1AIC Kijabe Newborn Community Health Project

Newborn Community Health ProjectFive-Year Report | June 30, 2013

2AIC Kijabe Newborn Community Health Project

IIIAIC Kijabe Newborn Community Health Project

Newborn Community Health ProjectFive-Year Report | June 30, 2013

IVAIC Kijabe Newborn Community Health Project

AIC Kijabe Hospital, 2013

P.O. Box 20, Kijabe 00220 Kenya

Tel: {+254} 736 507666 :: {+254} 736 205549 :: {+254} 020 3246453/500

Email: info.kh@kijabe.net

Website: www.kijabehospital.org

Design and layout by Six Ideas Branding Co. (theideafactory@sixideas.co.ke)

Graphic of hands holding baby from shutterstock.com

Contact person:

Newborn Community Health Project - Five-Year Report, June 2013

Dr. Mary B. Adam MD, MA, PHD,

Director Newborn Community Health Project Kijabe Hospital Kenya.

Email: mary.b.adam@gmail.com

VAIC Kijabe Newborn Community Health Project

Table of Contents

ACKNOWLEDGEMENTS VII

PROJECT TEAM IX

ABBREVIATIONS X

PREFACE XI

PRE-IMPLEMENTATION PHASE: BIRTH OF A VISION Year 1 1

IMPLEMENTATION PHASE: LEARNING TO WALK, FALLING DOWN AND TRY-ING AGAIN, Year 2 and 3 2

HELPING OTHERS TO WALK Year 4 and 5 5

RUNNING THE RACE: RESULTS THAT MATTER - MAJOR ACHIEVEMENTS 6

Training of volunteers 6

DEVELOPMENT OF BEST PRACTICES 9

DEVELOPMENT OF A TRAINING CENTER YEAR 5 11

PROVING IT WORKS: EVALUATION AND RESEARCH 12

HOPE FOR MANY: CONCLUSION AND WAY FORWARD 13

APPENDIX I: REGIONAL INFORMATION 14

Gilgil District: Eburru Location 14

Kinangop District: Nyakio Location 16

Kinangop District: Magumu Location 16

Lari District: Kinale Location 17

VIAIC Kijabe Newborn Community Health Project

VIIAIC Kijabe Newborn Community Health Project

ACKNOWLEDGEMENTS

We are deeply indebted to the partners who helped turn this project from a dream into a reality. This has truly been a collaborative effort. We owe a debt of gratitude to many. It is by their support and encouragement that this work was not only made possible, but has been flourishing.

Financial Partners:

German Institute for Medical Mission (DIFAEM)

Action Medeor, Germany

Intergreen Kenya Ltd Naivasha, Netherlands

Stichting ROeR, Netherlands

Equipping Africa, USA

Help for Brethren, Germany

Rotary Club Hamburg Haake, Germany

Help a Child Program, Germany

Those Who Provided Program Technical Assistance:

Dr. Jochen Bitzer, Dr. Herman Weigold, and Dr. Alexandra Geisser from DIFAEM

Those who provided intellectual muscle, technical assistance, and research support:

Maria Dillman, University of Ulm, Germany

Dr. Beatrice Murage Kenya

Dr. Mei Kuang, University of Arizona, USA

Those mission agencies that supported our project leadership:

The Navigators - Dr. Mary Adam

Co-workers International, Germany - Renate Zipperer, RN, KRCHN

Christian Services International, Germany - Dr. Meissner

VIIIAIC Kijabe Newborn Community Health Project

Additionally:

We are extremely grateful to the board and senior management team of AIC Kijabe Hospital for their approval and administrative support to the vision of the Newborn Community Health Project.

Kenya Ministry of Health both at the national level, specifically the Division of Community Health Services under the very able leadership of Dr. Mwitari, and at various district levels.

We also sincerely thank the dedicated pastors, Community Health Extension Workers, and volunteer Community Health Workers and facilitators who tirelessly engage the community in conversations about health, inspiring hope, but ultimately safeguarding women and their children.

IXAIC Kijabe Newborn Community Health Project

PROJECT TEAM

Project Director: Dr. Mary Adam (from January 1, 2011)

Deputy Director: Dr. Peter Meissner (from January 1, 2011)

Technical Assistance: Dr. Jochen Bitzer (Pediatrician, DIFAEM) and Dr. Herman Weigold (Obstetrics & Gynecology, DIFAEM)

Newborn Community Health Nursing Staff: Eunice Waweru, 2008-2012; Peter Kamau, 2008-2011; Priscilla Mumbi, 2011-2013; Simon Mbugua, 2008-present; Joram Ndungu, 2010-present; Robina Anne - Mulli, 2012-present

Community Health Workers, Community Health Facilitators and Community Health Extension Workers in Naivasha District Eburru location, Nyakio District, Kinangop District and Lari District

Please note: The Newborn Community Health Project curriculum content maps onto the curriculum developed by the Ministry of Health and published in late 2011 (year 4 of the project) titled, Community Based Newborn and Maternal Care: A Training Course for Community Health Workers (2011). A community health facilitator is someone who has received the maternal newborn training, but has not yet had the benefit of the government community health worker basic training module. For simplicity, in the 5-year report the term community health worker will be used to refer to both.

(2011). Community Based Newborn and Maternal Care: A Training Course for Community Health

Workers. Ministry of Public Health and Sanitation. Nairobi Kenya, Ministry of Health. 1: 70.

XAIC Kijabe Newborn Community Health Project

ABBREVIATIONS

AIC African Inland Church

ANC Antenatal Care

APHIA+ Aids, Population, and Health Integrated Assistance

BScN Bachelor of Science in Nursing

CBO Community-based Organization

CHW Community Health Worker

CHEW Community Health Extension Worker

CHAK Christian Health Association of Kenya

DMOH District Medical Officer Health

DPHN District Public Health Nurse

HCF Health Care Facility

KRCHN Kenya Registered Community Health Nurse

MOU Memorandum of Understanding

NCH Newborn Community Health Project

NGO Non-governmental Organization

NHIF National Hospital Insurance Fund

TBA Traditional Birth Attendant

XIAIC Kijabe Newborn Community Health Project

PREFACE

This report tells the story of how the AIC Kijabe Newborn Community Health Project (NCH) has impacted the lives of mothers and infants by promoting health. It is a summary of what has been accomplished in five short years. It is a story of hope. Hope that together we can create a sustainable environment that fosters quality training to actively combat newborn and maternal deaths in Kenya starting at the community level. Hope that science and information effectively prompt safer, healthier behavior in the Kenyan context.

The AIC Kijabe NCH Project has demonstrated that community volunteers, who are local small-scale farmers (as well as other low-wage earners), can be trained to deliver accurate maternal and newborn health messages, improve community linkages to existing health care facilities, and decrease barriers that rural families face in accessing health care. Their work is sustained long after the project ends because the volunteers still live and work in these communities.

The volunteers, trained as community health facilitators and workers, have been recognized by their communities as valuable resources because they have adopted a lifestyle of promoting safe motherhood and newborn care. Part of that lifestyle is using cell phones to connect individuals in need of care to local health care professionals in order to efficiently identify potential danger signs, or necessary referrals. Furthermore, they successfully encourage women to deliver at facilities where a skilled birth attendant can assist, which greatly improves chances of survival for both mother and baby.

The investment in these communities and in the individuals who were mentored by project staff, means that promotion of health for the families in these communities will be sustained long after the project has moved on to other areas.

This is a success story success documented by careful research. It is also a story of Gods faithfulness. Gods faithfulness in giving a vision to Dr. Peter Meissner, the project founder. Gods faithfulness in bringing together a team of incredible talented nurses who had a heart for the community and share a commitment to work in difficult circumstances. Gods faithfulness to give the daily strength they need to continue a work of compassion to serve communities struggling with the pain of all too frequent loss of a mother or a baby. But most of all, this 5-year report is a story of Gods faithfulness in providing hope. Hope for newborns, their mothers, and families.

Dr. Mary B. Adam MD, MA, PHD,

Director Newborn Community Health Project Kijabe Hospital Kenya

XIIAIC Kijabe Newborn Community Health Project

Community Health Worker from Kenton

One of the sub-chiefs shared a scenario of a mother who was

coming from hospital after delivery. When she was alighting

from a public vehicle, she had her baby, bag and basin, and

yet she was all-alone. It was at this point that the sub-chief

assisted the mother out of the vehicle. As they walked away,

they realized that the husband was within the vicinity yet he

was not concerned with the wife even after recognizing her. She

appreciated the NCH Project for empowering men in their

communities, some of whom are now changing their behavior.

Stories from the community

1AIC Kijabe Newborn Community Health Project

PRE-IMPLEMENTATION PHASE: BIRTH OF A VISION Year 1

Kenya has many communities that have not had the benefit of evidenced-based health interventions in maternal and new