply which leads to feeding of the tumour.
Are breast cancers the same?
There exist different stages based on the size of the tumour and whether the cancer has spread. It’s important for doctor and patient to know the stage of the cancer as it helps in making treatment options
How can I identify breast cancer, what can I look for?
The most common sign would be a lump, abnormal thickening of the breast, change in colour or shape of the breast.
Other signs
• Dimpling or puckering of the skin
• Swelling , redness or warmth that does not go away
• Nipple discharge that starts and appears only on one breast

What’s the situation in Kenya?
In 2012, Kenya established a National Cancer and Prevention and Control Act making it one of the few countries with legislation for cancer. This development means the Ministry of Health called for revenue allocation for cancer control in the government budget.
A faulty national health insurance plan which hinders access to medical care compounded by apathy and lack of access to accurate information makes screen rare and cancers undetectable.
Myths exist with belief cancers are curse from the ancestors and elders
What is the treatment for breast cancer?
Patients with breast cancer have many treatment options. Most treatments are adjusted specifically to the type of cancer and the staging group. Treatment options should be discussed with your health-care team. Below you will find the basic treatment modalities used in the treatment of breast cancer.
Most women with breast cancer will require surgery. Broadly, the surgical therapies for breast cancer can be divided into breast conserving surgery and mastectomy.
Breast-conserving surgery
This surgery will only remove part of the breast (sometimes referred to as partial mastectomy). The extent of the surgery is determined by the size and location of the tumor.
In a lumpectomy, only the breast lump and some surrounding tissue is removed. The surrounding tissue (margins) are inspected for cancer cells. If no cancer cells are found, this is called “negative” or “clear margins.” Frequently, radiation therapy is given after lumpectomies.
During a mastectomy (sometimes also referred to as a simple mastectomy), all the breast tissue is removed. If immediate reconstruction is considered, a skin-sparing mastectomy is sometimes performed. In this surgery, all the breast tissue is removed as well but the overlying skin is preserved.
Radical mastectomy
During this surgery, the surgeon removes the axillary lymph nodes as well as the chest wall muscle in addition to the breast. This procedure is done much less frequently than in the past, as in most cases a modified radical mastectomy is as effective.
Modified radical mastectomy
This surgery removes the axillary lymph nodes in addition to the breast tissue.
Depending on the stage of the cancer , your health-care team might give you a choice between a lumpectomy and a mastectomy. Lumpectomy allows sparing of the breast but usually requires radiation therapy afterward. If lumpectomy is indicated, long-term follow-up shows no advantage of a mastectomy over the lumpectomy.
Written by Don King
Additional information sourced from