We empower and educate the vocational way

IMG_7250

 

Education of girls is essential in the drive by nations to achieve development goals.

Despite this fact, the girl child is often perceived and treated as inferior and has been socialized to put their needs second after everyone’s thus undermining their self-esteem.

Many girls hardly get the relevant type of education that would make them overcome the social, cultural and health challenges.

As a result many girls end up dropping out of school for a number of reasons. To empower such girls so as to attain knowledge and skills that help them make a change in their life, KMET came up with SFC (Sisterhood For Change) program.

The SFC program empowers girls to attain knowledge and skills that will improve their economic independence and soundness.

The goal of SFC is to increase access to livelihood opportunities and sexual reproductive health information/services to adolescent girls and young women from poor backgrounds.  Participants are trained in vocational, reproductive health or life skills besides hairdressing, dress making and food and beverage courses.

For those who wish to enroll and have children; no need to worry because KMET has also established a daycare facility to take care for the little ones as their mothers learn.

SFC works with a range of stakeholders into meeting some of its objectives. These includes the police, Government ministries, local administrators, community leaders, religious leaders, parents whose mandate is to provide ongoing support, guidance, contribute to the growth of the program and feedback to the KMET management on how best to improve quality of services offered at SFC. This forms a committee named the Youth Advisory Committee (YAC).

In addition, KMET offers referral sites on health related matters affecting the adolescent girls at SFC to bring in positive health seeking behavior among the adolescents and young women to reduce the social and structural factors that contribute to HIV vulnerability.

Once the participant is through with Vocational training they are placed in a 3-month internship, where they develop their vocational skills.

Courses Offered.

Food and Beverage  (6months)
Hairdressing Beauty Therapy  (6months)
Dress making  (one year).
The courses run for six months apart from the Tailoring course that runs for one year.

Intake is ongoing. If you wish to enroll please contact:
Jennifer Musuya
Email:j.musuya@kmet.co.ke
Cell: 0719364388
You can also reach us by visiting our website: http://www.kmet.co.ke or follow us on Facebook and twitter.

Defaulting TB medication puts you & your loved ones at risk

Jedida and her family together with KMET TB Reach Program Officer, Adriano Ngaywa (far right, white shirt) when he made contact tracing.

Jedida(blue tshirt, second right) and her family  when we made contact tracing at he house.

Jedida Atieno lives a modest life in Malunga village, Siaya County with her husband and seven children. The grass thatched house is evidently too crowded for the children- the eldest 8 and youngest 4 years old.  She and her husband are subsistence farmers.
In 2013, Jedida started feeling unwell a little more often. The persistent cough and night sweat continued even after buying over the counter medication for a while. She still experienced the on and off signs prompting her to seek further medical attention.
In June, she went to Siaya County Hospital where a sputum test turned positive for TB. She was then put on medication which was to run for six months. However, she defaulted having taken her medication for June, July, and August.
She had gone to a funeral and had overstayed for two months failing to take her medication as prescribed.
In December, Jedida gathered courage and went to Ngiya Mission Hospital where a sputum microscopy was done same for HIV test. Both tests turned positive.
She was initiated to second line treatment of TB from the month of December to August 2014. During this period Jedida  became pregnant.

KMET TB Reach Quality Assurance Officer, Dennis Nyaoko talks to Jedida Atieno when she visited one of the Huduma Poa facilities for assessmentWhen the baby was born she was started on isoniazid prophylaxis for six months to prevent her from getting TB from the mother.
The child kept on getting sick with persistent fever, night sweats and did not respond to Paracetamol. The little girl was frequently admitted to Siaya County Hospital between the months of June and September continuously losing weight.
Luckily in November, a Community Health Worker (TB agent) working in the KMET TB reach program visited Jedida’s house where she revealed her predicament. She told the CHW about the babies’ situation.

When the KMET Tb reach team visited the area the CHW led them to Jedida’s residence. From there they made an assessment for the child recommending contact tracing for the husband and the children. The child was then taken to the paedtrics at Ngiya Mission Hospital where she scored nine above the normal range that is seven on the Paedtrics TB score chart.
She was immediately put on TB treatment. With time her condition has improved, she has gained weight, the fever has subsided and she is now active like any other child at her age.

“Thank you KMET for coming to my aide, my condition is getting better. I would like to advice others they need to adhere to medication so as to fight the disease” Jedida says.

In 2005, its estimated 7.6 per cent of patients in Kenya defaulted from TB treatment.

Why nutrition and family planning programs need to be integrated

Finah Chemiat with her son Levy on her first visit to the clinic

Finah Chemiat with her son Levy on her first visit to the clinic

On the month of November while on routine supervisory visit in one of the Huduma Poa franchise facilitates in Trans-Nzoia County, I met Levy a 3 year old who was extremely malnourished.

His eyes were clear and full of life, only that his body betrayed the look in his eyes. He was frail and only weighed 7 kilograms. A child Levy’s age should be weigh 11 to 12 kilograms.
This day he was feeling unwell and had been brought to Seed of Hope Clinic for treatment by the mother.
The mother is a 22 year old housewife with two children; the first born being Levy and last born a 3 month old girl.
Finah and her husband live a modest life in a small center off Kitale town. The two dropped out of primary school and have no steady source of income. At times the husband works as a grounds man in the clinic compound.
The income he earns is insufficient to take care of his family’s basic needs he says. Their meals are mainly composed of ugali made of maize flour and kales; sometimes they take a mixture of beans and maize and Levy grew up taking lots of maize flour porridge for meals.
The boy was severely malnourished, which led to delayed milestones and stunted growth. He looked like a 6 month old child and when I talked to the mother to inquire about the possible causes of her child’s condition she said: “Nimejaribu kumlisha lakini sioni mabadiliko.” (I have tried to feed him but his condition has not improved).
After a lengthy conversation with Finah, she saw the need to call her husband who came from home and joined us in a health talk. I talked to the couple regarding nutrition and family planning in relation to quality of life since they were not on any contraceptive.
The husband was enthusiastic about the idea of contraception and encouraged the wife to start using any method of family planning but Finah said she would think about it. She felt that the health of her the boy was more of a priority this day.
Levy was referred to Namanjalala Health Centre for further management which comprises of nutritional counselling and food offered by prescription to the child.
After a month, Finah came back to the clinic a happy woman thanking the provider for the health messages we shared. She reported that the boy had improved and was in good health. She was ready to take up a contraceptive method and settled on a 3 year Implanon.

She was hopeful that her 3 months old baby will not be malnourished like the first born.
In the view of health workers, the primary cause of malnutrition is poor feeding, especially at the time of weaning and up to the age of five years.
Even though efforts are made to teach mothers the principles of a balanced diet and the importance of suitable weaning foods given frequently during the day, the ability of parents to provide the right nutrition plays a major role in managing malnutrition and emphasizing family planning as a way of spacing birth and controlling child birth to a number a couple can manage will come a long way in improving quality of lives.
The key to sustaining this momentum lies in the health education and mobilization forums that give the clients an opportunity to share their fears, myths, misconceptions and experiences about family planning and cervical cancer screening.
By Beatrice Amayo
Quality Assurance Officer, KMET

Bridging the gap of unmet contraceptive needs and cancer screening among HIV-infected women

Joshua Adhola, a Huduma Poa demand creation officer offers a health talk at Osani Heallth Centre during an event day.

Joshua Adhola, a Huduma Poa demand creation officer offers a health talk at Osani Heallth Centre during an event day.

“Three years ago, Kenya was ranked the fourth country with the highest HIV epidemic in the world. Although HIV prevalence among the general population has fallen in Kenya, women continue to be disproportionately affected by the epidemic.

Homa Bay County where I work as a Demand Creation Officer records the highest HIV incidence rate in the country with a prevalence rate of 27.1 percent compared to the national average of 5.6 percent according to the 2012 Kenya Aids Indicator Survey Report (KAIS).

The survey also indicates that 6.9 percent of women were living with HIV compared with 4.2 percent of men. With these facts in mind, most health interventions in the county therefore focus on reducing the prevalence rate.

Located in Ndhiwa Sub County, approximately 45 kilometers from Homa bay town is Osani Community Health Centre which is one of the health facilities in the County that offer comprehensive care to HIV clients.

Client queue to receive health services at Osani Community Hospital

Client queue to receive health services at Osani Community Hospital

Being a member of the Huduma Poa social franchise some of the other core services offered at the facility include family planning; HIV Testing and Counseling; and Prevention of Mother to Child transmission of HIV.

The nurse in charge of the facility acknowledges that since they joined the franchise in 2012, clients accessing family planning services have been on a steady rise which she attributed to the Huduma Poa event days.

Despite the gains, there had been a forgotten group in provision of family planning and cervical cancer screening services. Initially the facility attended to HIV positive client who are on care and treatment without any deliberate attempt to directly involve them in the activities of the event days.

Conversely during the last quarter (October –December, 2014), clients from the HIV care and treatment centre were involved in the event days that were held in the facility. The change of tact resulted to more women who are aware of their HIV status receiving implants and other contraceptives as well as cervical cancer screening.

As we get into a new year we purpose to strengthen the ‘Supermarket approach’ so that HIV care and treatment and reproductive and child health services are not seen as independent services in the facilities but mutually inter-dependent. Going by the lessons of the last quarter, attempts to deliberately target known positives should be scaled up.

This will be in tandem with Kenya Aids Indicator Survey Report (2012) which recommends that, efforts should be directed at further reducing the unmet need for family planning, with a focus on HIV-infected women and that there is need to scale up cervical cancer screening in women of reproductive age— among both HIV-infected and HIV-uninfected.

By Joshua Adhola, Demand Creation Officer, KMET

Rose’ story of poor housing conditions and risk of TB infection

Rose’ family at her house during a contact tracing follow up visit by the KMET team

She wakes up very early in the morning to prepare breakfast for the seven children she lives with in her house at one of Kisumu’s informal settlements. She then kneads dough that she will later on use to make chapatti by the roadside.
Rose a 38 year old single mother lives in Nyawita where she cooks and sells chapatti for a living. The mother of two; eldest child 10 and the youngest 2years, is also HIV positive and shares the predicament of most slum dwellers in terms of housing.
Rose’ house is nothing different from most of the houses in her neighborhood, it’s not only modestly limited in space but has neither windows nor ventilation. Rose is a mother of two but lives with four of her elder sister’s children together with a younger sister who also has a child.
In the year 2006, Rose was diagnosed with TB after she could not bear a persistent cough and tremendous weight loss despite using antibiotics that was prescribed for her in a pharmacy.
She dutifully took her medication for eight months and recovered.
Eight years down the line, she was spotted at the roadside where she cooks chapatti by a KMET community health worker (TB Agent), Damaris Akinyi, who had noted that Rose had been coughing for a while.
Damaris booked a date with her and together with KMET’s TB Reach Programme Officer, Adriano Ngaywa’’, they paid her a visit in her home.
Rose and her younger sister were given a health talk, screened and they happened to present TB symptoms like chest pains, sweating at night and coughing.
They were referred to KMET’s Corkran clinic for further lab tests where Rose was once again found to be TB positive and immediately initiated into medication. Her sister on the other hand was negative.
Given the nature of their house and the number of occupants, the children were at high risk of getting infected hence they were later screened too and fortunately they were TB negative.
Rose say she is not ignorant about the importance of proper aeration in TB prevention and her only plea is to the landlords of the slum houses to install windows since even if she wanted to, she cannot afford well built houses. Adriano says the area is considered a key population since statistics show that majority of the residents are HIV positive weakening their immune system hence making them susceptible to TB infection.
In the subsequent quarter, KMET has planned to carry out outreaches in the area and other informal settlements within the city to give TB health talks, screening and collect sputum samples from door to door.
.

TB screening in prison saves warden’s family from infection

jela ya saya

She was on her official day-off, she planned to relax at home and catch up with her children but then she heard that a medical team was coming to test in-mates and staff of tuberculosis. She abandoned her initial idea and reported to Siaya Prison.

32 year old Maria is one of the few female wardens at the correctional facility based in Siaya County. She had been coughing and experiencing chest pains. She had gone to a nearby pharmacy and bought some septrin tablets which she took for a week or so.

Her condition did not get any better and she had trouble sleeping citing discomfort and experiencing night sweats. “I used to cough so much and sweat a lot at night just like a work mate of mine who was once diagnosed with TB,” she says.
A month before this day she had visited a clinic within town and later on was referred to a government facility where she was diagnosed with pneumonia and started on antibiotics. The mother of two notes that though she had a slight improvement after taking the antibiotics, she was still worried at the slow progress of her recovery.

The team of medics from KMET TB Reach program in collaboration with the Ministry of health officials in Siaya camped at the facility for three days talking to staff and inmates about tuberculosis infection, management and prevention as well as screening them for the infection.

mariah siaya

Maria willingly accepted to be screened for TB on the first day since she wanted to ensure whatever was ailing her was not TB. She did not wish to infect her family, especially her six months old baby having learnt that it is an airborne disease.
She was scheduled for tuberculosis tests. The results came the following day and unfortunately her fears were confirmed; the tests were positive.

To ascertain that the family was safe, Maria’s husband and two children were requested to come for Tb screening and tests to ensure they had not contracted TB too. The tests were negative

Maria was started on anti TBs and her six months baby was put on drugs too in a bid to reduce chances of the baby contracting TB from the mother.

Maria had been misdiagnosed and was on the wrong drugs for a month. Denis Nyaoko, the KMET TB-reach program coordinator confirms that there are other diseases with similar symptoms as TB such as pneumonia, bronchitis, or influenza.
In Kenya Approximately 3 million cases go undetected each year and the country is ranked 15th among the 22 high burden countries that collectively contribute about 80% of the world’s TB cases.

Denis says they are taking services to people in prisons and even slums ‘key population’ since their environment make them to be at high risk of TB infection and due to lack of information as well as misconceptions about TB, rarely take the initiative to walk into a facility for screening until it is late.

He adds that a well aerated environment is key in preventing TB infection, yet it is one thing that the people within the key population group find a luxury too expensive to afford.

By Dennis Nyaoko.

A closer look at Huduma Poa Sky (Telemedicine) Project

LInda Adero, a tele-medicine Nurse Counselor making a tele-consultation at the Central Medical Facility based at KMET Health Complex

LInda Adero, a tele-medicine Nurse Counselor making a tele-consultation at the Central Medical Facility based at KMET Health Complex

Kisumu Medical and Education Trust (KMET) in collaboration with World Health Partners (WHP) runs a Telemedicine based project in Kisumu and Siaya Counties dubbed ‘Huduma Poa Sky’ (HPS). The project utilizes the medical Knowledge, skills and experience of a medical doctor based at the Central medical facility (CMF) at KMET Complex to reach patients in 7 Sky Health centers mostly Huduma Poa Clinics.
In order to carry out tele-consultations, the Sky centers and the CMF are connected via internet and cellular technology. The clinics are manned by nurses and Clinical officers who also work with a network of Community Health Volunteers (CHVs) attached to the Sky health Centers. The role of the CHVs is to refer clients and where necessary and practical also make house calls to connect patients at the comfort of their homes with a medical Doctor. Once the patients are consulted, diagnosis, request for laboratory investigations and drug prescriptions are sent electronically. The patient gets the drugs from the sky centers and follow ups are done from the CMF.
Since its inception in late June 2014, the project has carried out 287 successful tele-consultations resulting into better patient care and treatment. The project intends to have 3 additional Sky Centers in the region and increase the number of CHVs attached to the facilities to a minimum of 6 per facility. In addition the project will bring on board Medical consultants and specialist on specific days, apart from equipping the CHVs with affordable drugs to dispense at the community level. The ultimate goal of this initiative is to reach the undeserved population with quality health care within a walkable distance.
By Daniel Omolo (HPS Project Team Leader)