We empower and educate the vocational way

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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.

It can be any woman’s struggle; Violated twice and almost gang raped.

Did you know that a rape victim is statistically more likely to get raped again than a female who has never been raped?  There’s no common denominator like- job, age or even neighborhood. It’s just that if it happened once, it’s more likely to happen again.

In a 1999 longitudinal study of 3,000 women, researchers found women who had been victimized before were seven times more likely to be raped again.

Vera*(not her real name) had just lost her parents at the age of thirteen and the future seemed so dark. Being the first born, she assumed the role of a parent to her siblings who were still young.

Luckily, she got a job as a house help and now her siblings could find something to eat. Little did she know that hell was about to break loose. One evening while she was going about her duties her employer’s husband raped her and threatened to take away her job if she dared say a thing.

This went on for two years without the wife’s knowledge and when she complained of experiencing pain, this man would only say isebet kitimo chode (you have been prostituting).

One fine morning, her Aunt decided to come for her and take her to school where her children were also studying. Her life had just begun to show some light and there was so much hope for the future, this time round nothing could go wrong.

One day after classes her teacher sent her to clean the chicken house and she went without hesitating, he later asked her to wash the dishes and this was another sad ending as she was raped again! Something she thought would never happen.

She sought for someone to confide in and at that time her uncle was the only one but too bad she was already pregnant and her teacher opted to marry her at seventeen.

Pain from the memories of her previous rapist were fresh in her mind whenever she got  intimate with her husband and this went on for two years till she felt she could not take it anymore. Her husband got angry and most times he would leave the house without giving her any money yet she had a baby to take care of.

This was not happening again, this time round she had to be in control, enough of all the pain! She decided to escape and rent her own house with her now two children. Her job was well paying, the only job this sad world had taught her and she did not care what anyone else thought-she was a prostitute!

Her job would end late yet with two young children she had to rush back home at odd hours. One night along the street he met with three men who wanted to gang rape her, she had to think fast.

“I have AIDS”, she yelled. Luckily enough two of the men who could not stand the thought of contracting the disease left and she was left with one who was very persistent. She later managed to escape with the help of a motorist passing by.

“I haven’t shared my story with any one till I came to Kmet to gain basic skills. My teacher has been very supportive and that’s why i decided to open up to her, she counseled me and even gave me a shoulder to cry on .I feel better now, I don’t prostitute any more”. She concluded.

In order to reduce occurrences of SGBV, KMET has come up with Freedom House (rescue center) to help tackle challenges young women face. It aims to educate and empower GBV victims as well as give them the opportunity to indulge, share and overcome experiences of abuse.

Ending the violence starts with you and that is why we encourage everyone to be responsible enough to report the cases at any nearest responsible center.

  You can also call us for free on 0800724500 or contact these numbers for help: Child line Kenya-116 and Health Assistance Kenya-1195.

If you wish to contact JOOTRH Gender based Violence Centre Call 07141388868 or beep for medical attention.

By, Beryl Onyango

Follow KMET KENYA on Facebook   and  Twitter

Reaping the benefits of quality health financing

Godswill Clinic

Public funding for healthcare is grossly insufficient and many small private clinics serving much of the population struggle to meet demand and finance badly needed upgrades and facility expansion.
Godswill Medical Centre located in Nyalenda informal settlement, Kisumu City is a small private clinic offering health care services to the underserved population drawn from Milimani and Nyalenda estates.
Since its existence in 2001 the facility has been providing medical services mainly to clients who  pay out of pocket.
When it opened its doors the facility offered only curative services. After partnering with KMET in the Medical Credit Fund program they have been able to introduce a number of services among them- youth friendly services, immunization, laboratory care, admission of maternity cases. The centre also provides outpatient services, minor procedures and cervical cancer screening.
Before joining the program the facility only offered basic health care services. Inadequate equipment, poor waste management and improper patient data management characterized the facility.
With time the facility  got a new face lift. They enrolled into  MCF and accessed 2.5 million shillings  loan. This facilitated the purchase of several medical equipment and expansion activities at the centre.

The Medical Credit Fund has a set of standards to rate  clinics as the initial step  is providing a process for them to improve the quality of care they provide. It also provides a technical assistance program around business skills to provide training on the job, to make sure they have audited financial statements.
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This loan helped them move from  two rooms to a spacious facility  adding a maternity wing, Director’s Office, waiting lounge and consultation room.
It has also benefited from several SafeCare training leading to its graduation from Level 1 to Level 2 during 2014 certification survey.
This means the facility has made step towards institutionalizing the provision of quality healthcare, improved staff attitude through team work.
The gradual expansion and provision of quality services gives it the chance to attain a centre of excellence certification in this new certification phase.

“We are helping these clinics build a financial track record showing they have borrowed money and repaid it, and that helps individual clinics,” explains Medical Credit Fund Managing Director Monique Dolfing-Vogelenzang

He furthers adds, “But we hope to reach a tipping point where this market of small clinics, which are providing so much of the health care in Africa, becomes interesting for banks.”

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.
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Menopause blood or Cervical Cancer?

At Ahono Primary School in Siaya County a long queue of clients waited to access integrated reproductive health services that had been brought closer home. It was a Huduma Poa community based event day set aside for contraceptive services, cervical cancer screening and HIV testing and counseling.

In the queue was Teresa Adhiambo, waiting patiently just like the other women for her turn to get into the room and see a reproductive health personnel. For the last two years Teresa has not been having her monthly periods until they reappeared in September 2014 with intense waist pains and continuous profuse bleeding.

Teresa Adhiambo aged 43 years is a widow with a perfect story of the ruggedness of life one wouldn’t tell by just looking at her composed self, especially on a day like this.

The mother of seven, the oldest being 16 years and the youngest 10 years, was widowed in the year 2000 after her husband succumbed to a fatal road accident.

The following year she was inherited by her brother-in-law according to the Luo customs. After only two years in union, her new husband and the co-wife passed on after a series of prolonged illnesses.

Out of a mixture of fear, suspicion and caution she went for a HIV test, this being the second time. She turned out HIV positive.

Teresa somberly recalls how she insisted that the brother in law and her get tested first before their union which he accepted due to her persistence. They both turned out to be negative then.

Her predicament distressed her each day as she questioned how she came to get the virus. She says she suffered a period of regrets, self-blame and desperation.

‘I had a feeling my brother in law knew his HIV status earlier and had struck a deal with the nurse in charge not to disclose to me when we went to be tested. I would never have allowed him to infect me because I have children to take care of’, she discloses.

While still on her path to emotional healing, another complication arose. Her monthly periods reappeared after two years of no signs of bleeding only that this time she experienced intense waist pains and continuous heavy bleeding.

When she could not ignore the condition anymore she went to seek medication and without being tested, she was prescribed drugs to reduce the pain. Her condition did not improve despite being on medication and she continued to bleed for three months.

She says a nurse once told her that those were signs of approaching menopause.

Her face fills with melancholy as she recalls how she had to sell a goat to buy medicine costing 1300 shillings yet she still lived with the worst agony a single mum without a source of income

On this particular day she had come to seek a second medical opinion after her sister who lives in Sagam informed her of KMET’s Huduma Poa event day at Ahono Primary School.

After a cervical cancer screening she was found to have an advanced cervical cancer and she has been bleeding because her cervix tissues had already become cancerous.

The news shook her. She went quiet for some minutes and the first thing she uttered during counseling was where she would get money for her medication since she was referred to the nearby Yala Sub-County Hospital for examination under anesthesia and possible biopsy for histology. To her, this was a great reprieve “I hope all will be well and thank you KMET, you should come out here more frequently to help people like me”

By Pamela Nyagol,

 

TB screening in prison saves warden’s family from infection

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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.

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