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Building a Sustainable Community Health System - Kenya

By Narayan Chetry (2019 UNC Chapel Hill MPH Intern)


As a Masters in Public Health in Maternal and Child Health(MCH) candidate and a Rotary Peace Fellow, I have the opportunity to learn about the various health issues of mothers, newborns and children. In my studies, I focus on peace and conflict resolution through mediation and negotiation. Coming from the state of Assam, a backward and remote part of India, I have witnessed conflict situations and found that the common sufferers, due to such conflict, are the maternal, newborn and child populations. After completing my degree, I would like to bring peace through my work by improving the health of such vulnerable populations.

This summer, I have the opportunity to work with an international non-profit organization called Curamericas Global, based in Raleigh, North Carolina. Curamericas also has an international project site in Kenya. I am currently working on a project at this site, which includes training Community Health Volunteers (CHV) to utilize resources to mobilize community members to seek health facility deliveries and newborn care. We are also training CHVs to do routine home visits for pre-natal and post-natal care of mothers and care of newborns after delivery. After the training program, the skills of the CHVs are assessed through a Quality Improvement Verification Checklist (QIVC) to find out if there are any gaps or additional skills that need to be strengthened. This process of community involvement is to improve the health seeking behavior of pregnant mothers and thus to decrease the rate of maternal, newborn as well as under-five mortality. I am contributing to this project by developing the training curriculum for the CHVs, providing hands on training and evaluating their skills through the QIVC. As malnutrition in children is a common condition in Kenya, the CHVs are enlightened with the basic knowledge of anthropometric measurements of children less than 5 years of age, to detect early malnutrition. We also trained the CHVs on how to measure weight, height/length and mid-upper arm circumference in children less than 5 years of age, to detect stunting and wasting in malnourished children.

The project also includes the assessment of remote community birthing centers, using qualitative and quantitative data collection methods. We are performing assessments at three remote health facilities in Kisii County, Kenya – Matongo Health Facility, Iranda Health Facility and the Nyagoto Health Facility. I performed assessments of the community birthing center to provide quality improvements using innovative the Rapid Community Birthing Center (R-CBCA) tool. The whole process of the assessment is to promote respectful, culturally appropriate maternal care and decrease maternal mortality.

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