Women are dying not because we cannot treat but because societies are yet to decide that their lives are worth saving. This is especially because of stigma related issues associated with abortion.
Abortion stigma is a form of gender discrimination and punishment that represents social control of both women who seek abortion care services and health care providers who offer the services.
Stigma contributes to the idea that women who procure abortion are not morally upright.
Despite the fact that 300,000 abortions occur in Kenya annually, abortion is still ascertained as something wrong, inappropriate or deviant.
Women who have abortion are seen as sexually promiscuous, sinful and having violated religious norms. Fighting stigma is a daunting challenge but the first battle however is to look into the root cause.
KMET under the Stigma reduction project (STIREP), trained 15 healthcare providers in Kisii central sub county on the role they can play in reducing abortion stigma. 40 male champions were also mobilized and had focused group discussions where they gave their opinions on abortion stigma and how it affects their communities.
STIREP utilizes IPAs abortion stigma tool to measure its impact and to increase awareness of abortion stigma among providers, women, youth and communities while creating awareness on effects of abortion stigma at different levels.
Some of the consequences of abortion stigma include; secrecy, denial, guilt, self-induction and death. The stigmatized often feel disgraced leaving them with little power to access resources that can change their situation. At societal levels they are often excluded and marginalized.
According to KMET’s programs manager, Sam owoko, more awareness meetings with private and public sector providers are taking place. “Sensitization meeting with male champions in 5 counties where KMET is currently working on abortion issues is also ongoing,” he added.
Women should have the power and right to make their own decisions by laws, society and health systems. We shall have won the fight against unsafe abortion when no deaths occur, and no woman suffers negative circumstances against unsafe abortion.
MATERNAL ULTRASOUND BY MID-LEVEL PROVIDERS
Ultrasound equipment and training are rapidly improving and new ultrasound machines are far more affordable than ever before. Consequently, point of care ultrasound in the hands of front-line doctors, nurses and midwives is revolutionizing diagnostic capabilities in developed countries. However this has not been the practice in Developing countries. For this reason;
KMET in partnership with Massachusetts General Hospital, Harvard medical School USA and Sonosite is rolling out ultrasound knowledge and skills to mid-level providers in Kenya.
Currently the program is operating in Western, Rift valley and Nyanza provinces through the use of hand carried (portable) ultrasound machine.
The goal of this program is to empower mid-level health care providers with knowledge and skills on proper and effective use of ultrasound as a diagnostic tool to make early diagnosis of obstetric complications to ensure safe delivery and prompt action on complicated cases. This would in turn reduce maternal and child mortality rates as a result of late diagnosis leading to late decision making.
• So far 238 (Nurses midwives, Clinical officers and Doctors) health providers have been trained and are currently doing quality obstetric ultrasound in their respective hospitals.
• These scans have changed decision making leading to better care of clients.
• Strong partnership with the Government of Kenya on roll out of the program.
• The training of these providers has revived the use of ultrasound machines which were lying unused due to lack of radiographers.
UTERINE BALLOON TAMPONADE INTERVENTION (UBT)
Uterine balloon TOT team from Western & Nyanza Provinces.
In Kenya, the maternal mortality ratio is at 488 per 100 000 live births [KDHS, 2008/9] with the risk of dying being 1:20 . Close to 60% of all deliveries are conducted at home by an unskilled attendant and the Post natal care attendance within 48 hours of delivery is at 42%. PPH contributes to 34% of maternal deaths and it is the most common cause of maternal mortality in Kenya. It is therefore critical that health care workers expand their options of managing PPH. One such option is to help healthcare workers to master use of a uterine balloon for tamponade. Uterine balloon tamponade (UBT) is a medical technique used to control postpartum hemorrhage uncontrolled by primary interventions. UBT uses a balloon to apply pressure to the inside of the mothers’ uterus to stop bleeding after delivery. UBT can be performed with devices ranging from expensive, high-grade manufactured balloons to simple balloons made of condoms or rubber gloves.
In an effort to compliment the Ministry of health ‘s strategies to achieve the millennium Development goal(MDG)5; improve Maternal Health, MET in partnership with Massachusetts General Hospital(MGH),Harvard Medical School,USA is piloting the use of UBT with 12 private midwives to document evidence that UBT can alleviate hemorrhage and saves live. The facilities are based in Siaya, Kisumu and Nairobi.
• There has been successful usage of 17 UBT kits in managing PPH
• 14 TOTs from nyanza and western province (Reproductive health coordinators) from MOH/G.O.K have been trained on UBT. This will facilitate rollout of UBT in public facilities especially at the peripheries
Massachusetts General Hospital (Mass General or MGH) is a teaching hospital of Harvard Medical School and a biomedical research facility in Boston, Massachusetts.
36 residents of Nyalenda and Obunga slums got a boost in their income generating activities on Thursday 30th when KMET in partnership with CONCERN worldwide, an international NGO offered them business start-up kits. Completing
The population, majority being the youth received equipment for businesses such as tailoring, hairdressing, beauty therapy, catering, computer and information technology solutions, electrical engineering among others-each according to their areas of training and expertise.
Charles Odhiambo, CONCERN’s Kisumu urban livelihoods and social protection programs manager said that the beneficiaries of the project were identified through community conversation (CC) groups as vulnerable members of the community and were enrolled to various vocational training colleges in Kisumu.
“These are our brothers and sisters who in one way or another are deprived of basic education, healthcare access, and proper means of income, but were willing to learn and acquire business skills,” explained Mr. Odhiambo.
CC groups are a KMET initiated intervention that aims at providing communities with platforms to identify problems and own them. This is implemented through KMET’s urban livelihoods Programme.
Sam Owoko, KMET’s program coordinator says that this way the community interrogate existing developmental gaps, design community based solutions and implement them.
KMET trains community conversation facilitators that guide these meetings and help with group dynamics. The facilitators also work closely with community health workers to help address issues of health such as HIV/AIDS stigma and family planning.
In addition, KMET works to provide the communities with linkages to partners who are willing to help solve some of their societal issues.
Peter Muga, KMET, SACCO society manager says that community conversation groups provide a good opportunity to help empower societies’ economically and socially and as such CONCERN worldwide and KMET moved in to provide soft loans to members of the CC groups that were already running income-generating activities to boost their businesses.
The issuance of start-up kits for such demographics is the third of its kind to be offered by the two organizations, the first group of beneficiaries were from Nyalenda and were awarded in May 2012 while the second group were from Kasagam and got similar kits in August 2012.
Residents of Obunga estate woke up to a surprise clean up exercise by members of Kamakowa community conversation group on Tuesday 28th July.
Like most informal settlements around the world, a large portion of the estate is riddled with poor sewage and garbage disposal, which pose a great health risk to the residents especially children.
The group chairperson, Pamela Ibrahim says that most parts of the estate are in hazardous state due to poor sanitation, a predicament she attributes to Kisumu city council’s laxity to enforce waste disposal by laws as well as residence’s apathy towards the environment.
‘We have community based youth groups that sell garbage bags at twenty shillings inclusive of the disposal fee but some households still dispose of solid and liquid wastes on estate paths,’ laments Pamela. She adds that this requires not only intervention of the city council but also attitudinal change as a remedy.
Community conversation groups such as Kamakowa are a KMET intervention through its HIV, urban livelihood & social protection programs that support communities to form groups where they regularly discuss issues that affect the community, identifying gaps that need to be filled and offer solution on the same.
It is in such a forum that Kamakoa residents identified the filth in their environment as a threat to their health.
Rose Ogolla, KMET’s urban livelihoods Programme Coordinator, says that the community conversations (CC) that have been formed in 43 villages in Kisumu East District, purposes to achieve a holistic analysis of the communities’ situation and pave way for negotiations between segments within the community and with external actors which eventually leads to sustainable community driven development.
Members of such groups have also had massive capacity enhancement as far as economic issues are concerned. KMET through partners like CONCERN worldwide and other external actors have offered support in entrepreneurial training, soft loans, business mentorship as well as vocational training to youth members and member’s siblings who are unemployed.
Currently, the CC beneficiaries of the vocational training who have completed their course are receiving start-up kits to enable them launch businesses in their areas of expertise such as catering, hairdressing, computer technology and mechanics just to mention the four.
KMET-Corkran Clinic is staffed with a team of friendly, professional nursing and clinical staff. The clinic provides specialized diagnostic services like Maternal Ultrasound, Cervical Cancer Screening, Dental and Laboratory Services. A well stocked dispensing pharmacy is also in place and opens to the general public.
KMET-Corkran Clinic collaborates with KMET-Youth Friendly Clinic in HIV Testing and Counseling for its youthful clients. With the help of laboratory department, arrangement is in place to improvise an STI testing panel including HIV for referred clients from the Youth Friendly Clinic.
KMET-Corkran Clinic had a free cervical cancer screening as part of its integral health program for an early-detection effort for its members of staff. KMET Clinic medical staff urges eligible women to take advantage of the clinical cervical cancer screening at a subsidized cost. The free cervical cancer screening was however, only available on 13th May, 2013.
The following is a list of laboratory tests done at KMET-Corkran Clinic
1) H. pylori Antibodies – For Ulcer Diseases
2) Hepatitis B Surface Antigen – Just in case of liver infection presenting with jaundice
3) Complete Blood Count (CBC) Manual with Erythrocyte Sedimentation Rate (ESR) – To detect suspected cases of Anemia, Leukemia and other blood disorders secondary to infection.
4) For our diabetic clients we have Random/Fasting Blood Sugar package for you.
5) Gram Staining
6) TB diagnosis
For any inquiries, kindly call us at our clinic.
KMET in partnership with Medical Credit Fund (MCF), strives to improve the quality of health care services through provision of affordable loans to the private health facilities in western Kenya.
The private health sector in Kenya provides about 50% of all care to patients much as in other sub-Saharan countries.People turn to the private health sector since the public sector is often overburdened in service delivery.However,the private sector lacks access to capital due to poor qualification levels and cost of capital.The program aims at strengthening partnership between public and private health sector
QHFP Program sites in Kenya: Western, Rift valley and Nyanza.
Identification of health facility:
Health facilities are selected using snowball method, County Health Management teams (CHMT) and self identification .The already existing KMET network members identify other health facilities with potentials to offer quality and affordable health care services but who haven’t joined the KMET network yet. CHMT also help in identification The facilities which already belong to KMET network and already providing integrated health services are issued with the eligibility criteria to ensure they meet the basic requirements before being recruited into the MCF network. They then sign a participation agreement with KMET which stipulates the roles of KMET as the TA organization and the facility in the MCF program. The facilities further identify with the eligibility criteria by signing a participation agreement after which an expert opinion,situational analysis,loaning process,assessment, training,quality/business planning and certification are subsequently implemented.The proprietors are then offered technical support to achieve all the steps of the program through certification.
Entry loan provision:
After enrolment of the facility proprietors are issued with entry loans of up to a maximum Euro 4,000 to help them meet their immediate needs in the facility and assess their financial credibility.
The participants are trained on quality improvement and business planning to enhance their capacity to invest wisely with the goal of improving patient safety and client satisfaction.
KMET is a partner in the USAID APHIAplus Health Communications and Marketing (HCM) Program. The goal of this program is to improve the health of Kenyans through sustainable,country-led programs and partnerships.The Program with support from the American people through USAID seeks to promote access to and demand for quality;create demand in the utilization of quality health services,product and information to improve adoption and maintenance of healthy behaviours among consumers of health care.By the end of this program, Kenyans should see improvements in maternal,neonatal and child health,family planning and reproductive health,malaria,HIV and tuberculosis.For sustainability, the HCM program is strengthening local leadership, management and governance of the total Kenyan health market. KMET is implementing HCM in three regions: Nyanza, Western and Rift Valley.
Vision: To enable the government to harness the skills and energy of all the players in the health market in Kenya to deliver sustainable health improvements for all Kenyans.
ROLE OF STRATEGIC PARTNERS
Population Services International (PSI), Family Health International (FHI 360) and its Gold Star Network (GSN) will expand social franchising and improve the quality and scope of services offered by franchise.
Liverpool VCT, Counseling and Testing (LVCT) will expand its existing call center to provide individualized health information and counseling
PharmAcess Foundation- SafeCare will help the APHIAplus HCM team establish a Kenyan certification agency capable of certifying the quality of providers well into the future.
Centre for Behaviors Change Communications (CBCC) – Will facilitate training of KMET HCM team and CHEWs on SBCC. The CHEWs will then be expected to orientate/ refresh the CHW’s on task areas of: HIV, Family Planning, Malaria, TB and Maternal neonatal child health. This is also aimed at sharpening the skills of the CHW’s on social behaviour change communication (SBCC) since they will be involved in social marketing activities in the community.
As an organization that champion innovation in quality healthcare, KMET is, hosting 15 students from the United States in a 6-week study christened the Harvard Summer Program.
The 15 will be seeking to examine and understand the role of innovations and technologies in encouraging sustainable healthcare improvements in Africa.
Genevieve Purcell one of the coordinators of Harvard summer program says the aim of the program is to equip students with an in depth understanding of approaches to tackling healthcare challenges through the implementation of effective innovations and technologies that can have an immediate and lasting impact on the poor.
KMET has since 1995 been a front runner in providing underserved communities in Kenya with quality reproductive healthcare services such as family planning and maternal healthcare, a feat that has so far birthed a social health network of over 46 private health centres under the umbrella of Huduma Poa social franchise.
Liddy Dulo the program Coordinator of KMET’s African institute of Innovation and Technology (AIIT), applauds the partnership saying that it will aid in conceptualization of new and innovative health solutions that are locally relevant and scaled for impact.
KMET is hosting the Harvard summer program for the first time though it has been on going in Western Kenya annually and was hosted by the Great Lakes University in 2012.
Thomas F. Burke, the MD, Assistant Professor of Surgery, Harvard Medical School adds that The program is designed to accommodate students from all fields interested in the role of innovations and technologies to transform healthcare delivery in Africa.
“The six week intensive training course will be conducted through guided discussions, lectures, guest speakers, field work, assigned readings, and presentations by students,’’ explains the Professor.
The universities represented include Harvard University, Emory University, Brown University, University of Toronto, and University of Northern British Columbia.
For more information on the summer program, visit www.summer.harvard.edu